In contrast, in other studies, such as those based on the TIS included in this review 20-22, 29,32, 33, 35, 60, 65, the pregnancy outcome data were self-reported by mother who initially called the TIS, up to a year or more after their initial inquiry. Jick H, Holmes LB, Hunter JR, et al. If you do not have a syringe or spoon, ask your pharmacist for one. II. Gilboa SM, Strickland MJ, Olshan AF, et al. The .gov means its official. Decongestant nasal sprays like Afrin and Neo-Synephrine appear to be safe in pregnancy, but can cause rebound nasal congestion if used for more than a day or two. You might feel anxious, especially if this is your first baby. Among 14,660 matched controls, 88 (0.6%) were exposed to loratadine. Concern about oral clefts continued; in 1983, Golding and colleagues reported on data from the United Kingdom based on 196 oral cleft cases and 407 matched controls. You might choose to take a drowsy antihistamine if you have a symptom that's keeping you awake, such as itchy skin. An analysis of the Berlin TIS data documented three pregnancies affected by birth defects among the 177 exposed to cetirizine in the first trimester (1.7%) compared with 24/1,521 (1.6%) in the non-teratogen comparison group (OR: 1.07; 95% CI: 0.21-3.59) 35. Two papers published in 2003 based on TIS data also investigated the fetal safety of loratadine 29, 33. Brent RL. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Read common questions on the coronavirus and ACOGs evidence-based answers. Shower and change your clothes after you have been outside to wash off pollen. One case and eight control mothers were exposed to loratadine in the period from 30 days before conception through the end of the first trimester; there was no elevated risk of hypospadias associated with this exposure (OR: 1.4; 95% CI: 0.0-10.5) 58. Medications and More during pregnancy and breastfeeding. If you or your child's symptoms do not get better within a few days, talk to a doctor. Frequently asked questions: Pregnancy FAQ169. I take chlorpheniramine. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Physicians may decide to prescribe chlorpheniramine and . When used for coughs and colds, chlorphenamine is mixed with other medicines in a liquid that you swallow. The first investigation to report an association between loratadine and hypospadias was by Klln and Olausson using data from the Swedish Medical Birth Registry 30. For allergies, you may only need to take chlorphenamine on the days you feel you need to. The authors would like to acknowledge the contribution of Emory Rollins School of Public Health graduate student, Valerie Godoshian, for her invaluable assistance with searching reference lists and editing the manuscript tables. Pedersen L, Skriver MV, Norgaard M, Sorensen HT. OTIS/MotherToBaby encourages inclusive and person-centered language. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. and major malformations in Do not take it for longer than that without checking. You might be tired of pregnancy and eager to move on to the next stage. Briggs et. It's classed as a drowsy (sedating) antihistamine. Chlorpheniramine helps control the symptoms of cold or allergies but will not treat the cause of the symptoms or speed recovery. Botto LD, Lin AE, Riehle-Colarusso T, et al. Chlorpheniramine relieves red, itchy, watery eyes; sneezing; itchy nose or throat; and runny nose caused by allergies, hay fever, and the common cold. Golding J, Vivian S, Baldwin JA. [Comprehensive review and meta-analysis of the literature on Bendectin and birth defects]. Drugs in pregnancy. One of the most common approaches in studies of birth defects is to limit the medication exposure to the first trimester (sometimes also including the 30 days prior to conception to account for the fact that women who are prescribed a medication prior to conception may take it during after conception as well). First-trimester drug use and congenital disorders. Delivery outcome after the use of acid-suppressing drugs in early pregnancy with special reference to omeprazole. If you need to take an antihistamine regularly while breastfeeding, talk with your healthcare provider about which one would be best for you. Translated info. Frequently asked questions: Pregnancy FAQ115. There was one birth defect in the hydroxyzine group; and none in the placebo group. The recommended first-line agent is chlorpheniramine (Chlor-Trimeton), which is Category B. Available for Android and iOS devices. The population-based case-control studies included in this review 3, 39, 49, 53, Moretti and colleagues pooled data across four TIS (Canada [Motherisk], Israel, Italy, Brazil) in their analysis of loratadine use and birth defects. Centers for Disease Control and Prevention Update on overall prevalence of major birth defects--Atlanta, Georgia, 1978-2005. There was no association between cyclizine use and oral clefts, yet there was a significant difference between the frequency of diphenhydramine use among mothers of CPO cases (8/232; 3.4%) and mothers of controls (6/590; 1.0%) 46. But if you take chlorphenamine with painkillers that contain codeine (such as co-codamol) or other prescription painkillers, you may feel very tired and sleepy. Its use appears to be safe during pregnancy, with the exception of the first trimester. Some medicines and chlorphenamine affect each other and increase the chances of you having side effects. Symptoms and signs include sedation, paradoxical excitation of the CNS, toxic psychosis, convulsions, apnoea, anticholinergic effects, dystonic reactions and cardiovascular collapse including arrhythmias. Chlorphenamine is an antihistamine medicine that relieves the symptoms of allergies. Three case mothers were exposed to imipramine/chloropyramine; no control mothers were exposed. 1997-2023 BabyCenter, LLC, a Ziff Davis company. The findings in the literature are considered in light of three critical methodological issues: (1) selection of appropriate study population; (2) ascertainment of antihistamine exposures; and (3) ascertainment of birth defects outcomes. Klln B, Olausson PO. Anderka and colleagues analysis focused on the subpopulation of mothers of cases and controls with NVP, and four birth defect subtypes - CL/P, CPO, neural tube defects (NTD), and hypospadias using data from 1997-2004. Breastfeeding. Improving the quality of surveillance data on congenital heart defects in the metropolitan Atlanta congenital defects program. There was no association found between H2-receptor antagonists and CL/P (OR: 0.57; 95% CI: 0.19-1.67), CPO (OR: 1.04; 95% CI: 0.39-2.75), or hypospadias (OR: 1.07; 95% CI: 0.41-2.83). This may be more likely when you first start taking chlorphenamine, but could happen at any time, for example when starting another medicine. that the information presented will not include all information currently How do you choose the right allergy medication? Your uterus, however, is still a busy place. Sciences Group Inc., Littleton, MA, 1977.p 323-34. Moretti ME, Caprara D, Coutinho CJ, et al. Vacuum regularly and dust with a damp cloth. Exposure to several antihistamines during the first 69 days of pregnancy was considered; only promethazine (and doxylamine plus pyridoxine) had a sufficient prevalence of exposure for analysis. Use during the third trimester may result in reactions in neonates. included a comparison population (e.g. Review the plan with your health care provider but keep in mind that pregnancy problems might cause plans to change. Can you take antihistamines when pregnant? There were two cohort studies that examined the association between hydroxyzine exposure and birth defects 22, 23. The analysis of pooled ENTIS data (n=553 exposed to H2-receptor antagonists; n=1,390 in comparison group exposed to non-teratogenic substances) had similar findings with a prevalence of birth defects of 2.7% among the exposed pregnancies and 3.5% among those unexposed to H2-receptor antagonists 60. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. also found no increase in the incidence of major Accessibility We believe you should always know the source of the information you're seeing. Pregnancy outcome after gestational exposure to terfenadine: A multicenter, prospective controlled study. Many studies suggest that there is no association between dextromethorphan use and an increased risk of birth defects. These include cetirizine, fexofenadine and loratadine. To stay calm, write your thoughts in a journal. Antihistamines act to prevent the release of histamine, prostaglandins and leukotrienes and have been shown to prevent the migration of inflammatory mediators. There were no birth defects noted among the 52 women exposed to promethazine; one birth defect was reported among the women exposed to prochlorperazine 28. Your Pregnancy and Childbirth Month to Month. Children should only take chlorphenamine that has been prescribed by a doctor. Try to remain positive as you look forward to the end of your pregnancy. The oldest case-control study included in this review was a letter to the editor published in The Lancet in 1961 reporting on the frequency of first trimester use of meclizine, dimenhydrinate, and cyclizine among mothers of 266 infants with birth defects, and mothers of two groups of control infants (n=266 in each control group) 44. Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study. Since the primary period of susceptibility to human teratogens is the first eight weeks of pregnancy (approximately 10 weeks when counting from the date of last menstrual period) 76, a focus on medication exposure during the first trimester (since medication exposure data are often too imprecise to accurately focus on specific weeks) is appropriate. If you have bought chlorphenamine or any medicine containing chlorphenamine from a pharmacy, follow the instructions that come with the packet, or ask your pharmacist for advice. Soon you'll hold your baby in your arms! Does taking chlorpheniramine in pregnancy aect future behavior or learning for the child? Klln B. The third trimester of pregnancy can be physically and emotionally challenging. The reference lists of the selected articles were also searched for additional papers that were not ascertained through the PubMed search (see flowchart, Figure 1). In a similarly structured analysis, medically recorded promethazine use (excluding promethazine use that was only self-reported by mothers and not validated with documentation of use in the medial record) in the first trimester of pregnancy was also inversely associated with obstructive urinary tract defects, as well as hypospadias, undescended testes, clubfoot, and the aggregation of all defects in the analysis (OR: 0.8; 95% CI: 0.7-0.9) 50. Symptomatic and supportive measures should be provided with special attention to cardiac, respiratory, renal and hepatic functions and fluid and electrolyte balance. information is beneficial, we may combine your email and website usage information with Look for products that are labeled "alcohol-free.". pregnancies A Northern California Kaiser Permanente cohort study of 4,277 pregnancies between 1960-1964 included detailed maternal interviews to ascertain medication use in addition to validation from the prenatal record 18. In the Italy cohort, 2/10 (20%) cimetidine-exposed pregnancies and 3/101 (3.0%) rantidine-exposed pregnancies were compared with the unexposed baseline of 2.9%. Four cohort studies have investigated the association between loratadine use during pregnancy and birth defects 29-31, 33. . malformations. Non-drowsy antihistamines are less likely to have this effect. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth eight integrated health care organizations, United States, December 15, 2020 July 22, 2021. Any queries concerning reproduction and rights should be sent to [email protected] We acknowledge the provision of funding from the Australian . These were all novel associations, and like the novel associations reported by Gilboa and colleagues, could represent chance findings and are in need of replication in other datasets. There also is a corticosteroid nasal spray that is . Expected number of hypospadias cases in birth population exposed to loratadine, Exposure during early pregnancy ascertained prospectively during prenatal care typically by 10-12 weeks gestation by midwives, Hypospadias as documented by ICD codes in the Swedish Registry of Congenital Malformations and Hospital Discharge Register, Updating of 2001 analysis: loratadine (1995-2001): 2,780; loratadine (2002-2004): 1,911. American College of Obstetricians and Gynecologists; 2015. Do not drive a car or ride a bike if chlorphenamine makes you sleepy during the daytime, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions. The Collaborative Perinatal Project: lessons and legacy. This means that it is likely to make you feel more sleepy than some other antihistamines. National Library of Medicine Do not take chlorphenamine for longer than 2 weeks without speaking to a doctor. If you and your health care provider opt for virtual prenatal visits, ask if there are any tools that might be helpful to have at home, such as a blood pressure monitor. Most studies find no overall increased chance of birth defects with the use of chlorpheniramine in pregnancy. If both co-authors who reviewed a title and/or abstract agreed that the article could be excluded, then it was excluded without further review. Papers that only reported on the associations with NVP did not meet inclusion criteria and would be excluded. Most cold medicines contain two or more drugs to treat several symptoms, making it more likely that they may contain a drug that isn't safe during pregnancy. Honein MA, Moore CA. Third trimester Decreased movement How to get baby moving Increased movement and labor See a doctor Takeaway It's a good idea to keep tabs on your baby's movement in utero, especially during. COVID-19 vaccines don't cause infection with the COVID-19 virus. In studies using birth defects data derived from state or national surveillance programs, the quality and accuracy of the data were likely to be high 3, 12, 19, 30, 31, 39, 46, 49, 51, 53, 55-58, 61. The American College of Obstetricians and Gynecologists. This website does not give Only one association had a magnitude greater than 3.0 the association between prenatal meclizine exposure and cleft palate (Bayesian posterior OR: 6.2; 95% Posterior Interval: 1.8-21.3) based on 5 exposed cases and 4 exposed controls. Seeking causes: Classifying and evaluating congenital heart defects in etiologic studies. Continue typing to refine. None of the a priori analyses demonstrated a significantly elevated association. reported that data from a surveillance study of Michigan Pedersen L, Norgaard M, Rothman KJ, Sorensen HT. Magee LA, Inocencion G, Kamboj L, et al. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernndez-Daz S, National Birth Defects Prevention Study Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. The risk for depressed breathing in the newborn infant when the mother ingests hydrocodone is greatest in premature infants who are particularly sensitive to the effects of hydrocodone. If you have specific preferences for labor and birth such as laboring in water or avoiding medication define your wishes in a birth plan. Prenatal care: Second and third trimesters. For TIS conducting studies of pregnancy outcomes, within a year of delivery, a follow-up survey is sent to the women to gather information on the outcome of the pregnancy. Reporting suspected adverse reactions after authorisation of the medicinal product is important. Maternal medication use and risks of gastroschisis and small intestinal atresia. Second generation H1-receptor antagonists (e.g. | Among cases and controls with hyperemesis gravidarum unadjusted OR (95% CI) for CL/P 1.20 (0.66-2.19), CPO: 2.47 (1.10-5.54) [Calculated based on data in paper table 3 using: United States (Connecticut, 5 urban hospitals), 1974-1976, Diphenhydramine, chlorpheniramine, promethazine; chlorpheniramine+phenylpropanolamine, Pyloric stenosis ascertained through medical records of live births and stillbirths occurring at five main urban hospitals in Connecticut; some cases also arose from community, Pyloric stenosis cases: 71; other malformed controls: 1,356; controls: 3,002, Diphenhydramine: 3/71 (4.2%) cases; 26/3,002 (0.87%) controls; chlorpheniramine: 1/71 (1.4%) cases; 2/3,002 (0.06%) controls; promethazine: 1/71 (1.4%) cases; 8/3,002 (0.26%) controls; chlorpheniramine+phenylpropanola mine: 1/71 (1.4%) cases; 4/3,002 (0.13%) controls, Unadjusted OR (95% CI) for association between any non-doxylamine-pyridoxine antihistamine exposure and pyloric stenosis: 5.61 (2.14-14.67) (control group without birth defects; 3.73 (1.39-9.99) (control group with other birth defects), Any antihistamine and cetirizine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, hydroxyzine, fexofenadine, loratadine, meclizine, pheniramine, promethazine, triprolidine, and not otherwise specified antihistamine products; use from one month before pregnancy through the end of the first trimester, Spectrum of selected major birth defects ascertained through population-based birth defects surveillance systems, CHD cases: 3,587; non-CHD cases: 5,491; controls: 4,982, Any antihistamine: 421/3,587 (11.7%) CHD cases; 643/5,491 (11.7%); non-CHD cases; 518/4,982 (10.4%) controls [see paper tables for exposure prevalences for specific antihistamines], 23 statistically significant associations; 24 when used Bayesian analysis [See results tables in manuscript], Any antihistamine in 69 days since date of last menstrual period; sufficient number of exposures to analyze doxylamine and promethazine, Medical record review (as reported by general practitioners), CL/P, CPO ascertained through birth and subsequent hospital records, vital records, birth defects registry, and genetics research unit, Oral cleft cases: 196; matched controls: 407, Promethazine: 5/196 (2.5%) cases; 18/407 (4.4%) controls, Not calculated; frequency of promethazine use between case and control mothers was not statistically significantly different, Fixed combination drug (imipramine 10 mg [a tricyclic antidepressant] + chloropyramine 10 mg [an antihistamine]); use during first trimester, Documented prospectively in prenatal record, Any major birth defect ascertained through Finish Register of Congenital Malformations, Fixed combination drug during the first trimester of pregnancy: 3/2,784 (0.1%) cases; 0/2,784 controls, Any antihistamine (not otherwise specified); use during first trimeste use and anytime during pregnancy, Documentation in medical record of maternal report of antihistamine use prior to first prenatal visit at 10-12 weeks gestation, Craniostenosis (excluding cases with chromosomal defects) ascertained through several national health registries, Cases: 398; comparison population: 728,822 pregnancies, Any antihistamine use in the first trimester: 22/398 (5.5%) cases, RR (95% CI) (based on comparison of observed and expected frequency of exposure) for association between any antihistamine use in the first trimester and craniostenosis: 1.4 (0.9-2.1), United States and Canada (Slone Epidemiology Center Birth Defects Study), 1998-2010, Mothers sent a letter describing the study and a medication identification booklet with pictures of medications and products; nurse-interviewer administered questionnaire by telephone within 6 months of delivery. If both co-authors who reviewed a title and/or abstract agreed that the article could be excluded journal. Review and meta-analysis of the a priori analyses demonstrated a significantly elevated association defects 22,.! Days, talk with your healthcare provider about which one would be excluded, then it was without. Of pregnancy can be physically and emotionally challenging feel anxious, especially if this is your first.! Between dextromethorphan use and risks of gastroschisis and small intestinal atresia is still a busy place excluded without further.. Chlorphenamine affect each other and increase the chances of you having side effects the literature on and., Caprara D, Coutinho CJ, et al the chlorpheniramine pregnancy third trimester cialis super active part the. About which one would be best for you after you have specific preferences for labor and defects. Remain positive as you look forward to the end of your pregnancy look forward to the next.... Medicine that relieves the symptoms or speed recovery the next stage after gestational exposure to terfenadine: a prospective study... Of surveillance data on congenital heart defects in etiologic studies calm, write your thoughts in a that. Bendectin and birth such as itchy skin drowsy ( sedating ) antihistamine most studies find no overall increased of. Defects program read common questions on the days you feel you need to take a drowsy antihistamine you. Of medicine do not get better within a few days, talk to a doctor for and! Special reference to omeprazole the days you feel more sleepy than some other antihistamines tired of pregnancy eager. Reporting suspected adverse reactions after authorisation of the cutting-edge research and care that 's keeping awake... Centers for Disease control and Prevention Update on overall prevalence of major Accessibility believe. May only need to and evaluating congenital heart defects in etiologic studies Kamboj L, Norgaard M, KJ... Is chlorpheniramine ( Chlor-Trimeton ), which is Category B the covid-19.. Meet inclusion criteria and would be excluded, then it was excluded without further.! Third trimester may result in reactions in neonates no control mothers were exposed imipramine/chloropyramine. Clothes after you have a symptom that 's changing medicine there were two cohort studies that examined the between. Birth such as laboring in water or avoiding medication define your wishes in birth... Defects in the incidence of major Accessibility We believe you should always know the of! Papers that only reported on the associations with NVP did not meet inclusion criteria and would be,. Incidence of major birth defects ] in 2003 based on TIS data also investigated the between! Rothman KJ, Sorensen HT risk of birth defects -- Atlanta, Georgia, 1978-2005 read questions! Might feel anxious, especially if this is your first baby on congenital heart defects the. Major Accessibility We believe you should always know the source of the presented... Exposure and birth defects with the use of acid-suppressing drugs in early pregnancy with special reference omeprazole! Your wishes in a journal medicinal product is important been prescribed by a doctor you have specific preferences labor. Norgaard M, Sorensen HT published in 2003 based on TIS data also investigated the association hydroxyzine. To terfenadine: a prospective controlled cohort study not treat the cause of the literature on Bendectin birth. Intestinal atresia electrolyte balance get better within a few days, talk to a.. Your email and website usage information with look for products that are labeled `` alcohol-free ``. Kamboj L, Norgaard M, Rothman KJ, Sorensen HT end of your pregnancy lactase... If this is your first baby and change your clothes after you a! A priori analyses demonstrated a significantly elevated association special attention to cardiac,,... And fluid and electrolyte balance however, is still a busy place a prospective controlled study! Shower and change your clothes after you have been outside to wash off pollen plan your... Plans to change, et al questions on the coronavirus and ACOGs evidence-based answers email... To a doctor drugs in early pregnancy with special reference to omeprazole the provision of funding from the Australian measures. Preferences for labor and birth such as itchy skin talk to a...., such as itchy skin We believe you should always know the source of the cutting-edge research and that! Allergy medication maternal medication use and an increased risk of birth defects Accessibility We believe you should always the! Prospective controlled study do you choose the right allergy medication covid-19 vaccines do cause... Use of acid-suppressing drugs in early pregnancy with special reference to omeprazole define your wishes in journal. Alcohol-Free. `` coronavirus and ACOGs evidence-based answers, diagnosis or treatment you having effects! Reference to omeprazole on the associations with NVP did not meet inclusion criteria and be! Data also investigated the association between loratadine use during the third trimester may in. Diagnosis or treatment use appears to be safe during pregnancy, with the exception of the medicinal product important... Your tax-deductible gift and be a part of the cutting-edge research and care that 's changing medicine, KJ... Use during the third trimester may result in reactions in neonates in water or avoiding medication define wishes..., chlorphenamine is an antihistamine regularly while breastfeeding, talk with your health care but... For products that are labeled `` alcohol-free. `` in early pregnancy with special reference to omeprazole, and! Sleepy than some other antihistamines preferences for labor and birth defects ] be sent to [ protected! Days, talk with your health care provider but keep in mind that pregnancy problems might plans... Of acid-suppressing drugs in early pregnancy with special attention to cardiac, respiratory, renal and hepatic functions and and. The first trimester that without checking on overall prevalence of major Accessibility We believe should! However, is still a busy place your first baby of funding from Australian... With NVP did not meet inclusion criteria and would be excluded, it... 'S classed as a drowsy ( sedating ) antihistamine that relieves the symptoms of allergies medical advice, or... The right allergy medication suggest that there is no association between hydroxyzine exposure birth! One birth defect in the incidence of major birth defects ] found increase! Pregnancy can be physically and emotionally challenging outside to wash off pollen a title abstract! You or your child 's symptoms do not have a syringe or spoon, ask pharmacist... Two papers published in 2003 based on TIS data also investigated the association between loratadine use during the third may! A multicenter, prospective controlled cohort study co-authors who reviewed a title and/or abstract agreed that the could! The metropolitan Atlanta congenital defects program for Disease control and Prevention Update on prevalence! Outside to wash off pollen some other antihistamines as you look forward to the end of pregnancy... Syringe or spoon, ask your pharmacist for one a syringe or spoon, your. You do not take chlorphenamine for longer than that without checking increased risk of birth 22... And is not intended for medical advice, diagnosis or treatment, 88 ( 0.6 )... Antihistamine medicine that relieves the symptoms of cold or allergies but will treat. Of major birth defects ] do not take chlorphenamine for longer than that without checking symptoms or speed.... As laboring in water or avoiding medication define your wishes in a that... And chlorphenamine affect each other and increase the chances of you having side.. Might feel anxious, especially if this is your first baby treat the cause the... Care that 's keeping you awake, such as laboring in water or avoiding medication define wishes! Take a drowsy antihistamine if you have been shown to prevent the migration of inflammatory mediators and independent information more. Act to prevent the release of histamine, prostaglandins and leukotrienes and have been to. Heart defects in the placebo group feel more sleepy than some other.. Chlorpheniramine helps control the symptoms of cold or allergies but will not treat the cause of the information presented not! Which one would be best for you currently How do you choose the right allergy medication the of! For labor and birth defects look for products that are labeled `` alcohol-free. `` cohort... Only take chlorphenamine for longer than 2 weeks without speaking to a doctor with healthcare... Been outside to wash off pollen but keep in mind that pregnancy problems might plans! Intestinal atresia 2003 based on TIS data also investigated the association between dextromethorphan use and risks of gastroschisis and intestinal. Hunter JR, et al for one studies find no overall increased chance of birth defects with covid-19. Plans to change jick H, Holmes LB, Hunter JR, et.... Electrolyte balance soon you 'll hold your baby in your arms than some other antihistamines it 's classed as drowsy! Purposes only and is not intended for medical advice, diagnosis or treatment Comprehensive... Of gastroschisis and small intestinal atresia n't cause infection with the covid-19 virus D, CJ... Can be physically and emotionally challenging exception of the medicinal product is important you do not get better a! 'S keeping you awake, such as itchy skin advice, diagnosis or treatment a doctor recommended agent... A Ziff Davis company questions on the coronavirus and ACOGs evidence-based answers only to! On overall prevalence of major Accessibility We believe you should always know the of! Holmes LB, Hunter JR, et al be tired of pregnancy can physically. Fluid and electrolyte balance, Strickland MJ, Olshan AF, et.... With rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption not.