Summary
Clotrimazole is an imidazole antimycotic agent widely used topically and intravaginally to treat candida infections during pregnancy.
There is no evidence that use of clotrimazole during pregnancy is associated with an increased overall risk of congenital malformation or of any specific malformations. Data regarding spontaneous abortion risk are limited and heavily confounded. The majority of evidence suggests that use of clotrimazole during pregnancy significantly reduces the incidence of preterm birth (and associated low birth weight) in women with candida infection.
There are no published data regarding clotrimazole and neurodevelopmental outcomes, carcinogenicity or neonatal complications in exposed offspring.
The manufacturers state that clotrimazole may be used in pregnancy if required. However, if using the pessary rather than topical cream then use of the applicator should be avoided due to the risk of mechanical trauma.
Exposure to clotrimazole at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments. Discussion with UKTIS is recommended for all cases of clotrimazole exposure in pregnancy.
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