Anticonvulsant
PREGNANCY RECOMMENDATION: Compatible—Maternal Benefit >> Embryo–Fetal Risk
BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible
PREGNANCY SUMMARY
Although the human pregnancy experience is very limited, the embryo–fetal risk is thought to be lower than the more potent phenytoin.
FETAL RISK SUMMARY
Ethotoin is a low-potency hydantoin anticonvulsant (1). The fetal hydantoin syndrome has been associated with the use of the more potent phenytoin (see Phenytoin). Only six reports describing the use of ethotoin during the 1st trimester have been located (2–4). Cleft lip/palate and patent ductus arteriosus were observed in two of the offspring (3,4).
BREASTFEEDING SUMMARY
No reports describing the use of ethotoin during human lactation have been located. However, a more potent hydantoin anticonvulsant (see Phenytoin) is considered compatible with breastfeeding and ethotoin should be classified the same.
References
1.Schmidt RP, Wilder BJ. Epilepsy. In: Contemporary Neurology Services. Vol. 2. Philadelphia, PA: FA Davis Co, 1968:154.
2.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977:358–9.
3.Zablen M, Brand N. Cleft lip and palate with the anticonvulsant ethantoin. N Engl J Med 1978;298:285.
4.Nakane Y, Okuma T, Takahashi R, Sato Y, Wada T, Sato T, Fukushima Y, Kumashiro H, Ono T, Takahashi T, Aoki Y, Kazamatsuri H, Inami M, Komai S, Seino M, Miyakoshi M, Tanimura T, Hazama H, Kawahara R, Otsuki S, Hosokawa K, Inanaga K, Nakazawa Y, -Yamamoto K. Multi-institutional study on the teratogenicity and fetal toxicity of antiepileptic drugs: a report of a collaborative study group in Japan. Epilepsia 1980;21:663–80.