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Can Fam Physician. 2010 July; 56(7): 634.
PMCID: PMC2922796

Drug use in pregnancy: resources and recommendations

Carol A. Repchinsky, Editor-in-Chief

An article in the March 2010 issue of Canadian Family Physician1 correctly identifies the Compendium of Pharmaceuticals and Specialties (CPS) as “the most frequently used reference for evaluating safety when prescribing medication to pregnant women in Canada.” The article, written by Law et al of the Motherisk team, might mislead readers about the content of the CPS. Indeed “[the CPS’s] contents are legal product monographs provided by the manufacturers.”1 The product monographs include the Food and Drug Administration’s pregnancy risk categories because Health Canada requires that information; it is not a requirement of the CPS.

The Canadian Pharmacists Association (CPhA) recognized the need for better information regarding the management of pregnant and breastfeeding women many years ago and has taken steps in the CPS and in our other publications to address this void. In addition to the manufacturer-supplied monographs, the CPS includes 140 nonproprietary monographs compiled by editorial staff at the CPhA. These CPhA monographs provide the best available evidence on many widely used drugs, and are peer reviewed by Canadian experts. Each CPhA monograph contains a section on pregnancy and breastfeeding; all monographs are indexed and easily identified throughout the CPS. The Clin-Info section includes a document authored by Motherisk physicians, which provides the principles of prescribing during pregnancy and drugs of choice during pregnancy.

Further, the CPhA publishes Therapeutic Choices, a peer-reviewed Canadian reference manual based on the best available evidence on treatment options for common medical conditions. The sixth print edition—tentatively set for release in the spring of 2011— will include information on pregnancy and breastfeeding in most chapters. A new section will discuss the effects of the condition on pregnancy, the effects of pregnancy on the condition, and the management of the condition during pregnancy.

Patient Self-Care, another CPhA publication for health care professionals, addresses the treatment of minor ailments and includes an appendix about the treatment of many self-care conditions in pregnancy. These articles are authored by a Motherisk specialist. The second edition of Patient Self-Care is due for release in August 2010.

Publications by the CPhA are also available to subscribers online at www.e-therapeutics.ca, where content is regularly updated. For example, the new pregnancy and lactation information from Therapeutic Choices has already been added to several topics. Other regular updates include revisions to drug monographs, new products, and Health Canada advisories.

The CPhA provides more than Health Canada–approved product monographs. Our comprehensive print and online resources represent the CPhA’s commitment to providing the most complete, accessible, and relevant drug and therapeutic information for Canadian health care professionals. We encourage our readers to look further within CPS, e-CPS, and e-Therapeutics when seeking relevant information regarding drug use during pregnancy.

Reference

1. Law R, Bozzo P, Koren G, Einarson A. FDA pregnancy risk categories and the CPS. Do they help or are they a hindrance? Can Fam Physician. 2010;56:239–41. [PMC free article] [PubMed]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada