MDMA (Molly, Ecstasy)

Selected References:

  • Barenys M. 2009. Chronic exposure to MDMA (ecstasy) increases DNA damage in sperm and alters testes histopathology in male rats. Toxicol Lett 191:40-46
  • Barneys M, et al. 2020. Developmental neurotoxicity of MDMA. A systematic literature review summarized in a putative adverse outcome pathway. Nurotoxicology 78:209-241.
  • Committee on Drugs, American Academy of Pediatrics. 2001. The transfer of drugs and other chemicals into human milk. Pediatrics 108:776-89.
  • Cooper AJ & Egleston CV. 1997. Accidental ingestión of Ecstasy by a toddler: Unusual cause for convulsion in a febrile child. J Accid Emerg Med 14(3):183-184.
  • Draper ES, et al. 2008. Recreacional drug use. A major risk factor for gastroschisis? Am J Epidemiol 167(4):485-491.
  • Fríguls B, et al. A comprehensive review of assay methods to determine drugs in breast milk and the safety of breastfeeding when taking drugs. Anal Bioanal Chem 397:1157–1179.
  • Kolbrich EA, Goodwin RS, Gorelick DA, Hayes RJ, Stein EA, Huestis MA. 2008. Plasma pharmacokinetics of 3,4-methylenedioxymethamphetamine after controlled oral administration to young adults. Ther Drug Monit. Jun;30(3):320-32.
  • Marcela C, et al. 2019. Stimulant use in pregnancy – An under-recognized epidemic among pregnant women. Clin Obstet 62(1):168-184.
  • McElhatton P, et al.1999. Congenital anomalies after prenatal ecstasy exposure. Lancet 354:1441-2.
  • Parrott A, et al. 2014. MDMA and heightened cortisol: a neurohormonal perspective on the pregnancy outcomes of mothers used ‘Ecstasy’ during pregnancy. Hum Psychopharmacol 29(1):1-7.
  • Plessinger M, 1998. Prenatal exposure to amphetamines. Risks and adverse outcomes in pregnancy. Obstet Gynecol Clin North Am 25:119-38.
  • Singer LT, et al. 2012. Neurobehavioral outcomes of infants exposed to MDMA (Ecstasy) and other recreational drugs during pregnancy. Neurotoxicol Teratol 34(3):303-10.
  • Singer L. et al 2012. One-year outcomes of prenatal exposure to MDMA and other recreational drugs. Pediatrics 130(3): 407–413.
  • Singer LT, et al. 2015. Developmental outcomes of 3,4-methylenedioxymethamphetamine (ecstasy)-exposed infants in the UK Hum Psychopharmacol 30(4): 290-294.
  • Singer LT, et al. 2016. Motor delays in MDMA (ecstasy) exposed infants persist to 2 years. Neurotoxicol Teratol 54: 22-28.
  • Smid MC, et al. 2019. Stimulant use in pregnancy: An under-recognized epidemic among pregnant women. Clin Obstet Gynecol 62(1):168-184.
  • van Tonningen-van Driel MM, et al. 1999. [Pregnancy outcome after ecstasy use; 43 cases followed by the Teratology Information Service of the National Institute for Public Health and Environment (RIVM)]. Ned Tijdschr Geneeskd 143(1):27-31.
  • Wouldes TA, Lester BM. 2019. Stimulants: How big is the problem and what are the effects of prenatal exposure? Semin Fetal Neonatal Med 24(2):155-160.


MDMA (Molly, Ecstasy)

Selected References:

  • Banihani SA, Khasawneh FH. 2018. Effect of lansoprazole on human sperm motility, sperm viability, seminal nitric oxide production, and seminal calcium chelation. Res Pharm Sci.13:460‐468.
  • Dağlı U, Kalkan IH. 2017. Treatment of reflux disease during pregnancy and lactation. Turk J Gastroenterol. 2017 Dec;28(Suppl 1):S53-S56.
  • Diav-Citrin O, et al. 2005. The safety of proton pump inhibitors in pregnancy: A multicenter prospective controlled trial. Aliment Pharmacol Ther; 21:269-75.
  • Escoffier, J, Arnaud, B, Kaba, M, et al. 2020. Pantoprazole, a proton‐pump inhibitor, impairs human sperm motility and capacitation in vitro. Andrology. 8: 1795– 1804.
  • Hastie R et al. 2019. Proton Pump Inhibitors and Preeclampsia Risk Among 157 720 Women. Hypertension. 73(5):1097-1103. doi: 10.1161/HYPERTENSIONAHA.118.12547.
  • Kallen BA. 2001. Use of omeprazole during pregnancy–no hazard demonstrated in 955 infants exposed during pregnancy. Eur J Obstet Gynecol Reprod Biol. 96(1):63-68.
  • Mahadevan U, Kane S. 2006. American Gastroenterological Association Institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology.131(1):283-331
  • Majithia R, Johnson DA. 2012. Are proton pump inhibitors safe during pregnancy and lactation? Evidence to date. Drugs. 72(2):171-179.
  • Marshall JK, et al. 1998. Omeprazole for refractory gastroesophageal reflux disease during pregnancy and lactation. Can J Gastroenterol. 12(3):225-7.
  • Matok I, et al. 2012. The safety of fetal exposure to proton-pump inhibitors during pregnancy. Dig Dis Sci.. 57(3):699-705.
  • Pasternak B, Hviid A. 2010. Use of proton pump inhibitors in early pregnancy and the risk of birth defects. N Egl J Med. 363(22): 2114-2123.
  • Plante L, et al. 2004. Excretion of pantoprazole in human breast. J Reprod Med. 2004;49:825-7.
  • Saito J, et al. 2020. Esomeprazole During Pregnancy and Lactation: Esomeprazole Levels in Maternal Serum, Cord Blood, Breast Milk, and the Infant’s Serum. Breastfeed Med. 15(9):598-601. doi: 10.1089/bfm.2020.0175. Epub 2020 Jul 7.
  • Ruigomez A, et al. 1999. Use of cimetidine, omeprazole, and ranitidine in pregnant women and pregnancy outcomes. Am J Epidemiol. 150(5):476-481.
  • Thélin CS, Richter JE. 2020. Review article: the management of heartburn during pregnancy and lactation. Aliment Pharmacol Ther. 51(4):421-434. doi: 10.1111/apt.15611. Epub 2020 Jan 17. PMID: 31950535 Review.


MDMA (Molly, Ecstasy)

Selected References: 

  • Bloor M, et al. 2012. Tramadol in pregnancy and lactation. Int J Obstet Anesth 21:163-7. 
  • Bowie AC, et al. 2022. Prescribed opioid analgesics in early pregnancy and the risk of congenital anomalies: a population-based cohort study. CMAJ. 194(5):E152-E162. 
  • Ferrer E, et al. 2025. Tramadol during pregnancy: risk of adverse pregnancy outcome and major congenital anomalies. A comparative study in the EFEMERIS database. Pharmacoepidemiol Drug Saf. 34(4):e70143. 
  • Hartenstein S, et al. 2010. Neonatal abstinence syndrome (NAS) after intrauterine exposure to tramadol. J Perinat Med 38: 695–6. 
  • Ilett KF, et al. 2008. Use of a sparse sampling study design to assess transfer of tramadol and its o-desmethyl metabolite into transitional breast milk. Br J Clin Pharmacol. 65:661-6. 
  • Kallen B & Reis M. 2015. Use of tramadol in early pregnancy and congenital malformation risk. Reprod Toxicol. 23;58:246-251.  
  • Kaur Makkar J, et al. 2015. Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor. Clin Anesth. 27(2):159-63.  
  • Meyer FP, et al. 1997. Tramadol withdrawal in a neonate. Eur J Clin Pharmacol 53: 159–60. 
  • O’Mara K, et al. 2010. Treatment of neonatal withdrawal with clonidine after long-term, high-dose maternal use of tramadol. Ann Pharmacother 44: 1342–4. 
  • Sawaddiruk P. 2011. Tramadol hydrochloride/acetaminophen combination for the relief of acute pain. Drugs Today (Barc). 47(10):763-772.  
  • Schuckit MA. 2016. Treatment of opioid-use disorders.  N Engl J.Med. 375:357–68 
  • Sørensen AMS, et al. 2022. Exposure to tramadol during early pregnancy and risk of spontaneous abortion or major congenital malformations. Obstet Gynecol.139(4):545-553.  
  • Subedi A. et al. 2013. Analgesic effects of intrathecal tramadol in patients undergoing caesarean section: a randomised, double-blind study. Int J Obstet Anesth. 22(4):316-21.  
  • U.S. Food & Drug Administration. Updated 10/2023. FDA drug safety communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against the use in breastfeeding women. Available from URL: https://www.fda.gov/Drugs/DrugSafety/ucm549679.htm  
  • Willaschek C, et al. 2009. Tramadol withdrawal in a neonate after long-term analgesic treatment of the mother. Eur J Clin Pharmacol 65: 429–30. 


MDMA (Molly, Ecstasy)

Selected References:

  • Abdellatif M, et al. 2019. Association between exposure to macrolides and the development of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Eur J Pediatr 178(3):301-314.
  • Adair CD, Gunter M, Stovall TG et al. 1998. Chlamydia in pregnancy: A randomized trial of azithromycin and erythromycin. Obstet Gynecol 91:165-168.
  • Andersson NW, Olsen RH, Andersen JT. 2021. Association between use of macrolides in pregnancy and risk of major birth defects: nationwide, register based cohort study. BMJ. 372:n107.
  • Bahat Dinur A, et al. 2013. Fetal safety of macrolides. Antimicrob Agents Chemother 57(7):3307-11.
  • Berard A, et al. 2015. Use of macrolides during pregnancy and the risk of birth defects: a population-based study. Pharmacoepidemiol Drug Saf 24(12):1241-1248.
  • Cohen I, et al. 1990. Improved pregnancy outcome following successful treatment of chlamydial infection. JAMA 263:3160-3163.
  • Committee on Drugs, American Academy of Pediatrics. 2001. The transfer of drugs and other chemicals into human breast milk. Pediatrics 108:776-89.
  • Damkier P, et al. 2019. In utero exposure to antibiotics and risk of congenital malformations: A population-based study. Am J Obstet Gynecol 221:648.e1-15.
  • Fan H, et al. 2020. Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study. BMJ 368:m331.
  • Flenady V, et al. 2013. Prophylactic antibiotics for inhibiting preterm labour with intact membranes. Cochrane Database Syst Rev 5;12:CD000246.
  • FitzSimmons J et al. 1990. Chlamydial infections in pregnancy. J Reprod Med 31:19-22, 1986.
  • Goldstein LH, et al. 2009. The safety of macrolides during lactation. Breastfed Med 4:157-200
  • Källén B, Danielsson BR, 2014. Fetal safety of erythromycin. An update of Swedish data. Eur J Clin Pharmacol 70(3):355-60.
  • Lin KJ, et al. 2013. Safety of macrolides during pregnancy. Am J Obstet Gynecol 208(3):221.e1-8.
  • Lund M, et al. 2014. Use of macrolides in mother and child and risk of infantile hypertrophic pyloric stenosis: nationwide cohort study. BMJ 11;348:g1908.
  • Marlow N, et al. 2017. The ORACLE Children Study: educational outcomes at 11 years of age following antenatal prescription of erythromycin or co-amoxiclav. Arch Dis Child Fetal Neonatal Ed 102(2):F131-F135.
  • McCormack WM et al. 1987. Effect on birth weight of erythromycin treatment of pregnant women. Obstet Gynecol 69:202-207.
  • McGregor JA et al. 1986. Adjunctive erythromycin treatment for idiopathic preterm labor: Results of a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 154:98-103.
  • Romøren M, et al. 2012. Pregnancy outcome after gestational exposure to erythromycin – a population-based register study from Norway. Br J Clin Pharmacol 74(6):1053-62.
  • Ryan GM Jr, Abdella TN, McNeeley SG, et al. 1990. Chlamydia trachomatis infection in pregnancy and effect of treatment on outcome. Am J Obstet Gynecol 162:34-39.
  • Sorensen, HT et al. 2003. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis 35:104-6
  • WHO Working Group, Bennet PN (ed). 1988. Drugs and Human Lactation. Elsevier, Amsterdam, New York, Oxford, pp. 253-4.
  • Schachter J et al. 1986. Experience with the routine use of erythromycin for chlamydial infections in pregnancy. N Engl J Med 314:276-9.


MDMA (Molly, Ecstasy)

Selected References:

  • Caballero Bermejo A, et al. 2020. Sarilumab versus standard of care for the early treatment of COVID-19 pneumonia in hospitalized patients: SARTRE: a structured summary of a study protocol for a randomised controlled trial. Trials; 21(1):794. PMID: 32938496 PMCID: PMC7492787 DOI: 10.1186/s13063-020-04633-3
  • Khiali S, et al. 2021. A comprehensive review on sarilumab in COVID-19
  • Affiliations expand. Expert Opin Biol Ther; 21(5):615-626. PMID: 33161757 DOI: 10.1080/14712598.2021.1847269
  • Garcia-Vicuña R, et al. 2020. Subcutaneous Sarilumab in hospitalised patients with moderate-severe COVID-19 infection compared to the standard of care (SARCOVID): a structured summary of a study protocol for a randomised controlled trial. Trials; 21(1):772. PMID: 32907638 PMCID: PMC7480631 DOI: 10.1186/s13063-020-04588-5
  • No authors listed, 2020. Sarilumab. In: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006–.PMID: 29999974 Bookshelf ID: NBK500915. https://www.ncbi.nlm.nih.gov/books/NBK500915/ Accessed 01/2022.
  • Prieto-Peña D, et al. 2021. Biologic agents and small-molecule inhibitors in systemic autoimmune conditions: an update. Pol Arch Intern Med; 131(2):171-181. PMID: 32550671 DOI: 10.20452/pamw.1543