Purgative
PREGNANCY RECOMMENDATION: Compatible
BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible
PREGNANCY SUMMARY
Casanthranol is an anthraquinone purgative. Although the data are limited, there is no evidence that drugs in this class pose a risk to the embryo–fetus.
FETAL RISK SUMMARY
In a large prospective study, 109 patients were exposed to this agent during pregnancy, 21 in the 1st trimester (1). No evidence of an increased risk for malformations was found (see also Cascara Sagrada).
In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 96 newborns had been exposed to casanthranol during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Four (4.2%) (four expected) major birth defects were observed. Specific data were available for six defect categories, including (observed/expected) 2/1 cardiovascular defects, 1/0 spina bifida, and 1/0.5 polydactyly. No anomalies were observed in the other three categories (oral clefts, limb-reduction defects, and hypospadias. These data do not support an association between the drug and congenital defects.
BREASTFEEDING SUMMARY
No reports describing the use of casanthranol during human lactation have been located. Although diarrhea in a nursing infant is a potential effect, the drug is probably compatible with breastfeeding. (See also Cascara Sagrada.)
Reference
1.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977:384–7, 442.