Table 3.11

Adverse effects of IOP-lowering medications during pregnancy/breast-feeding

Animal StudiesHuman
Theoretical riskReported cases
Parasympathetic agentsCTeratogenicTeratogenicity Dysregulation of placental perfusionMeningism in newbornSeizures, fever, diaphoresis
Sympathetic agents • brimonidineBNo significant effectDelay in labor/ uterine hypotonyNo reported side-effectsCNS depression, hypotension andapnea
Prostaglandin analogsCHigh incidence of miscarriageUterine contractionsOne case of miscarriageNo reported side-effects
Beta-blockersCDelayed fetal ossification, fetal resorptionTeratogenicity (1st trimester) Cardiac rhythm changes RespiratoryArrhythmia and bradycardia Impaired respiratory control in newbornsControversy overconcentrations inbreast milk. Apnea and bradycardia
Carbonic anhydrase inhibitors • TopicalCDecreased weight gainVertebral body malformationLower fetal weightNo reported side-effects
No reported side-effects • OralCForelimb anomaliesLimb malformationsOnecase of teratomaNo reported side-effects