This sheet is about exposure to formoterol in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.

What is formoterol?

Formoterol (also called eformoterol) is a medication that has been used to treat asthma and chronic obstructive pulmonary disease (COPD). It is in a class of medications called long-acting beta2-agonists (LABAs). LABAs are bronchodilators. Bronchodilators relax the muscles in the lungs, making it easier to breathe. Formoterol is taken by inhalation (breathing in). Some brand names of formoterol are Foradil® and Perforomist®.

Formoterol combined with corticosteroids are sold under the brand names Symbicort® and Dulera®.

MotherToBaby has a fact sheet on corticosteroids here: https://mothertobaby.org/fact-sheets/inhaled-corticosteroids-icss-pregnancy/.

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. When asthma is not well-controlled, it can increase risks to a pregnancy. MotherToBaby has a fact sheet on asthma here: https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.

I take formoterol. Can it make it harder for me to get pregnant?

Studies have not been done to see if taking formoterol can make it harder to get pregnant.

Does taking formoterol increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if formoterol can increase the chance of miscarriage.

Does taking formoterol increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like formoterol, might increase the chance of birth defects in a pregnancy. Animal studies and human case reports do not suggest an increased chance of birth defects with the use of formoterol during pregnancy.

A study on the use of LABAs as a group reported an increased chance of heart defects when used in the first trimester. However, it is not known if the medication, the condition being treated, or other factors caused the reported birth defects.

Does taking formoterol in pregnancy increase the chance of other pregnancy-related problems?

It is not known if formoterol might increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). In 1 report with 33 individuals who used formoterol during pregnancy, 5 infants were reported to be delivered preterm. Another study, which compared 162 pregnancies exposed to formoterol with those exposed to another LABA, found no differences in birth weight, gestational age, or the likelihood of preterm delivery.

When asthma is not well-controlled during pregnancy, it has been associated with higher rates of pregnancy complications such as preterm delivery, and low birth weight.

Does taking formoterol in pregnancy affect future behavior or learning for the child?

It is not known if formoterol can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking formoterol:

There are no studies on the use of formoterol while breastfeeding. Information on a similar medication suggests that inhaled formoterol would be unlikely to pass into the breast milk in large amounts. Inhaled bronchodilators are generally considered acceptable for use during breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes formoterol, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if formoterol could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references. 

This sheet is about exposure to albuterol in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is albuterol?

Albuterol (also called salbutamol) is a medication used for the treatment of breathing conditions like asthma. It is a bronchodilator (a beta2-agonist bronchodilator). Bronchodilators help to open the airways in the lungs so you can breathe better. Albuterol has commonly been used as an inhaled medication in fast-acting inhalers for immediate treatment of trouble breathing and wheezing. Some brand names are Proventil® and Ventolin®. Albuterol can also be found in combination with another medication, budesonide in a medication called Airsupra®.

When albuterol is inhaled, it is absorbed into the body in lower amounts compared to pill / tablet forms of the medication. It is unknown how much, if any, of the medication reaches the fetus when used as an inhaler. Research suggests that the amount is likely small. Use of a fast-acting albuterol inhaler more than two days per week can be a sign that asthma symptoms may not be well controlled. If so, talk with your healthcare provider about the best way to treat your asthma.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to treat asthma during pregnancy. Talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. Untreated asthma increases the chance for complications for both the woman who is pregnant and the fetus. For more information, please see the MotherToBaby fact sheet on Asthma at https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.

I take albuterol. Can it make it harder for me to get pregnant?

Studies in humans have not been done to see if taking albuterol can make it harder to get pregnant. Animal studies have shown no effect on fertility.

Does taking albuterol increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if albuterol increases the chance of miscarriage.

Does taking albuterol increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like albuterol, might increase the chance of birth defects in a pregnancy. Although data is limited, studies do not suggest an increased chance for birth defects with the use of inhaled albuterol during pregnancy.

One study looked at the use of 5 different inhaled beta2-agonist bronchodilators in the first trimester of pregnancy. This study did not find an increase in the number of birth defects with use of any of these medications. Of the 259 women who were pregnant in this study, 20 of them took albuterol. Another study found a link between albuterol use and several types of birth defects. However, this study could not rule out the influence of asthma. Other studies do not support the suggestion that albuterol causes an increased chance for a pattern of birth defects.

Does taking albuterol in pregnancy increase the chance of other pregnancy-related problems?

Albuterol has been used in the second and third trimester of pregnancy to prevent preterm delivery (delivery before 37 weeks of pregnancy). For treatment of preterm delivery, albuterol was given in high oral doses (by mouth). Treatment with high oral doses has been associated with an increase in maternal and fetal heart rate and a drop in maternal blood pressure. These effects are temporary. Long term effects from increased fetal heart rate have not been reported. Treatment with inhaled albuterol at prescribed doses has not been shown to cause these effects.

Does taking albuterol in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if albuterol can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking albuterol:

There have not been any studies among women taking albuterol while breastfeeding. However, using an albuterol inhaler is expected to lead to low amounts in the blood system and therefore likely low amounts at most in breastmilk. Inhaled bronchodilators have generally been considered acceptable for use during breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes albuterol, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if albuterol could affect male fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

MotherToBaby is currently conducting a study looking at asthma and the medications used to treat asthma in pregnancy. If you would like to learn more, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

Please click here to view references.

This sheet is about exposure to acyclovir/ valacyclovir in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is acyclovir/valacyclovir?  

Acyclovir (Zovirax®) is an antiviral medication that has been used to treat symptoms from cold sores and genital herpes caused by the herpes virus. It is also prescribed to treat chickenpox and shingles. Acyclovir can help relieve the pain and help the healing of sores or blisters. Valacyclovir (Valtrex®) is like acyclovir and is used to treat the same types of infections. Valacyclovir changes to acyclovir once inside the body. 

Acyclovir/valacyclovir has been prescribed during pregnancy when a woman has a primary (first time) genital herpes infection. Primary infections can be life-threatening or lead to complications in a pregnancy. A rare but serious lung complication caused by chickenpox virus infection called varicella pneumonia might also require treatment with these medications. MotherToBaby has a fact sheet on varicella infection (chickenpox) here: https://mothertobaby.org/fact-sheets/varicella/. 

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take acyclovir/valacyclovir. Can it make it harder for me to get pregnant? 

It is not known if acyclovir/valacyclovir can make it harder to get pregnant. 

Does taking acyclovir/valacyclovir increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not found an increased chance of miscarriage with acyclovir/valacyclovir use. 

Does taking acyclovir/valacyclovir increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like acyclovir/valacyclovir, might increase the chance of birth defects in a pregnancy. 

Taking acyclovir/valacyclovir during pregnancy is not expected to increase the chance of birth defects. Studies have not found an increased chance of birth defects in over 500 births reviewed by the manufacturer and the Centers for Disease Control and Prevention (CDC). Another study found no increased chance of birth defects in more than 1,500 infants exposed to acyclovir and over 200 infants exposed to valacyclovir during the first trimester of pregnancy. 

Does taking acyclovir/valacyclovir in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if acyclovir/valacyclovir use can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37 of pregnancy) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, clinical case reports have not reported increased chances of preterm delivery, which is reassuring. It is important to note that untreated infections could cause problems for the woman who is pregnant, the pregnancy, and the newborn. Be sure to talk to a healthcare provider if you have or suspect you have an untreated infection during pregnancy.  

Does taking acyclovir/valacyclovir in pregnancy affect future behavior or learning for the child?   

Studies have not been done to see if acyclovir/valacyclovir can affect a child’s future behavior or learning after exposure during pregnancy. 

Breastfeeding while taking acyclovir/valacyclovir: 

Acyclovir passes into breast milk in small amounts. Acyclovir is commonly used in newborns and is not expected to cause problems for breastfed babies. If you apply acyclovir cream or ointment to your breast, clean the area before breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes acyclovir/valacyclovir, could it affect fertility or increase the chance of birth defects? 

Information on the effects of acyclovir/valacyclovir on men’s fertility (ability to make healthy sperm) is limited. One study in 20 men found that high doses of acyclovir for 6 months did not lower sperm production. Studies have not been done to know if acyclovir/valacyclovir can increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.   

Please click here for references.  

This sheet is about exposure to clonidine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is clonidine? 

Clonidine is a medication that has been used to treat high blood pressure, attention deficit hyperactivity disorder (ADHD), bipolar disorder, and pain. Some brand names include Catapres®, Duraclon®, and Kapvay®. Clonidine is sometimes used in combination with other medications for the management of opioid withdrawal.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take clonidine. Can it make it harder for me to get pregnant?  

It is not known if clonidine can make it harder to get pregnant. One study suggests the use of clonidine may increase the chance of pregnancy in women with polyendocrine metabolic ovarian syndrome (PMOS) (PMOS is the new name for polycystic ovary syndrome (PCOS).  

Does taking clonidine increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if clonidine can increase the chance of miscarriage.  

Does taking clonidine increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like clonidine, might increase the chance of birth defects in a pregnancy. The use of clonidine in pregnancy is not expected to increase the chance of birth defects. 

Does taking clonidine in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if clonidine can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [about 2,500 grams] at birth).  

One report that suggests that clonidine use might lead to a slower heart rate in the pregnant woman, leading to lower birth weight in the baby. In cases where clonidine was being used to treat high blood pressure, blood pressure issues might have played a role in the reduced weight of the baby.  

I need to take clonidine during my pregnancy. Will it cause withdrawal symptoms in my baby after birth?  

The use of clonidine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms might include high or low blood pressure, drowsiness, and irritability. Most of the time the symptoms go away on their own, usually within a few weeks. Not all babies exposed to clonidine will have these symptoms. It is important that your healthcare providers know you are taking clonidine so that if symptoms happen, your baby can get the care that is best for them. 

Does taking clonidine in pregnancy affect future behavior or learning for the child?   

It is not known if clonidine can increase the chance of behavior or learning issues in children. One older study noted that children exposed to clonidine during pregnancy showed higher rates of hyperactivity and sleep disturbances compared to a control group. Because clonidine is also used to treat conditions such as ADHD, if a child who was exposed to clonidine during pregnancy is later diagnosed with ADHD, it can be hard to determine whether this is related to the medication, to underlying familial or genetic issues, or other factors. 

Breastfeeding while taking clonidine: 

Clonidine passes into breastmilk in small amounts. There are case reports of infants exposed to clonidine through breast milk who did not have any reported side effects. There is 1 report that described a newborn baby who was drowsy, floppy (poor muscle control), had periods of not breathing, and possible seizure activity. These symptoms started soon after delivery and went away when breastfeeding was stopped, days after birth. It is not known if the symptoms were due to pregnancy exposure to clonidine, breastfeeding while taking clonidine, or other reasons. 

Taking clonidine might lower milk supply. If you notice your milk supply is lower than usual, talk with your baby’s pediatrician or a lactation consultant.  

If you suspect the baby has any symptoms (such as being more sleepy than usual, poor muscle control, breathing problems, or seizures) contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes clonidine, could it affect his fertility or increase the chance of birth defects? 

Trouble with getting and keeping an erection (impotence, a form of erectile dysfunction) has been reported in some men with high blood pressure being treated with clonidine. Also, one report suggests that clonidine may block or change the effects of the hormone progesterone on sperm. This can affect the ability to conceive a pregnancy. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references.  

This sheet is about exposure to labetalol in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is labetalol? 

Labetalol is a medication that has been used to treat high blood pressure and chest pain. Labetalol lowers blood pressure and improves blood flow by slowing the heart rate and opening blood vessels. Labetalol belongs to a group of medications called beta-blockers.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take labetalol. Can it make it harder for me to get pregnant? 

It is not known if labetalol can make it harder to get pregnant. 

Does taking labetalol increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if labetalol can increase the chance of miscarriage. Having high blood pressure that is not well managed might increase the chance of miscarriage.     

Does taking labetalol increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like labetalol, might increase the chance of birth defects in a pregnancy. 

Information on the use of labetalol in pregnancy is limited. Available information does not suggest that the use of labetalol in pregnancy increases a higher chance of birth defects. 

Does taking labetalol in pregnancy increase the chance of other pregnancy-related problems?  

Most studies do not suggest that labetalol can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), or stillbirth.  

Temporary symptoms starting shortly after birth have been reported in some infants who were exposed to labetalol late in the pregnancy. These symptoms include slowed heart rate, low blood pressure, and/or low blood sugar. In most cases, these symptoms go away within a few days. It has been suggested that infants who were exposed to labetalol during the pregnancy be monitored after birth; so that if symptoms occur, the baby can get the care that is best for them. 

There have also been cases in which infants exposed to beta-blockers during pregnancy had symptoms that started a week after birth. In these cases, the symptoms were more severe and life-threatening. The reported symptoms included abnormal breathing, sepsis (blood infection), and seizures. It has been suggested that preterm infants who were exposed to labetalol over a long period of time during pregnancy be carefully monitored during the first week after birth so that if symptoms occur, the baby can get the care that is best for them.   

Does taking labetalol in pregnancy affect future behavior or learning for the child?  

It is not known if labetalol can increase the chance of behavior or learning issues for the child. One study of 32 children between the ages of 3 and 7 years old who were exposed to labetalol during pregnancy found no differences in formal testing of learning and behavior compared to children who were not exposed to labetalol. Another study suggested a higher chance of attention deficit hyperactivity disorder (ADHD) in children who were exposed to labetalol during pregnancy compared to children exposed to a different type of high blood pressure medication or no high blood pressure medication. However, the study had limitations that made it hard to know if labetalol played any role in the cases of ADHD.  

Breastfeeding while taking labetalol:           

Labetalol passes into breast milk in small amounts. These amounts are not expected to cause problems in full-term breastfed infants. If the baby was born preterm, discuss the risks and benefits of taking labetalol while breastfeeding with your healthcare provider and the child’s healthcare provider. If you suspect the baby has any symptoms such as drowsiness, looking pale, or not eating well, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all of your breastfeeding questions. 

If a male takes labetalol, could it affect his fertility or increase the chance of birth defects?   

There have been case reports of sexual dysfunction (trouble with ejaculation) in men while they were taking labetalol. This can make it harder to get a woman pregnant. Studies have not been done to see if labetalol could increase the chance of birth defects in a partner’s pregnancy. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.