Most health care professionals can recall a time when a patient, family member, or friend has asked some variation of the question: “Is this drug safe in pregnancy?” The truthful, if difficult, answer to such a question is often “maybe,” or even “we don’t know.”
Health professionals who prescribe medications to women face the challenge of an often incomplete and constantly evolving body of evidence about the safety of medications during pregnancy. For these practitioners, and for curious consumers, enter an Android app: Pregnancy & Medication Safety, by fdable.
Most health care providers who use mobile technology in practice will already have other medication prescribing apps on their mobile device. So the answer to the crucial question—is this app a valuable addition to my repertoire?—really depends on whether the added clinical utility is worth the cost of Pregnancy Medication & Safety ($2.99).
Of course many of the popular medication prescribing apps include information on pregnancy safety class and lactation safety. But Pregnancy & Medication Safety goes further, adding more evidence from animal studies and lactation safety than is typically included in other apps like Epocrates, Medscape, Skyscape RxDrugs, or MPR. Note: this additional information is only available with the paid version of Pregnancy & Medication Safety; the “LITE” version’s content is significantly less robust.
When might this additional information be clinically useful?
In practice clinicians consider more than just the drug safety class to make clinical decisions. Unlike Class A, B, D, and X drugs which are generally considered safe, probably safe, not-safe, and definitely not safe respectively, the Class C designation is much more ambiguous. Class C drugs may be beneficial enough in some clinical circumstances despite suspected safety concerns.
But determining drug safety in pregnancy is more complex than a simple classification scheme. In practice, clinicians also consider the patient’s unique history and needs, the medical literature, and professional organization guidelines (i.e. the American College of Obstetricians and Gynecologists, or the American Pediatric Association). Although each drug profile in this app has information from the medical literature under the animal studies tab, it lacks guidelines from professional organizations. Health care professionals wishing to consult current guidelines on, for example, SSRI use in pregnancy will have to search elsewhere. Links to external guideline sources would make this app much more valuable.
Instead, this app lists information found on the FDA label.
Compared to free prescriber apps (Epocrates, Medscape Reference, Skyscape RxDrugs, and MPR), the user will find a lot of additional information about each drug on Pregnancy & Medication Safety. Generally, these larger free apps show little more than the pregnancy safety class.
Epocrates
Medscape Reference
Skyscape RxDrugs
MPR
Likes:
- More useful information about pregnancy safety and lactation than offered by free prescriber apps.
- Affordable at $2.99.
Dislikes:
- Sluggish performance and slow transitions compared to other apps on my phone.
- Redundant menu items. Searching for a given drug yields numerous formulations and doses for each drug. This is unnecessary and annoying.
- Some brand names are included (e.g. Zoloft), others are missing (e.g. Benadryl). Why?
- Lacks guideline information.
Conclusion:
Pregnancy & Medication Safety is clinically useful, but incomplete. The free LITE version is worth downloading, if only to test the performance and user interface, prior to purchasing the full app. At $2.99, this app is a useful supplement to other prescribing apps for women’s health care providers. Future editions would benefit from improved performance and user interface, and should include links to professional organization guidelines.
Download Pregnancy & Medication Safety online from the Market:
Full Version
LITE Version
