Expert: Lawrence Jay Rappaport <B>M.D.</B> - 7/12/2004
Question Hello,this might be long.Iīm from the States but living in Spain and 4 months pregnant.I had a yeast infection in the beginning of the pregnancy and they gave me a chalky white pill that didnīt do much.About a month later after having spotting I went to the States and my OBGYN after looking at me for one second saw I had a bad yeast infection.I had seen my doctor again and had been to the emergency room here in Spain and they didnīt detect it,they just said to get rest.I think I have another one so went to the doctor today and she prescribed me a medicine with the generic name Ketoconazol.Not trusting much in the medical service here I looked up the medicine online and saw it is a catagory C medicine,not known if it can be harmful to the unborn baby.I then proceeded to read the warnings on the paper that came with the medicine and it said it wasnīt recommended for pregnant women.What do you know about this drug.They are suppositories by the way.Are the doctors here really that far behind?
Answer Ketoconazole is a synthetic, broad spectrum antifungal agent. It is embryotoxic and teratogenic in rats, and can produce syndactyly and oligodactyly at 10 times the maximum recommended human dose. Ketoconazole has been used without fetal harm for the treatment of vaginal candidiasis occurring during pregnancy. In a major study using this medication, no major birth defects were observed.Since this study, the FDA has received six reports of limb defects. Limb malformations were also reported in a 1985 study. A better medication would be Monistat-7 cream (miconazole) which has not shown any assiciation to congenital defects if used during pregnancy. Most of the obstetricians I know recommend the use of Monistat-7 during pregnancy. I can't comment on the training of the doctors in Spain.
