A look at some medications under increased scrutiny amid abortion bans

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Since abortion bans have taken effect in many states, there is increased scrutiny on drugs that can be used to terminate pregnancies that also have other common uses, as well as on drugs for non-pregnancy-related conditions that are known to harm a developing fetus.

The list of drugs that can cause birth defects is long, including some antibiotics such as Cipro, mood stabilizers including lithium, and several medications to control arthritis, epilepsy and even acne.

Methotrexate, sold under brand names that include Xatmep and Trexall: The drug, which slows the growth of cells and inhibits inflammation, is used to treat severe rheumatoid arthritis, psoriasis and certain cancers of the breast, lung, head and neck, and blood. It can also be used to treat autoimmune diseases such as Crohn’s, lupus and multiple sclerosis. Methotrexate is given by injection to terminate ectopic pregnancies by stopping fetal cells from growing. The tissue is then reabsorbed.

Mifepristone, sold as Korlym or Mifeprex, can be used to control high blood sugar in patients with Cushing syndrome who also have Type 2 diabetes. The drug also dilates the cervix and blocks the effects of progesterone, which is needed to sustain a pregnancy. It can be given in pill form, along with misoprostol, for medication abortions in the first 10 weeks of pregnancy or to complete a miscarriage.

Misoprostol, or Cytotec, can be used to prevent stomach ulcers caused by anti-inflammatory medications such as aspirin and ibuprofen. During pregnancy, it can be used to induce labor and prevent postpartum hemorrhage. The drug is given in pill form along with mifepristone to complete miscarriages and for medication abortions. It can also be used to soften and open the cervix before a surgical abortion.

Anticonvulsants: Several drugs used to prevent seizures such as phenytoin (Dilantin) and carbamazepine (Tegretol) are associated with increased risk of physical birth defects in a baby. Some epilepsy medicines can also harm the baby’s growth or development.

Isotretinoin, most commonly known as Accutane, belongs to a class of vitamin-A based dermatologic medications known as retinoids, and is used to treat severe cystic or nodular acne by decreasing the production of oily sebum on the skin. People who are pregnant or plan to become pregnant are advised not to handle the drug, which can be absorbed through the skin and lungs, or to inhale its dust, because of the severe risk to the developing fetus. However, the system for prescribing the drug is already highly regulated, including a requirement of negative pregnancy tests from patients before they can get prescriptions.

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