When you’re pregnant, it’s vital to think carefully about any medication you take. What goes into your body also goes into the body of your developing baby. Unless proven otherwise, most drugs are considered unsafe to take during pregnancy. So, if you’re expecting and you need to take something, proceed with caution.
Antifungal infections are common during pregnancy, and they need to be treated. Dermatophytosis, for example, should be addressed quickly to prevent it from becoming a chronic condition.
But what’s the safest antifungal in pregnancy? That’s what we’ll explore in this article. We’ll review some of the safest topical and oral antifungal treatments available, so you can weigh the pros and cons with your healthcare provider and make the best decision for you and your baby.
Antifungal use during pregnancy
Whether you are trying to conceive, suspect you might be pregnant, or know that you are pregnant, it’s important to treat medications with caution. That’s because some medications may present a risk to your developing baby.
In general, topical antifungals, such as creams and ointments, are preferred over oral or injected (parenteral) medications during pregnancy. That’s because topical medications don’t get absorbed into your system at high levels.
Minimizing how much medication enters your system will reduce the risk to your baby.
If you have questions or concerns about antifungal medications, be sure to talk with a healthcare professional. It’s important to use caution when taking any medication if you’re pregnant or could become pregnant.
Factors influencing safety
When you’re pregnant, the first trimester is usually the riskiest time to take medication. That’s because your baby’s organs are developing during this period, and some antifungals should be avoided during this time.
Another thing to consider is how serious your infection is. If you delay treatment, you could end up with serious complications.
Safe topical antifungals in pregnancy
If you’re dealing with a fungal infection during pregnancy, you’ll want to know which antifungals are safe to use. Here’s a breakdown of topical options:
First-line topical agents
These are generally considered the safest options to start with:
- Clotrimazole (Canesten®): This is often the go-to treatment for vaginal yeast infections during pregnancy because it has a good safety record. Studies haven’t shown any known risks when using clotrimazole during pregnancy, and you can buy it without a prescription.
- Miconazole: Another common topical antifungal that’s generally considered safe during pregnancy and while breastfeeding.
- Nystatin: Nystatin is also a first-line topical antifungal. It’s not absorbed into your system very much, so it’s considered low-risk.
Second-line topical agents
These options can be considered if the first-line treatments aren’t working or if you can’t tolerate them:
- Butenafine, Ciclopirox, Naftifine, Oxiconazole, Terbinafine: There’s not a lot of information available on these, so they should be used cautiously.
- Ketoconazole and Selenium Sulfide: These are likely safe, but it’s best to use them on small areas and for short periods. Selenium sulfide can potentially reduce breast milk production, so keep that in mind if you’re breastfeeding.
Topical antifungals to avoid or use with caution
- Econazole: It’s best to avoid econazole during the first trimester. If you need to use it during the second or third trimesters, use it sparingly.
Oral Antifungals: Risks and Considerations
If you’re pregnant and dealing with a stubborn fungal infection, you might wonder about oral antifungal medications. Here’s what you should know:
General Recommendations
As a general rule, you should avoid taking oral antifungals during pregnancy, especially in the first trimester. It’s crucial to weigh the benefits against the potential risks to your developing baby. Before even considering an oral antifungal, you absolutely must talk with your healthcare provider.
Specific Oral Antifungals
Let’s look at some specific medications:
- Griseofulvin: Doctors typically avoid prescribing griseofulvin during pregnancy and while breastfeeding because of safety concerns. It’s generally only considered if absolutely necessary.
- Fluconazole: Fluconazole might be considered safe during pregnancy and breastfeeding under certain circumstances, but it should be used cautiously, especially at higher doses, due to potential risks.
- Itraconazole and Terbinafine: There’s limited information available about the safety of itraconazole and terbinafine during pregnancy. So, it’s best to avoid them if possible and carefully consider the potential risks to the fetus.
The bottom line? When you’re pregnant, it’s always best to err on the side of caution. If you think you need medicine, discuss all your options with a qualified medical professional.
Alternative and Supportive Measures
While prescription antifungals are often necessary, there are other things you can do to support your treatment and prevent future infections during pregnancy:
General Hygiene Practices
Good hygiene is always important, but it’s especially crucial when you’re pregnant. To reduce your risk of fungal infections:
- Don’t share towels or clothes.
- Wear loose-fitting clothing made from natural fibers.
- Treat excessive sweating.
Over-the-Counter Products
Be careful when using over-the-counter (OTC) products during pregnancy and while breastfeeding. For example, when considering options like Gentian Violet: Safe or Risky?, there are specific considerations you should discuss with your doctor. Some ingredients may not be safe. For example, Whitfield’s ointment has specific considerations you should discuss with your doctor.
Addressing Underlying Conditions
Certain health conditions, like diabetes, can increase your risk of getting fungal infections. Manage any underlying conditions to help prevent these infections from occurring in the first place.
Frequently Asked Questions
What is the safest antifungal cream for pregnancy?
When it comes to topical antifungal creams during pregnancy, many healthcare providers consider creams containing clotrimazole or miconazole to be generally safe for treating yeast infections. These are often available over-the-counter. However, it’s always best to consult with your doctor or midwife before using any medication, even topical ones, while pregnant.
What is the safest antifungal drug during pregnancy?
Oral antifungal medications are generally avoided during pregnancy unless absolutely necessary, due to potential risks to the developing fetus. If an oral antifungal is deemed essential, your doctor will carefully weigh the benefits against the risks and choose the safest option possible. Never take oral antifungals without direct medical supervision during pregnancy.
What antifungal can I use for a yeast infection during pregnancy?
For yeast infections during pregnancy, topical antifungal creams like clotrimazole or miconazole are often the first-line treatment recommended by healthcare professionals. These medications are applied directly to the affected area. It’s crucial to consult with your doctor or midwife for a proper diagnosis and to ensure that the chosen treatment is appropriate for your specific situation and stage of pregnancy. Avoid using douches or other unapproved treatments.
Putting It All Together
If you develop a fungal infection while you’re pregnant, topical antifungals like clotrimazole, miconazole, and nystatin are usually the safest way to treat it.
Because there isn’t much data available about how most antifungals affect pregnant women, it’s important to carefully consider the risks and benefits of each one with your doctor.
Always talk with your healthcare provider to get personalized advice about how to treat a fungal infection during pregnancy. Treating fungal infections early and practicing good hygiene can help keep the infection from becoming a long-term problem.