Anthelmintic
PREGNANCY RECOMMENDATION: Limited Human Data—No Relevant Animal Data
BREASTFEEDING RECOMMENDATION: Hold Breastfeeding
PREGNANCY SUMMARY
No reports associating the use of piperazine with congenital defects have been located, but the data are very limited. There are no relevant animal data.
FETAL RISK SUMMARY
A review of the treatment of threadworm infestation during pregnancy cited a personal communication involving two infants with congenital malformations who were exposed to piperazine (1). One of the infants had bilateral hare lip, cleft palate, and anophthalmia, but exposure to piperazine had occurred at 12 and 14 weeks’ gestation, after the period when an exposure could have caused the defects. The mother in the second case had taken the anthelmintic at 6 and 8 weeks’ gestation and her infant had a defect of the right foot (1). Based on the timing and scarcity of reports, the possibility of a causal relationship in the both cases is doubtful.
The Collaborative Perinatal Project monitored 50,282 mother–child pairs, 3 of whom had 1st trimester exposure to piperazine. No evidence was found to suggest a relationship to malformations (2).
BREASTFEEDING SUMMARY
Piperazine is excreted in breast milk (1), but specific data have not been located. According to one reviewer, the mother should take her dose immediately following feeding her infant, and then express and discard her milk during the next 8 hours (1).
References
1.Leach FN. Management of threadworm infestation during pregnancy. Arch Dis Child 1990;65:399–400.
2.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977:299.