Most medical professionals will agree that it is not usually safe to take alprazolam in pregnancy, as it may cause fetal harm, including spontaneous abortion. If a patient becomes pregnant while taking this medication, the doctor can provide advice on how to proceed. People who know they are pregnant, or are planning to get pregnant, should not start alprazolam therapy. There may be rare cases where the benefits of the medication outweigh the risks and a doctor recommends it during pregnancy.
The Food and Drug Administration in the United States classifies this as a category D drug. This indicates that studies on alprazolam in pregnancy show it is definitely connected with fetal harm. These studies include research from manufacturers as well as reported problems for patients on the drug after release onto the open market. This and other drugs in the benzodiazepine class are known to cross the placenta readily, and can pose risks to developing fetuses.
In addition to pregnancy loss, this medication can cause birth defects. Babies born to mothers who took alprazolam in pregnancy can also develop withdrawal symptoms after birth, which can complicate their care. For these reasons, care providers recommend against the routine use of this medication in pregnant women. Breastfeeding mothers should also avoid the drug, as it expresses in breast milk and may cause problems for the baby.
Patients already on alprazolam cannot quit suddenly, as they may experience complications associated with withdrawal. Women who discover they are pregnant and plan to continue the pregnancy can discuss how to stop taking the medication safely. The doctor may recommend slowly lowering the dose over time to reduce the risks of alprazolam in pregnancy without endangering the mother's health. It is also important to find an appropriate replacement for the medication to manage the underlying condition for which it was originally prescribed.
Certain circumstances may lead a doctor to recommend that a patient continue taking alprazolam in pregnancy. These cases are unusual, and require a careful review of the patient's medical history. The patient also needs to be fully informed about the risks and benefits.
Throughout the pregnancy, the doctor may recommend extra monitoring in order to catch problems as early as possible. Women who do experience pregnancy complications in such situations can report them to drug databases, where they will join the body of information on alprazolam in pregnancy. This can help care providers and regulators make recommendations about safe drug use for other patients.