Drug database
Pregnancy & gynaecology-specific. Every dose row is source-referenced; verify against institutional protocols.
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Magnesium sulfateEMERGENCY KITAnticonvulsant/uterorelaxant
Open Magnesium sulfate reference →
Indications: Eclampsia: stop seizures and prevent recurrence · Eclampsia: alternative when a reliable infusion pump and monitoring are available · Recurrent eclamptic convulsion after loading; reassess airway, glucose and magnesium toxicity · Imminent preterm birth: NICE offers at 24+0–29+6 weeks and considers at 30+0–33+6 weeks; discuss 23+0–23+6 individually
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Eclampsia: stop seizures and prevent recurrence | 4 g IV loading, then 5 g deep IM into EACH buttock (10 g IM total); maintenance 5 g IM into alternate buttocks | IV loading + deep IM | Loading once; maintenance every 4 hours | Continue until 24 hours after birth OR the last seizure, whichever is later · Using 50% (500 mg/mL): 4 g = 8 mL; dilute in 100 mL sodium chloride 0.9% and infuse over 15–20 min. Each 5 g IM dose = 10 mL of 50% solution. Check the actual ampoule strength. | Do not give maintenance when toxicity criteria are present; do not run an additional magnesium regimen | Monitor
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Eclampsia: alternative when a reliable infusion pump and monitoring are available | 4 g IV loading over 15–20 min, then 1 g/hour | IV infusion | One loading dose, then continuous infusion | 24 hours after birth or last seizure, whichever is later · 50% solution: withdraw 8 mL (4 g) into 100 mL sodium chloride 0.9% for loading; for maintenance make 20 g up to a FINAL 100 mL (200 mg/mL), run at 5 mL/hour by labelled pump
| Use ONE IV or IV/IM protocol; stop/adjust for toxicity or renal dysfunction | Monitor
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Recurrent eclamptic convulsion after loading; reassess airway, glucose and magnesium toxicity | 2 g IV additional dose after senior assessment | IV infusion | One rescue dose, followed by reassessment | Acute rescue; continue the selected maintenance regimen · 50% solution: 2 g = 4 mL, dilute in compatible sodium chloride 0.9%; give slowly by infusion and check the total loading already received | MSF ceiling: no more than 8 g IV in the first hour; persistent fits need anaesthesia/ICU, not repeated blind magnesium dosing | Monitor
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Imminent preterm birth: NICE offers at 24+0–29+6 weeks and considers at 30+0–33+6 weeks; discuss 23+0–23+6 individually | 4 g over 15 min, then 1 g/hour | IV infusion | Loading once, then continuous infusion | Stop at birth or 24 hours, whichever occurs first · 50%: 4 g = 8 mL diluted in compatible sodium chloride 0.9%; maintenance example 20 g made up to FINAL 100 mL, 5 mL/hour via pump | 24 hours for neuroprotection; do not add to an eclampsia regimen already running | Monitor
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Pregnancy safety
Standard of care in pregnancy for above indications
Lactation
Compatible
Trimester notes
All trimesters when indicated
Adverse effects
Flushing, weakness, diplopia, respiratory depression, cardiac arrest at toxic levels
MSFcheckedIN REVIEW
Tranexamic acidEMERGENCY KITAntifibrinolytic
Open Tranexamic acid reference →
Indications: PPH of any cause; first dose as soon as possible and WITHIN 3 h of birth · Heavy uterine bleeding unrelated to pregnancy after assessment
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
PPH of any cause; first dose as soon as possible and WITHIN 3 h of birth | 1 g IV over 10 min; repeat 1 g if bleeding continues after 30 min OR restarts within 24 h | IV only | One initial dose; at most one additional 1 g dose under those criteria | Acute PPH treatment, maximum 2 doses in this regimen · 100 mg/mL: 1 g = 10 mL. Give no faster than 1 mL/min, or dilute in compatible sodium chloride 0.9% and infuse over 10 min. Clearly label IV ONLY; never intrathecal
| 2 g total. The 24 h repeat rule does NOT permit a first dose after the 3 h window | Monitor
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Heavy uterine bleeding unrelated to pregnancy after assessment | 1 g (two 500 mg tablets) | Oral | Three times daily; if necessary up to four times daily | During bleeding only; stop when bleeding stops, maximum 5 days per episode · Swallow the prescribed 500 mg tablets with water; confirm pregnancy exclusion when clinically relevant
| 4 g/day and no more than 5 days per episode | Monitor
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Pregnancy safety
Used in obstetric haemorrhage per WHO; not prophylaxis
Lactation
Compatible
Adverse effects
Nausea/diarrhoea; thromboembolism theoretical risk
OxytocinEMERGENCY KITUterotonic
Indications: Prevention of PPH after birth, distinct from treatment or labour augmentation · Atonic bleeding after delivery; treatment continues alongside the PPH bundle · Inadequate contractions after obstetric assessment; exclude obstruction and contraindications to vaginal birth
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Prevention of PPH after birth, distinct from treatment or labour augmentation | 10 IU | IM (or slow IV by the approved birth-unit protocol) | Once after birth | Single prophylactic dose · For a 10 IU/mL ampoule: 10 IU = 1 mL IM. Verify the strength. Never give a rapid undiluted IV bolus | 10 IU for this prophylactic regimen | Monitor
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Atonic bleeding after delivery; treatment continues alongside the PPH bundle | 5–10 IU slowly IV, then 20 IU in 1 L isotonic crystalloid over 2 hours (MSF regimen) | Slow IV loading + IV infusion | Loading followed immediately by infusion | Initial infusion over 2 h; reassess continuously and prescribe further treatment according to response · With 10 IU/mL stock, 20 IU = 2 mL added to 1 L sodium chloride 0.9% or Ringer lactate. Pump 500 mL/hour = 10 IU/hour. Include this litre in total resuscitation fluid | MSF maximum total oxytocin 60 IU; avoid rapid boluses and excessive fluid | Monitor
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Inadequate contractions after obstetric assessment; exclude obstruction and contraindications to vaginal birth | Start 1–4 milliunits/min; increase in 1–2 milliunits/min steps no more frequently than every 20 min (specified product label) | IV infusion pump | Continuous, titrated to contractions and fetal heart rate | Until effective labour/birth or an indication to stop; reassess the indication throughout · 5 IU in FINAL 500 mL isotonic fluid = 10 milliunits/mL: 1 milliunit/min = 6 mL/hour; 2 = 12; 4 = 24. Use a dedicated labelled pump | 20 milliunits/min for the cited term-labour product regimen; higher rates require a different expressly authorised protocol | Monitor
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Pregnancy safety
Intrinsic hormone; safe appropriately used
Lactation
Compatible
Adverse effects
Water intoxication (prolonged high-dose), hypotension (rapid push), tachysystole
Carboprost (PGF2alpha)EMERGENCY KITUterotonic
Open Carboprost (PGF2alpha) reference →
Indications: Refractory atonic PPH after first-line uterotonic; do not use for trauma or retained tissue alone
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Refractory atonic PPH after first-line uterotonic; do not use for trauma or retained tissue alone | 250 micrograms (0.25 mg) deep IM | IM only | Repeat according to response at intervals of 15–90 min; NEVER sooner than 15 min | Acute rescue; ongoing bleeding requires parallel tamponade/surgery · 250 micrograms/mL: draw 1 mL undiluted. Verify units carefully: micrograms, not milligrams. Do not administer IV | 2 mg total = 8 doses of 250 micrograms | Monitor
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Pregnancy safety
Therapeutic use only
Lactation
Short-course compatible
Adverse effects
Bronchospasm, vomiting, diarrhoea, flushing, hypertension transient
MisoprostolEMERGENCY KITProstaglandin E1 analogue
Indications: Atonic PPH when IV oxytocin is unavailable or bleeding does not respond; additional uterotonic selection depends on drugs already given · After appropriate eligibility, pregnancy-location assessment and consent; comply with India MTP law and approved service arrangements · NICE NG126 medical management of confirmed missed miscarriage · NICE NG126 medical management of confirmed incomplete miscarriage · Unscarred uterus, live fetus and an approved hospital induction indication; cited 25-microgram product is for ≥37 weeks
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Atonic PPH when IV oxytocin is unavailable or bleeding does not respond; additional uterotonic selection depends on drugs already given | 800 micrograms | Sublingual; rectal if sublingual administration is not feasible | Single rescue dose | One acute dose; arrange further haemorrhage control if bleeding continues · Four 200-microgram tablets = 800 micrograms; place under the tongue. Do not confuse this with the 25-microgram labour-induction dose | 800 micrograms in this rescue regimen; do not automatically repeat | Monitor
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After appropriate eligibility, pregnancy-location assessment and consent; comply with India MTP law and approved service arrangements | 800 micrograms 24–48 h after mifepristone 200 mg | Sublingual, buccal or vaginal | Initial dose once; additional doses require a defined abortion-care regimen and reassessment | Initial combined course over 1–2 days; confirm completion using the service follow-up plan · Four 200-microgram tablets = 800 micrograms. Use the prescribed route; do not substitute the labour-induction dose | WHO permits repeat doses when required without a universal fixed maximum; do not import the ≥12-week 400-microgram schedule into this <12-week row | Monitor
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NICE NG126 medical management of confirmed missed miscarriage | 800 micrograms 48 h after mifepristone 200 mg orally, unless the sac has already passed | Vaginal, oral or sublingual | One initial dose | Single initial combined course; review if bleeding has not started within 48 h of misoprostol · Four 200-microgram tablets = 800 micrograms; provide analgesia and contact arrangements | 800 micrograms initially; further treatment follows reassessment rather than automatic repeat dosing | Monitor
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NICE NG126 medical management of confirmed incomplete miscarriage | 600 micrograms (800 micrograms may be used to align local protocols) | Vaginal, oral or sublingual | Once | Single initial treatment; follow-up and further intervention depend on symptoms/completion · 600 micrograms = three 200-microgram tablets; 800 micrograms = four. Do NOT add mifepristone for incomplete miscarriage | One initial 600/800-microgram dose; reassess persistent bleeding or retained tissue | Monitor
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Unscarred uterus, live fetus and an approved hospital induction indication; cited 25-microgram product is for ≥37 weeks | 25 micrograms orally every 2 h (alternative product regimen: 50 micrograms every 4 h) | Oral | Every 2 h for the 25-microgram regimen; stop further doses when labour begins or monitoring is abnormal | At most 24 h before review; stop for labour, tachysystole or fetal concern · Use a manufactured 25-microgram tablet. The cited tablet score is NOT for splitting. Do not estimate 25 micrograms by casually cutting a 200-microgram tablet
| 200 micrograms in 24 h; wait ≥4 h after the last dose before oxytocin | Monitor
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Pregnancy safety
Teratogenic reports with failed first-trimester exposure - counselling; therapeutic uses standardised by WHO/MTP guidance
Lactation
Compatible
Adverse effects
Pyrexia/shivering (antipyretics help), GI upset
MSFcheckedIN REVIEW
Ergometrine and methylergometrine — distinct preparationsEMERGENCY KITErgot alkaloid uterotonic
Open Ergometrine and methylergometrine — distinct preparations reference →
Indications: Alternative uterotonic for atonic PPH; use this row only when the ampoule is ERGOMETRINE · Atonic PPH after delivery; this is NOT the same formulation/dose as ergometrine
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Alternative uterotonic for atonic PPH; use this row only when the ampoule is ERGOMETRINE | 200–500 micrograms IM; severe haemorrhage option 250–500 micrograms slow IV by a senior clinician | IM; slow IV only for severe haemorrhage | Initial dose followed by reassessment; select another indicated intervention for continuing bleeding | Acute post-birth treatment; no routine multi-day course in this emergency row · 500 micrograms/mL formulation: 500 micrograms = 1 mL. For IV use the cited label permits dilution to 5 mL with sodium chloride 0.9%; administer slowly with BP monitoring | 500 micrograms per dose in this label; do not substitute the methylergometrine schedule or invent a cumulative ceiling | Monitor
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Atonic PPH after delivery; this is NOT the same formulation/dose as ergometrine | 0.2 mg (200 micrograms) | IM | May repeat after 2–4 h if necessary, following reassessment | Acute treatment after birth; do not prescribe repeated doses while delaying haemorrhage control · 0.2 mg/mL: 1 mL IM. Check the ampoule for the actual drug name. Routine IV use is avoided because of sudden hypertension/stroke risk
| 0.2 mg per injection; further doses require documented reassessment. No invented 15-minute repeat course | Monitor
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Pregnancy safety
Post-BIRTH only (never before delivery - fetal effects)
Lactation
Methylergometrine label: avoid breastfeeding during treatment and for 12 h after the final dose; check the specific ergometrine product.
Adverse effects
Hypertensive crisis in PET, nausea, coronary spasm rare
Manufacturer / emccheckedIN REVIEW
LabetalolEMERGENCY KITAlpha-beta blocker antihypertensive
Indications: Persistent severe hypertension in pregnancy or postpartum (systolic ≥160 OR diastolic ≥110 mmHg) · Maintenance hypertension during pregnancy/postpartum
Guideline conflict
India NHM CEmONC, chapter 4 — prose
20 mg, then 40 mg, then 80 mg at 10-minute reassessments; further dosing may reach a cumulative 300 mg.
Same NHM chapter — adjacent flowchart
Stops the displayed 20 → 40 → 80 mg sequence at a stated 140 mg maximum.
Population/setting difference: Same emergency setting; the flowchart and prose show different stopping points.
Practical India consideration: Use the approved local sequence and track every previous IV dose. Persistent severe BP needs senior/anaesthetic involvement.
App default: The card records the prose ceiling of 300 mg; persistent severe BP after the initial 140 mg sequence requires senior reassessment before additional doses or another agent.
Reason: A cumulative ceiling is not an instruction to continue dosing without reassessing treatment failure and contraindications.
Reason: A cumulative ceiling is not an instruction to continue dosing without reassessing treatment failure and contraindications.
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Persistent severe hypertension in pregnancy or postpartum (systolic ≥160 OR diastolic ≥110 mmHg) | 20 mg over 2 min; reassess at 10 min, then 40 mg; further 80 mg doses at 10-min intervals if severe BP persists | IV bolus | 10-minute reassessment and dose sequence | Acute control, then change to an appropriate oral regimen · 5 mg/mL stock: 20 mg = 4 mL, 40 mg = 8 mL, 80 mg = 16 mL. Give each dose slowly, record cumulative dose and check the stock strength | 300 mg cumulative in the cited Indian CEmONC regimen; seek escalation before continuing beyond it | Monitor
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Maintenance hypertension during pregnancy/postpartum | Start 100 mg twice daily; increase by 100–200 mg increments according to BP; higher daily doses divided three times daily | Oral | Twice daily initially; three divided doses if higher doses needed | Continue while clinically required; titrate down rather than stop abruptly, with a postpartum review plan · 100 mg or 200 mg tablets; prescribe the strength, dose and administration times | 2400 mg/day | Monitor
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Pregnancy safety
First-line across guidelines
Lactation
Compatible (low milk transfer)
Adverse effects
Bradycardia, hypotension, bronchospasm, neonatal hypoglycaemia late use
NifedipineEMERGENCY KITCalcium channel blocker
Indications: Acute severe hypertension when oral dosing is appropriate · Maintenance hypertension in pregnancy/postpartum · Selected threatened preterm labour to gain time for steroids/transfer, without infection, major bleeding or a reason for immediate birth
Guideline conflict
India NHM CEmONC, chapter 4 — prose
Acute oral nifedipine: 10 mg, reassess at 20 minutes, repeat 10–20 mg; stated initial-course maximum 30 mg.
Same NHM chapter — adjacent flowchart
The flowchart shows 10 mg, then 20 mg, then another 20 mg at 20-minute reassessments, implying 50 mg.
Population/setting difference: These refer to the same severe-pregnancy-hypertension setting; this is an internal document discrepancy, not a demonstrated population difference.
Practical India consideration: Confirm the sequence formally approved in the treating unit. Extended-release maintenance tablets are a separate regimen.
App default: Use the prose-based 30 mg initial limit with prompt senior reassessment and selection of another agent if severe BP persists.
Reason: This avoids silently combining incompatible limits or prolonging oral loading in uncontrolled severe hypertension.
Reason: This avoids silently combining incompatible limits or prolonging oral loading in uncontrolled severe hypertension.
Guideline conflict
MSF nifedipine tocolysis monograph
Advises against combining nifedipine with magnesium sulfate because of hypotension/neuromuscular-blockade concerns.
India NHM CEmONC 2024, chapter 4
States the feared interaction has not been demonstrated in retrospective reviews, while requiring careful BP and pulse monitoring.
Population/setting difference: MSF addresses nifedipine tocolysis; NHM discusses emergency hypertension/eclampsia care. Dose, indication and monitoring setting differ.
Practical India consideration: Magnesium for indicated seizure prevention or fetal neuroprotection has its own priority; do not withhold it merely to continue tocolysis.
App default: Avoid routine concurrent tocolytic nifedipine and magnesium in this reference. If both are clinically required, a senior obstetric/anaesthetic decision must define monitoring and doses.
Reason: This preserves the source-specific caution and does not turn a monitored emergency-use discussion into blanket permission for coadministration.
Reason: This preserves the source-specific caution and does not turn a monitored emergency-use discussion into blanket permission for coadministration.
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Acute severe hypertension when oral dosing is appropriate | 10 mg swallowed; reassess at 20 min and give another 10–20 mg if still severe | Oral, swallowed | Reassess after each 20-minute interval; switch/escalate when the initial-course limit is reached | Acute sequence, followed by senior review and a separately prescribed maintenance regimen · Use immediate-release oral tablets/capsules; swallow whole. NEVER sublingual administration; do not use an extended-release tablet as a rapid-loading substitute
| 30 mg cumulative for the NHM prose-based initial course; seek senior selection of another agent rather than continuing oral loading | Monitor
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Maintenance hypertension in pregnancy/postpartum | Start sustained-release nifedipine 10 mg twice daily; titrate according to BP and the exact release formulation | Oral extended release | Twice daily for the cited sustained-release regimen | While hypertension persists; reassess after birth and reduce when BP allows · Use the specified sustained-release tablet, swallowed intact. Other extended-release products may use different strengths/schedules; do not interchange them or use them for acute oral loading. | 80 mg/day for the NHM CEmONC sustained-release regimen | Monitor
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Selected threatened preterm labour to gain time for steroids/transfer, without infection, major bleeding or a reason for immediate birth | 10 mg orally; if contractions persist repeat every 15 min up to four loading doses; then 20 mg every 6 h | Oral, never sublingual | Loading as specified, then every 6 h | Maximum 48 hours · 10 mg immediate-release tablet/capsule; check BP before dosing and confirm the formulation | 40 mg loading; maintenance 80 mg/day; stop after 48 h | Monitor
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Pregnancy safety
First-line; most studied CCB
Lactation
Nifedipine is used in NICE postpartum/breastfeeding hypertension care; check the formulation and maternal/infant circumstances.
Adverse effects
Headache/flushing/tachycardia; additive weakness with MgSO4
HydralazineEMERGENCY KITDirect vasodilator
Indications: Alternative for acute severe hypertension
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Alternative for acute severe hypertension | 5 mg slowly IV over 2–4 min; reassess for 20 min and repeat 5 mg if still severe | IV | Every 20 min if required after reassessment | Acute control; transition to oral therapy once stable · Reconstitute a 20 mg vial with 1 mL water for injection, then add 9 mL sodium chloride 0.9%: 2 mg/mL. A 5 mg dose = 2.5 mL. Use immediately; do not mix with other drugs
| 20 mg cumulative in this MSF bolus regimen | Monitor
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Pregnancy safety
Established obstetric use
Lactation
Compatible
Adverse effects
Reflex tachycardia/headache/fluid retention
MSFcheckedIN REVIEW
MethyldopaCentral alpha-2 agonist
Indications: Maintenance hypertension during pregnancy; not emergency BP rescue
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Maintenance hypertension during pregnancy; not emergency BP rescue | 250 mg twice or three times daily for 2 days; increase by 250 mg every 2–3 days to response | Oral | Two or three divided doses initially; prescribed divided doses thereafter | During pregnancy if required; NICE recommends stopping within 2 days after birth and substituting another agent if needed · 250 mg tablets. Do not abruptly discontinue ongoing therapy without a replacement/reduction plan
| 3 g/day | Monitor
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Pregnancy safety
Long safety record
Lactation
Compatible short-term; depression risk limits postpartum use
Adverse effects
Sedation, dry mouth, depression, hepatitis (rare)
MSFcheckedIN REVIEW
Aspirin (low-dose)Antiplatelet
Open Aspirin (low-dose) reference →
Indications: NICE regimen for pre-eclampsia prevention in women meeting high/moderate-risk criteria
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
NICE regimen for pre-eclampsia prevention in women meeting high/moderate-risk criteria | 75–150 mg | Oral | Once daily | From 12 weeks until birth (NICE NG133); use a single named prevention protocol · Swallow the prescribed low-dose tablet; do not substitute analgesic-dose aspirin
| 150 mg/day in this NICE regimen | Monitor
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Pregnancy safety
Safe at low dose in pregnancy
Lactation
Low-dose indication and maternal/infant risks require review; avoid extrapolating this row to analgesic doses.
NICE · NG133checkedIN REVIEW
Enoxaparin (LMWH)EMERGENCY KITLow molecular weight heparin
Open Enoxaparin (LMWH) reference →
Indications: Confirmed or strongly suspected acute VTE in pregnancy unless anticoagulation is contraindicated · Risk-assessed obstetric thromboprophylaxis; standard-weight example, NOT VTE treatment
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Confirmed or strongly suspected acute VTE in pregnancy unless anticoagulation is contraindicated | 1 mg/kg using booking/early-pregnancy weight | Subcutaneous | Every 12 hours | For the remainder of pregnancy and at least 6 weeks postpartum; at least 3 months total anticoagulation · Use a graduated prefilled syringe of the correct mg strength; inject SC, not IM. Do not interchange mg, mL and anti-Xa units
| Weight-based therapeutic dose; renal dysfunction changes the regimen, not an arbitrary fixed maximum | Monitor
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Risk-assessed obstetric thromboprophylaxis; standard-weight example, NOT VTE treatment | 40 mg for a woman weighing 50–90 kg; other weight bands require the RCOG weight table | Subcutaneous | Once daily | According to the documented risk assessment: commonly 10 days after birth or 6 weeks for high risk; antenatal use when indicated · 40 mg/0.4 mL prefilled product: use the prescribed syringe SC. Confirm its actual concentration; do not give IM
| 40 mg/day applies ONLY to this standard-weight prophylactic row; renal impairment and weight extremes require adjustment | Monitor
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Pregnancy safety
Preferred anticoagulant in pregnancy
Lactation
Compatible
RCOGcheckedIN REVIEW
MetforminBiguanide
Indications: Selected GDM/type 2 diabetes; assess glucose, renal function and suitability for metformin versus insulin · Metabolic features of PCOS, particularly adults with BMI ≥25; not an interchangeable GDM regimen
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Selected GDM/type 2 diabetes; assess glucose, renal function and suitability for metformin versus insulin | Week 1: 500 mg with breakfast; week 2: 500 mg twice daily; increase by 500 mg/week if tolerated and needed | Oral | Once daily initially, then twice daily with meals | While indicated and tolerated; GDM treatment is normally stopped after birth, with a diabetes follow-up plan · 500 mg tablets taken with meals. Use slower titration for gastrointestinal intolerance; do not silently substitute a modified-release product
| 2 g/day (1 g twice daily) for this MSF regimen | Monitor
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Metabolic features of PCOS, particularly adults with BMI ≥25; not an interchangeable GDM regimen | Start 500 mg/day with food; increase by 500 mg every 1–2 weeks if tolerated toward the individually required dose | Oral | Once daily initially, then divided with meals; extended-release requires its own product instructions | Continue while metabolic benefit outweighs adverse effects; review the indication when pregnancy occurs · Use 500 mg immediate-release tablets for this example; slow titration reduces GI effects
| Suggested PCOS guideline maximum 2.5 g/day in adults and 2 g/day in adolescents, subject to the lower licensed product/renal limit | Monitor
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Pregnancy safety
NICE permits selected pregnancy use; discuss placental transfer, glucose targets and insulin alternatives.
Lactation
Compatible
Adverse effects
GI upset (titration), B12 deficiency long-term
MSFcheckedIN REVIEW
NPH insulin and prescribed mealtime insulinEMERGENCY KITEndocrine replacement
Open NPH insulin and prescribed mealtime insulin reference →
Indications: Pregnancy diabetes: match basal and meal insulin to the glucose pattern
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Pregnancy diabetes: match basal and meal insulin to the glucose pattern | Patient-specific dose in UNITS; NPH once or twice daily, with separately prescribed meal doses if needed. A universal 0.3-units/kg starting prescription is not appropriate for every GDM pattern | Subcutaneous only | NPH once/twice daily; short-acting insulin before meals according to its formulation | Continue and titrate throughout pregnancy; reduce/review promptly after birth. Type 1 diabetes always requires basal insulin · Use U-100 insulin with a matching insulin syringe/pen. Gently resuspend NPH until uniform. NPH is NEVER IV. If mixing compatible human insulins, draw clear short-acting insulin before cloudy NPH
| No universal fixed maximum: titrate the prescribed units against glucose and hypoglycaemia, with the diabetes team | Monitor
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Pregnancy safety
Individualise insulin to the glucose pattern; do not use NPH intravenously.
Lactation
Compatible
MSFcheckedIN REVIEW
BetamethasoneCorticosteroid
Open Betamethasone reference →
Indications: Imminent preterm birth within the guideline gestational window; do not delay urgent maternal/fetal delivery
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Imminent preterm birth within the guideline gestational window; do not delay urgent maternal/fetal delivery | 12 mg IM, then 12 mg IM 24 hours later | IM | Two doses, 24 h apart | One 24 mg course. Consider only ONE repeat course under NICE criteria; not routine weekly courses · Confirm product strength: for 6 mg/mL, 12 mg = 2 mL; volumes differ by formulation. Use the obstetric IM preparation
| 24 mg/course; NICE permits no more than 2 courses in total under its repeat-course criteria | Monitor
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Pregnancy safety
Benefit-proven; hyperglycaemia plan in diabetes
Lactation
Compatible
WHOsummary checkedIN REVIEW
Dexamethasone (antenatal alternative)Corticosteroid
Open Dexamethasone (antenatal alternative) reference →
Indications: Alternative fetal-lung-maturation course when appropriate
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Alternative fetal-lung-maturation course when appropriate | 6 mg IM every 12 h for four doses | IM | Every 12 hours, four doses | 24 mg total over 36 h; ONE course, subject to the same repeat-course restrictions · Check the injectable product: if 4 mg/mL, 6 mg = 1.5 mL; other strengths require recalculation. Give IM for this antenatal regimen | Four 6 mg doses = 24 mg/course; do not combine with a full betamethasone course | Monitor
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Pregnancy safety
Accepted equivalent
Lactation
Compatible
WHOsummary checkedIN REVIEW
CefazolinFirst-generation cephalosporin
Indications: Surgical prophylaxis, not treatment of established infection
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Surgical prophylaxis, not treatment of established infection | 2 g IV; 3 g for weight ≥120 kg in the cited surgical prophylaxis standard | IV infusion | Once, completed within 60 min before incision; redose for a prolonged operation or major blood loss | Single perioperative prophylaxis course; do not continue routine postoperative doses without an infection indication · Reconstitute and dilute the specific cefazolin vial according to its label; prepare a compatible IV infusion and administer over 30 min for the cited formulation. Never use an IM lidocaine diluent IV
| Initial 2 g (or 3 g ≥120 kg); redose cefazolin at 4 h if indicated, earlier after major blood loss per anaesthetic plan | Monitor
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Pregnancy safety
Safe
Lactation
Compatible
ASHP / IDSA / SIS / SHEAcheckedIN REVIEW
AmpicillinEMERGENCY KITAminopenicillin
Indications: Intra-amniotic infection, in combination with gentamicin; add anaerobic cover for caesarean according to the chosen guideline · GBS prevention during labour when prophylaxis is indicated
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Intra-amniotic infection, in combination with gentamicin; add anaerobic cover for caesarean according to the chosen guideline | 2 g | IV infusion | Every 6 hours | Continue through birth with postpartum review; the cited Malaysian NAG continues until afebrile/asymptomatic ≥48 h. Other national protocols shorten postpartum treatment after clinical recovery · Reconstitute the actual vial per label; dilute each adult dose in 100 mL sodium chloride 0.9% or glucose 5% and infuse over 30 min. Use a separate line/flush from gentamicin
| 8 g/day in this 2 g every-6-h regimen; renal impairment requires adjustment | Monitor
|
GBS prevention during labour when prophylaxis is indicated | 2 g IV initially, then 1 g IV | IV infusion | Initial 2 g load, then 1 g every 4 hours | Continue UNTIL BIRTH; this is not a multi-day infection-treatment course · Reconstitute according to the vial; dilute the adult dose in compatible fluid and infuse over 30 min. Do not mix with gentamicin
| 2 g loading, then 1 g per subsequent dose until birth | Monitor
|
Pregnancy safety
Safe
Lactation
Compatible
Ministry of Health MalaysiacheckedIN REVIEW
GentamicinAminoglycoside
Indications: Combination therapy for chorioamnionitis, postpartum endometritis or septic miscarriage
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Combination therapy for chorioamnionitis, postpartum endometritis or septic miscarriage | 5 mg/kg using the approved aminoglycoside dosing weight | IV infusion | Every 24 h initially if renal function allows; subsequent interval depends on drug levels and renal function | Daily review; limit unnecessary exposure, stop or narrow after source control and clinical recovery. Duration follows the infection, not a universal 48–72 h rule · 40 mg/mL stock: volume in mL = prescribed mg ÷40. Dilute the adult dose in 100 mL sodium chloride 0.9%/glucose 5%; infuse over 30 min. Use a separate line/flush from beta-lactams
| Weight-based; do not apply total body weight uncritically in obesity. Withhold/review further doses for accumulating levels or renal deterioration | Monitor
|
Pregnancy safety
Use when indicated (standard); fetal ototoxicity theoretical at prolonged high levels - keep courses short
Lactation
Compatible
MSFcheckedIN REVIEW
CeftriaxoneEMERGENCY KITThird-gen cephalosporin
Indications: Gonococcal cervicitis/urethritis; add pregnancy-appropriate chlamydia treatment if not excluded · Mild/moderate PID in a NON-PREGNANT patient suitable for outpatient treatment · Hospitalised PID, with appropriate combination antibiotics · Selected inpatient pyelonephritis in pregnancy, guided by cultures and resistance
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Gonococcal cervicitis/urethritis; add pregnancy-appropriate chlamydia treatment if not excluded | 500 mg IM once if weight <150 kg; 1 g IM once if ≥150 kg | IM | Once | Single treatment dose; partner management, test-of-cure when indicated and retesting remain necessary · Use the IM diluent specified for the exact vial; lidocaine-containing IM solution must NEVER be given IV. Reconstitution volumes vary by brand | 1 g for the ≥150 kg group in this CDC regimen | Monitor
|
Mild/moderate PID in a NON-PREGNANT patient suitable for outpatient treatment | 500 mg IM once, PLUS doxycycline 100 mg twice daily AND metronidazole 500 mg twice daily for 14 days | IM ceftriaxone + oral combination partners | Ceftriaxone once; partners twice daily | One ceftriaxone dose; oral partners for 14 days; reassess within 72 h · Use the vial-specific IM reconstitution. Do not use lidocaine-containing IM solution IV | If ≥150 kg with documented gonorrhoea, ceftriaxone 1 g IM (CDC). Do not repeat daily as an outpatient substitute for reassessment | Monitor
|
Hospitalised PID, with appropriate combination antibiotics | 1 g IV daily, PLUS doxycycline 100 mg twice daily AND metronidazole 500 mg twice daily | IV, with oral/IV combination partners | Ceftriaxone every 24 h; partners every 12 h | Switch after clinical improvement (usually 24–48 h) to appropriate oral therapy to COMPLETE 14 days; abscess needs adequate anaerobic cover · Reconstitute with water for injection per product, dilute in 100 mL compatible sodium chloride 0.9%/glucose 5% and infuse over 30 min. No calcium-containing diluent | 1 g/day in this CDC PID regimen; do not omit the combination partners | Monitor
|
Selected inpatient pyelonephritis in pregnancy, guided by cultures and resistance | 1–2 g | IV infusion | Every 24 hours | Review IV therapy by 48 h; step down when improving. ACOG uses 14 days TOTAL therapy for pregnancy pyelonephritis · Use water for reconstitution and a compatible non-calcium IV diluent; adult infusion example 100 mL sodium chloride 0.9% over 30 min. Do not give lidocaine-containing IM solution IV
| 2 g/day for this row; renal/hepatic dysfunction and severe infection need individual review | Monitor
|
Pregnancy safety
Safe
Lactation
Compatible
CDC · 2021 STI guidelinecheckedIN REVIEW
DoxycyclineTetracycline
Indications: Chlamydial infection in a non-pregnant adult · Non-pregnant PID; combine with ceftriaxone and metronidazole
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Chlamydial infection in a non-pregnant adult | 100 mg | Oral | Twice daily | 7 days · Take with a full glass of water while upright; stay upright for at least 1 h. Separate iron, calcium, zinc and antacids by ≥2 h | 200 mg/day in this regimen | Monitor
|
Non-pregnant PID; combine with ceftriaxone and metronidazole | 100 mg | Oral (IV if required in hospital) | Every 12 hours | 14 days TOTAL treatment · Oral route is effective when tolerated; use a full glass of water and remain upright. Separate from polyvalent cations | 200 mg/day in this PID regimen | Monitor
|
Pregnancy safety
The STI/PID rows here are for non-pregnant patients; use pregnancy-recommended alternatives. Other severe infections require their own risk-benefit assessment.
Lactation
Short courses acceptable but alternatives preferred
CDC · 2021 STI guidelinecheckedIN REVIEW
MetronidazoleNitroimidazole
Open Metronidazole reference →
Indications: Symptomatic BV, including pregnancy where treatment is indicated · Trichomoniasis, including symptomatic pregnant women · Anaerobic cover in the complete CDC PID regimen · Combination treatment of selected septic miscarriage/endometritis or caesarean chorioamnionitis
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Symptomatic BV, including pregnancy where treatment is indicated | 500 mg | Oral | Twice daily | 7 days · One 500 mg tablet each dose. Alternative formulations/regimens must be prescribed separately
| 1 g/day for 7 days in this CDC regimen | Monitor
|
Trichomoniasis, including symptomatic pregnant women | 500 mg | Oral | Twice daily | 7 days · One 500 mg tablet each dose; assess vomiting/adherence | 1 g/day for this 7-day regimen | Monitor
|
Anaerobic cover in the complete CDC PID regimen | 500 mg | Oral | Twice daily | 14 days · One 500 mg tablet twice daily, with doxycycline and the appropriate cephalosporin regimen | 1 g/day for this PID regimen | Monitor
|
Combination treatment of selected septic miscarriage/endometritis or caesarean chorioamnionitis | 500 mg | IV infusion | Every 8 hours | Review daily and switch to oral when feasible; duration is source-specific: uncomplicated infection recovery versus septic miscarriage (10–14 days in Malaysian NAG) · Ready-to-use 500 mg/100 mL (5 mg/mL) bag infused over 30 min; do not add other drugs to the bag
| 1.5 g/day in this regimen; severe hepatic impairment requires reduction | Monitor
|
Pregnancy safety
CDC permits treatment of indicated BV/trichomoniasis in pregnancy; select the syndrome-specific regimen.
Lactation
Usual divided-dose courses differ from a 2 g single dose; review the prescribed regimen and infant circumstances.
CDC · 2021 STI guidelinecheckedIN REVIEW
AzithromycinMacrolide
Indications: Recommended CDC regimen for chlamydia in pregnancy
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Recommended CDC regimen for chlamydia in pregnancy | 1 g | Oral | Once | Single dose; test-of-cure at approximately 4 weeks and retest at 3 months · Two 500 mg tablets (or four 250 mg tablets) taken together; check formulation instructions. Persistent vomiting requires reassessment | 1 g for this single-dose regimen | Monitor
|
Pregnancy safety
Safe
Lactation
Compatible
CDC · 2021 STI guidelinecheckedIN REVIEW
Erythromycin (latency PPROM)Macrolide
Open Erythromycin (latency PPROM) reference →
Indications: Confirmed PPROM without established infection or another indication for immediate birth
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Confirmed PPROM without established infection or another indication for immediate birth | 250 mg | Oral | Four times daily | Maximum 10 days OR until established labour, whichever occurs first (NICE NG25) · 250 mg tablets; confirm the erythromycin salt and avoid erythromycin estolate in pregnancy. Do not substitute co-amoxiclav for latency prophylaxis | 1 g/day for at most 10 days in this regimen | Monitor
|
Pregnancy safety
GTG73 regimen
Lactation
Compatible
NICE · NG25checkedIN REVIEW
Methotrexate (ectopic protocol)Antimetabolite
Open Methotrexate (ectopic protocol) reference →
Indications: Selected stable unruptured tubal ectopic pregnancy with assured follow-up; NICE selection criteria apply
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Selected stable unruptured tubal ectopic pregnancy with assured follow-up; NICE selection criteria apply | 50 mg/m² body-surface area | IM | Once on day 1; hCG on days 4 and 7 | Weekly hCG thereafter until resolution; falling values do not eliminate rupture risk · Record height and weight, calculate BSA and total mg. Cytotoxic pharmacy prepares the dose at the actual product concentration; independently verify prescribed mg and final mL. Do not reuse a fixed vial volume for every patient
| No automatic repeat dose: <15% day-4-to-day-7 fall, plateau or rise requires senior reassessment for another dose or surgery | Monitor
|
Pregnancy safety
INTENDED abortive/teratogenic here - strict eligibility
Lactation
Contraindicated during course
MifepristoneProgesterone receptor antagonist
Indications: Priming for a combined medical-abortion course <12 weeks, within the legal and service framework · Confirmed missed miscarriage choosing NICE medical management
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Priming for a combined medical-abortion course <12 weeks, within the legal and service framework | 200 mg | Oral | Once, followed by misoprostol 800 micrograms 24–48 h later | One combined course; confirmation of completion and emergency access are essential · One 200 mg tablet swallowed; arrange the exact subsequent misoprostol route, time and follow-up before treatment
| 200 mg in this priming regimen; not repeated daily | Monitor
|
Confirmed missed miscarriage choosing NICE medical management | 200 mg, followed 48 h later by misoprostol 800 micrograms unless the sac has passed | Oral | Once | One initial combined course · One 200 mg tablet; provide written timing and contact instructions. No mifepristone for incomplete miscarriage | 200 mg initially | Monitor
|
Pregnancy safety
Intended use under MTP Act framework
Lactation
The MSF monograph does not contraindicate breastfeeding after a single dose; repeated dosing needs separate advice.
WHOsummary checkedIN REVIEW
Ondansetron5-HT3 antagonist
Indications: Second-line nausea/vomiting or hyperemesis after assessment and discussion of benefits and small absolute fetal-risk signals · Second-line HG when oral treatment cannot be retained
Guideline conflict
MSF injectable ondansetron monograph
General postoperative-vomiting reference advises avoiding first-trimester use and does not recommend it for nausea/vomiting of pregnancy.
RCOG Green-top 69, 2024
Includes ondansetron as a second-line HG treatment with counselling about the small absolute fetal-risk signal and the harms of inadequately treated HG.
Population/setting difference: A general injectable/postoperative reference and a specialist pregnancy/HG pathway address different indications and prescribing decisions.
Practical India consideration: Review first-line response, gestation, electrolyte/QT risk and available routes with the patient and treating obstetric team.
App default: Use the RCOG HG-specific second-line schedules after assessment and counselling; do not import the postoperative injection schedule.
Reason: The specialist pregnancy pathway directly addresses HG, its competing risks and route-specific dosing.
Reason: The specialist pregnancy pathway directly addresses HG, its competing risks and route-specific dosing.
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Second-line nausea/vomiting or hyperemesis after assessment and discussion of benefits and small absolute fetal-risk signals | 4 mg every 8 h OR 8 mg every 12 h | Oral | Use ONE of these schedules | Review daily during acute illness; reduce/stop as oral intake and symptoms improve rather than prescribe a fixed long course · Use the prescribed tablet/orodispersible formulation; correct dehydration and electrolyte disturbance
| 12 mg/day for 4 mg every 8 h OR 16 mg/day for 8 mg every 12 h; severe hepatic impairment max 8 mg/day | Monitor
|
Second-line HG when oral treatment cannot be retained | 8 mg over 15 min | IV infusion | Every 12 hours | Review daily; change to oral treatment when tolerated · 2 mg/mL solution: 8 mg = 4 mL; dilute in compatible IV fluid according to the actual product label and infuse over 15 min, not rapid IV push | 16 mg/day in this RCOG HG regimen; severe hepatic impairment max 8 mg/day | Monitor
|
Pregnancy safety
RCOG second-line HG option after counselling; correct electrolytes and evaluate QT risk.
Lactation
Compatible
RCOG / BJOGcheckedIN REVIEW
Doxylamine/pyridoxine delayed release 10 mg/10 mgAntiemetic first-line NVP
Open Doxylamine/pyridoxine delayed release 10 mg/10 mg reference →
Indications: Nausea and vomiting of pregnancy: the cited product contains 10 mg/10 mg PER tablet
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Nausea and vomiting of pregnancy: the cited product contains 10 mg/10 mg PER tablet | Day 1: two tablets at bedtime. If inadequate: day 3 add one morning tablet; day 4 may add one mid-afternoon tablet | Oral delayed release | Daily scheduled dosing, not as-needed | Reassess during pregnancy; taper gradually when no longer needed · 10 mg doxylamine +10 mg pyridoxine gastro-resistant tablets: swallow whole with water on an empty stomach. Do not crush, split or substitute a different-strength combination | 4 tablets/day: one morning, one mid-afternoon, two bedtime (40 mg/40 mg total) | Monitor
|
Pregnancy safety
Best-established first-line
Lactation
The cited Xonvea product does not recommend breastfeeding use; review the product and maternal need.
Exeltis / emccheckedIN REVIEW
ThiamineEMERGENCY KITVitamin B1
Indications: Prolonged vomiting or markedly reduced dietary intake; protect against thiamine deficiency · Prolonged HG with inability to retain oral thiamine; before IV carbohydrate/nutrition
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Prolonged vomiting or markedly reduced dietary intake; protect against thiamine deficiency | 100 mg | Oral | Three times daily | While vomiting/restricted intake persists; review nutritional recovery · 100 mg tablet; if oral intake is unreliable, use prescribed parenteral supplementation BEFORE carbohydrate-containing fluids/nutrition | 300 mg/day for this oral supplementation regimen; suspected Wernicke disease requires a treatment regimen, not oral prophylaxis | Monitor
|
Prolonged HG with inability to retain oral thiamine; before IV carbohydrate/nutrition | 100 mg parenteral thiamine as the initial supplementation dose; follow the local vitamin-B preparation for subsequent doses | Slow IV infusion | Before carbohydrate administration, with continued prescribed supplementation while intake is inadequate | Acute supplementation with daily nutritional review; change to oral 100 mg three times daily once retained · If the product is 100 mg/2 mL, use one ampoule diluted as specified by its label and infuse very slowly over 30 min. Monitor for hypersensitivity
| This is PREVENTION, not a Wernicke-treatment dose; suspected Wernicke needs urgent higher-dose specialist IV treatment | Monitor
|
Pregnancy safety
Essential
Lactation
Compatible
RCOG / BJOGcheckedIN REVIEW
Iron (ferric carboxymaltose class)IV iron complex
Open Iron (ferric carboxymaltose class) reference →
Indications: Laboratory-confirmed iron deficiency when oral iron is ineffective/intolerable or faster replacement is indicated; assess trimester and infection
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Laboratory-confirmed iron deficiency when oral iron is ineffective/intolerable or faster replacement is indicated; assess trimester and infection | Determine TOTAL need from Hb and weight, then give up to 20 mg/kg per infusion, not exceeding 1000 mg | IV infusion only | Repeat only if calculated deficit remains; additional dose at least 7 days later | Finite replacement course, not automatic weekly indefinite treatment · 50 mg iron/mL: 1000 mg =20 mL. For >500–1000 mg dilute only in up to 250 mL sodium chloride 0.9% and infuse over at least 15 min. Do not dilute below 2 mg/mL
| Lesser of 20 mg/kg or 1000 mg per infusion; maximum 1000 mg/week for adults in this Ferinject label | Monitor
|
Pregnancy safety
Use only for a clear indication; the cited product restricts pregnancy use to the second/third trimester after benefit-risk assessment.
Lactation
Compatible
CSL Vifor / emccheckedIN REVIEW
Levonorgestrel ECPProgestogen EC
Open Levonorgestrel ECP reference →
Indications: After unprotected/inadequately protected intercourse; assess timing and offer the most effective suitable option
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
After unprotected/inadequately protected intercourse; assess timing and offer the most effective suitable option | 1.5 mg | Oral | Once, as soon as possible | Single treatment, ideally ≤72 h; CDC allows emergency pills within 5 days, with reduced LNG effectiveness late in the window · One 1.5 mg tablet (or two 0.75 mg tablets together). If vomiting within 3 h, repeat the dose promptly (CDC)
| 1.5 mg initial course; enzyme-inducing medicines need a separate EC plan, preferably copper IUD when suitable | Monitor
|
Pregnancy safety
No effect on established pregnancy
Lactation
Compatible
CDCcheckedIN REVIEW
Calcium gluconate 10%EMERGENCY KITElectrolyte antidote
Open Calcium gluconate 10% reference →
Indications: Antidote for clinically significant magnesium toxicity · Clinically important hypocalcaemia during major transfusion, guided by ionised calcium and physiology
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Antidote for clinically significant magnesium toxicity | 1 g (10 mL of 10% solution) slowly | IV | Initial antidote dose; reassess breathing, ECG and calcium before further dosing | Emergency reversal; stop magnesium and support the airway concurrently · 10% = 100 mg/mL; 10 mL contains 1 g calcium gluconate, NOT 1 g elemental calcium. Give over at least 5 min through a patent IV line; do not mix with other drugs | No automatic repeated-dose course; further calcium requires monitored reassessment | Monitor
|
Clinically important hypocalcaemia during major transfusion, guided by ionised calcium and physiology | 1 g (10 mL of 10% solution) slowly | IV | Initial dose followed by ionised-calcium/ECG reassessment; titrate further replacement to the monitored result | During the acute deficit and ongoing citrate exposure; stop/reduce when ionised calcium normalises · 10% = 100 mg/mL; 10 mL contains 1 g calcium gluconate, NOT 1 g elemental calcium. Give over at least 5 min through a patent IV line; do not mix with other drugs | No fixed every-four-units schedule: reassess calcium and prescribe further doses explicitly | Monitor
|
Pregnancy safety
Life-saving antidote
Lactation
n/a
MSFcheckedIN REVIEW
Adrenaline (epinephrine)EMERGENCY KITEmergency Drugs
Open Adrenaline (epinephrine) reference →
Indications: Airway/breathing/circulation compromise from suspected anaphylaxis, including pregnancy · Maternal cardiac arrest following the adult ALS algorithm · Persistent airway/breathing/circulation compromise after two appropriate IM doses; experienced critical-care/anaesthetic staff only
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Airway/breathing/circulation compromise from suspected anaphylaxis, including pregnancy | 500 micrograms (0.5 mg) | IM into the anterolateral mid-thigh | Repeat after 5 min if airway/breathing/circulation problems persist | Continue emergency reassessment; refractory reaction after 2 appropriate IM doses needs expert IV-infusion/critical-care support · 1 mg/mL ampoule: 0.5 mL = 500 micrograms IM. Use mg/mL labels rather than ratio alone. NEVER give this IM-strength dose as an IV bolus | No fixed total IM-dose ceiling while life-threatening features persist; repeat every 5 min and escalate | Monitor
|
Maternal cardiac arrest following the adult ALS algorithm | 1 mg | IV or IO | Every 3–5 min during CPR; immediately for non-shockable rhythm, after the third shock for shockable rhythm | During ongoing resuscitation, until ROSC or team decision · Use a 1 mg/10 mL (0.1 mg/mL) resuscitation syringe. If using 1 mg/mL stock, 1 mL diluted to FINAL 10 mL gives 0.1 mg/mL; independently check. Flush the IV/IO line and continue compressions | 1 mg each scheduled dose; do not confuse with 0.5 mg IM anaphylaxis treatment | Monitor
|
Persistent airway/breathing/circulation compromise after two appropriate IM doses; experienced critical-care/anaesthetic staff only | Start 0.5–1 mL/kg/hour of the 10-microgram/mL solution according to severity, then titrate to response | IV infusion pump | Continuous with immediate response-based titration | Until the reaction resolves and a supervised weaning/observation plan is established · Make 1 mg adrenaline up to FINAL 100 mL sodium chloride 0.9% =10 micrograms/mL. Use a dedicated labelled line and pump; do not piggyback where another infusion can cause an adrenaline bolus.
| No fixed universal rate ceiling; senior titration and invasive/continuous monitoring for refractory shock | Monitor
|
Pregnancy safety
IM anaphylaxis and IV/IO arrest are DIFFERENT doses and concentrations.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
Resuscitation Council UKcheckedIN REVIEW
Norepinephrine (noradrenaline)EMERGENCY KITEmergency Drugs
Open Norepinephrine (noradrenaline) reference →
Indications: Persistent shock while fluid responsiveness/source control are addressed; first-line vasopressor in maternal septic shock
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Persistent shock while fluid responsiveness/source control are addressed; first-line vasopressor in maternal septic shock | Start 0.1 microgram/kg/min of NOREPINEPHRINE TARTRATE; increase by 0.05 microgram/kg/min as required | IV infusion pump through a suitable monitored large vein | Continuous infusion; MSF reassessment/titration every 10 min initially | Until perfusion and BP recover; taper gradually, do not stop abruptly · For the cited stock 8 mg TARTRATE/4 mL (=4 mg BASE/4 mL): 2 mL contains 4 mg tartrate. Add 38 mL compatible fluid for FINAL 40 mL =100 micrograms TARTRATE/mL. Rate = dose × kg ×60 ÷100 mL/h; at 70 kg and 0.1, rate=4.2 mL/h | MSF peripheral protocol ceiling 1 microgram/kg/min TARTRATE; persistent/escalating shock requires ICU and central/arterial access planning | Monitor
|
Pregnancy safety
Life-saving vasopressor when indicated; specify TARTRATE versus BASE.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
MSFcheckedIN REVIEW
Unfractionated heparinEMERGENCY KITAnticoagulants
Open Unfractionated heparin reference →
Indications: Selected life-threatening PE, severe renal dysfunction or impending procedures when rapid reversibility is valuable
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Selected life-threatening PE, severe renal dysfunction or impending procedures when rapid reversibility is valuable | 80 units/kg IV loading, then 18 units/kg/hour; subsequent changes follow APTT/anti-Xa nomogram | IV loading + IV infusion | Continuous infusion after the initial loading dose | Until a definitive anticoagulation/reperfusion plan permits transition; duration individualised around bleeding and procedures · Example: 25,000 units made up to FINAL 50 mL sodium chloride 0.9% =500 units/mL. Pump mL/h = prescribed units/h ÷500. Independently check vial units/mL, patient weight and label | No fixed cumulative ceiling; dose to APTT/anti-Xa with the approved nomogram. Omit/review bolus after thrombolysis or when bleeding risk requires | Monitor
|
Pregnancy safety
Specialist-selected IV anticoagulation when rapid reversibility is needed.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
RCOGcheckedIN REVIEW
AlteplaseEMERGENCY KITEmergency Drugs
Indications: Expert-led reperfusion decision for haemodynamically unstable massive PE; pregnancy/postpartum bleeding risks require simultaneous obstetric/critical-care input
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Expert-led reperfusion decision for haemodynamically unstable massive PE; pregnancy/postpartum bleeding risks require simultaneous obstetric/critical-care input | 100 mg over 2 hours (adult Activase-labelled PE regimen) | IV infusion | One reperfusion course | 2-hour course followed by monitored anticoagulation planning; arrest dosing may follow a different resuscitation protocol · Reconstitute the specific 50/100 mg vial only with the supplied preservative-free sterile water to 1 mg/mL. Gently swirl, do not shake; use a dedicated line. This PE regimen differs from stroke dosing | 100 mg for the cited adult PE regimen; check local product weight limits and do not borrow an arbitrary stroke bolus schedule | Monitor
|
Pregnancy safety
Life-threatening PE: multidisciplinary decision weighing maternal death against major bleeding.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
Genentech / DailyMedcheckedIN REVIEW
Lorazepam — status epilepticusEMERGENCY KITEmergency Drugs
Open Lorazepam — status epilepticus reference →
Indications: Seizure lasting ≥5 min or recurrent seizures without recovery; also assess/treat eclampsia when possible
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Seizure lasting ≥5 min or recurrent seizures without recovery; also assess/treat eclampsia when possible | 2 mg IV over 1 min; if not terminating, another 2 mg after 2–3 min (up to 4 mg); a repeat benzodiazepine dose at 10 min if still seizing under the GGC pathway | Slow IV | Initial staged dose; at most one repeat treatment before moving to second-line therapy | Time-critical rescue; prepare airway/ventilation and second-line therapy concurrently · Use the actual IV lorazepam product; dilute according to its label. Prescribe in mg and verify mg/mL, including any dilution | 4 mg initial treatment; count any benzodiazepine already given. Persistent status needs second-line loading and ICU, not endless benzodiazepines | Monitor
|
Pregnancy safety
Time-critical seizure treatment with airway support; distinguish eclampsia and its magnesium regimen.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
NHS Greater Glasgow and ClydecheckedIN REVIEW
Levetiracetam — status loadingEMERGENCY KITEmergency Drugs
Open Levetiracetam — status loading reference →
Indications: Ongoing convulsive status after adequate first-line benzodiazepine treatment; non-eclamptic cause or seizures refractory to eclampsia care
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Ongoing convulsive status after adequate first-line benzodiazepine treatment; non-eclamptic cause or seizures refractory to eclampsia care | 60 mg/kg, maximum 4500 mg | IV infusion | One loading dose with urgent reassessment | Emergency loading; ongoing maintenance is a separate neurology prescription · 100 mg/mL concentrate: prescribed mg ÷100 =mL to withdraw. Dilute the dose in at least 100 mL compatible sodium chloride 0.9% and infuse over 15 min (Keppra product preparation); the 60 mg/kg, maximum 4500 mg status load is off-label GGC emergency guidance. | 4500 mg per loading dose | Monitor
|
Pregnancy safety
Emergency loading followed by a separate maintenance plan and pregnancy counselling.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
NHS Greater Glasgow and ClydecheckedIN REVIEW
Glucose — severe hypoglycaemiaEMERGENCY KITEndocrine Metabolic
Open Glucose — severe hypoglycaemia reference →
Indications: Impaired consciousness or unsafe swallowing; never give oral fluid to an unconscious patient
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Impaired consciousness or unsafe swallowing; never give oral fluid to an unconscious patient | 20 g glucose: 200 mL of 10% OR 100 mL of 20% solution | IV infusion | Give over 10–15 min; recheck glucose at 10 min and repeat if still <4 mmol/L with reassessment | Acute rescue followed by longer-acting carbohydrate when awake and safe to swallow, or prescribed ongoing infusion · 10% =100 mg/mL; 200 mL =20 g. 20% =200 mg/mL; 100 mL =20 g. Check IV patency and use a limited volume so a whole large bag cannot infuse accidentally | Reassess after each 20 g treatment; recurrent/prolonged hypoglycaemia needs monitored ongoing treatment | Monitor
|
Pregnancy safety
Treat severe hypoglycaemia promptly during pregnancy.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
JBDS-IP / ABCD / Diabetes UKcheckedIN REVIEW
Glucagon — hypoglycaemia rescueEMERGENCY KITEndocrine Metabolic
Open Glucagon — hypoglycaemia rescue reference →
Indications: Severe insulin-associated hypoglycaemia when IV access is unavailable
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Severe insulin-associated hypoglycaemia when IV access is unavailable | 1 mg | IM | One rescue dose; obtain IV access and recheck glucose after 10 min | Bridge to reliable glucose delivery; give carbohydrate after recovery · Reconstitute the 1 mg vial with its supplied solvent immediately before IM use; verify final dose | 1 mg initially; repeated glucagon may be ineffective and must not delay IV glucose | Monitor
|
Pregnancy safety
Rescue when IV access is unavailable; may fail with starvation/depleted glycogen.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
JBDS-IP / ABCD / Diabetes UKcheckedIN REVIEW
Soluble human insulin — DKA infusionEMERGENCY KITEndocrine Metabolic
Open Soluble human insulin — DKA infusion reference →
Indications: Pregnancy DKA, including euglycaemic DKA; urgent monitored obstetric/diabetes care
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Pregnancy DKA, including euglycaemic DKA; urgent monitored obstetric/diabetes care | 0.1 units/kg/hour IV; no routine IV insulin bolus. Consider 0.05 units/kg/hour once glucose <14 mmol/L alongside glucose infusion | IV infusion pump | Continuous with hourly response-based review | Continue until ketones <0.6 mmol/L AND venous pH >7.3, clinical recovery and safe transition; not merely until glucose normalises · Using U-100 SOLUBLE insulin: 50 units =0.5 mL; add to 49.5 mL sodium chloride 0.9% for FINAL 50 mL =1 unit/mL. At 0.1 units/kg/h, 70 kg =7 units/h =7 mL/h. NEVER use cloudy NPH IV | No universal fixed hourly ceiling; inadequate ketone fall needs line/pump and dose reassessment. Potassium <3.5 mmol/L requires urgent senior-led replacement and insulin review | Monitor
|
Pregnancy safety
Pregnancy DKA requires a joint obstetric/diabetes/critical-care plan.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
JBDS-IP / Diabetes UKcheckedIN REVIEW
ClindamycinEMERGENCY KITAntibiotics
Indications: Postpartum endometritis, in combination with gentamicin when appropriate · Symptomatic bacterial vaginosis when an oral alternative is appropriate
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Postpartum endometritis, in combination with gentamicin when appropriate | 900 mg | IV infusion | Every 8 hours | Continue until clinical improvement and afebrile for 24–48 h in the cited NAG regimen; persistent fever needs source reassessment · 150 mg/mL concentrate: 900 mg =6 mL; dilute in compatible IV fluid and infuse over at least 30 min (not IV push) | 2700 mg/day in this regimen | Monitor
|
Symptomatic bacterial vaginosis when an oral alternative is appropriate | 300 mg | Oral | Twice daily | 7 days · 300 mg capsule or two 150 mg capsules per dose; swallow with a full glass of water
| 600 mg/day in this BV regimen, separate from 900 mg IV emergency dosing | Monitor
|
Pregnancy safety
Use for an indicated infection with appropriate combination therapy.
Lactation
Acute maternal stabilisation takes priority; review ongoing treatment and infant exposure with the linked source and specialist team.
Ministry of Health MalaysiacheckedIN REVIEW
EnalaprilAntihypertensive / ACE inhibitor
Indications: After birth only; NICE recommends enalapril with maternal renal-function and potassium monitoring
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
After birth only; NICE recommends enalapril with maternal renal-function and potassium monitoring | Start 5 mg once daily; use a lower supervised initial dose if volume depleted or renally impaired; titrate to BP response | Oral | Once daily initially | Review BP and dose after birth; reduce/stop as hypertension resolves or continue for persistent hypertension after medical review · 5 mg tablet swallowed with water, with or without food. Correct volume depletion; check creatinine and potassium before starting
| 40 mg/day in the product label; usual maintenance 20 mg/day, not an automatic postpartum target | Monitor
|
Pregnancy safety
Use postpartum; do not initiate during pregnancy
Lactation
Postpartum option with infant and maternal monitoring
Milpharm / emccheckedIN REVIEW
TerbutalineBeta-2 agonist
Indications: Hospital external cephalic version after eligibility assessment, consent and baseline CTG
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Hospital external cephalic version after eligibility assessment, consent and baseline CTG | 250 micrograms, 10 minutes before ECV | Subcutaneous | One pre-procedure dose | One ECV attempt episode; not a maintenance preterm-labour regimen · 0.5 mg/mL ampoule: withdraw 0.5 mL =250 micrograms. This row is SC, not an interchangeable IV bolus
| 250 micrograms for the cited ECV regimen; no automatic repeat | Monitor
|
Pregnancy safety
Short procedural ECV use after obstetric assessment
Lactation
Single procedural exposure; assess maternal/infant context
NHS Greater Glasgow and ClydecheckedIN REVIEW
Benzylpenicillin sodiumPenicillin antibacterial
Open Benzylpenicillin sodium reference →
Indications: Intrapartum GBS prophylaxis when indicated, distinct from treatment of maternal sepsis · Adult neurosyphilis, ocular or otosyphilis with specialist evaluation
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Intrapartum GBS prophylaxis when indicated, distinct from treatment of maternal sepsis | 3 g (5 million units) IV loading, then 1.5 g (2.5 million units) every 4 hours | Slow IV injection or infusion | Load once, then every 4 hours until delivery | Intrapartum only; do not delay an indicated birth to complete four hours of antibiotics · For the cited 1.2 g vial, dissolve each vial in at least 8 mL water for injections/0.9% saline for IV injection (powder displacement ~0.8 mL), or at least 20 mL for infusion. Account for final concentration when withdrawing partial vials. Give doses >1.2 g at least 1 minute per 300 mg: 3 g ≥10 min; 1.5 g ≥5 min
| 3 g loading then 1.5 g every 4 hours; stop at birth. Do not confuse grams with million units. | Monitor
|
Adult neurosyphilis, ocular or otosyphilis with specialist evaluation | 4 million units (2.4 g) IV every 4 hours; this selects the upper end of the CDC 18–24-million-unit/day range | Slow IV injection/infusion | Every 4 hours | 10–14 days; additional stage-dependent benzathine treatment may be considered after completion · For the cited 1.2 g (2-million-unit) sodium vials, use two vials per 2.4 g dose. Dissolve each in at least 8 mL water for injections/0.9% saline and give the complete dose slowly over at least 8 minutes (label: ≥1 minute per 300 mg). For infusion, reconstitute each vial in at least 20 mL compatible fluid. Verify the local product and account for sodium/fluid load
| 24 million units/day in this selected schedule; reduce/adjust for significant renal impairment | Monitor
|
Pregnancy safety
Used in pregnancy when indicated
Lactation
Penicillin exposure requires routine infant observation for GI/allergy effects
Bowmed Ibisqus / emccheckedIN REVIEW
LevothyroxineThyroid hormone replacement
Open Levothyroxine reference →
Indications: Already receiving replacement before pregnancy · RCOG: overt hypothyroidism or TSH >10 mIU/L; distinguish milder subclinical disease
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Already receiving replacement before pregnancy | At positive pregnancy test increase the weekly dose by about 25–30%, e.g. double the usual daily dose on two days each week; then titrate to TFTs | Oral | Daily, with a clearly written seven-day dose schedule | Through pregnancy; make an individual postpartum dose plan and repeat TFTs about 6 weeks after birth · Use the prescribed microgram-strength tablets consistently before breakfast; separate oral iron/calcium by 4–5 hours. Micrograms are not milligrams
| No universal fixed maximum: titrate to pregnancy-specific TFTs; the initial 25–30% rise is not an instruction for repeated weekly increases | Monitor
|
RCOG: overt hypothyroidism or TSH >10 mIU/L; distinguish milder subclinical disease | Overt/severe disease: 1.6 micrograms/kg/day initial replacement. For selected subclinical disease with TSH above the gestational range but ≤10, consider 1.0–1.2 micrograms/kg/day after discussing benefit | Oral | Once daily | Recheck TFTs after 4 weeks and titrate; postpartum continuation/withdrawal depends on the original diagnosis, dose and TFTs · Calculate weight-based MICROGRAMS, prescribe an achievable tablet-strength schedule, take before breakfast and separate iron/calcium by 4–5 hours
| Individualised TFT-guided dosing, not a fixed universal maximum | Monitor
|
Pregnancy safety
Essential replacement when indicated; dose follows pregnancy TFTs
Lactation
Continue indicated maternal replacement
Propylthiouracil (PTU)Antithyroid agent
Open Propylthiouracil (PTU) reference →
Indications: Overt hyperthyroidism requiring antithyroid medication; preferred early-pregnancy option when appropriate · ICU/endocrine-led treatment of storm from increased hormone synthesis; assess pregnancy stage and hepatic function
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Overt hyperthyroidism requiring antithyroid medication; preferred early-pregnancy option when appropriate | Product adult initial range 300–600 mg/day in divided doses until controlled; then usually 50–150 mg/day. In pregnancy use the lowest effective dose, individually selected from FT4 and severity, rather than automatically starting at the upper adult range | Oral | Divide the prescribed daily dose, commonly every 8 hours | Titrate with specialist follow-up; if still needed beyond 20 weeks consider changing to carbimazole because of PTU hepatotoxicity · 50 mg tablets; prescribe the exact mg per administration. Do not confuse the outpatient dose with the separate thyroid-storm loading regimen
| 600 mg/day is the top of the cited adult starting range, not a routine pregnancy target or an instruction to escalate without endocrine review | Monitor
|
ICU/endocrine-led treatment of storm from increased hormone synthesis; assess pregnancy stage and hepatic function | 500–1000 mg loading, then 250 mg every 4 hours | Oral or NG through a protected airway | Load once, then every 4 hours | Acute high-dose treatment only; reduce promptly as the patient stabilises, with an explicit endocrine maintenance plan · 50 mg tablets: loading 10–20 tablets, maintenance 5 tablets per dose; pharmacy-assisted NG preparation if needed. Record administration before starting iodine
| One initial load; 1500 mg/day maintenance at 250 mg every 4 h. No repeated loading without specialist reassessment | Monitor
|
Pregnancy safety
Lowest effective dose; pregnancy timing and hepatic risk determine choice
Lactation
Discuss maternal dose and infant monitoring using RCOG guidance
Wockhardt / emccheckedIN REVIEW
CarbimazoleAntithyroid agent
Indications: Specialist antithyroid option; pregnancy timing and PTU suitability determine selection
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Specialist antithyroid option; pregnancy timing and PTU suitability determine selection | Adult product initial range 20–60 mg/day in 2–3 divided doses; maintenance usually 5–15 mg/day. Pregnancy requires the lowest effective dose. When switching, PTU 200 mg/day is approximately carbimazole 10 mg/day (20:1) | Oral | Initially divided 2–3 times daily; maintenance may be once daily | Reassess TFTs within 2 weeks after a switch/dose change; continuation through pregnancy and after birth is individualised · Use the stated tablet strength to deliver the exact mg; carbimazole and methimazole are not mg-for-mg equivalent
| 60 mg/day is the adult label starting-range ceiling, not a routine pregnancy goal; thyroid-storm treatment is a separate regimen | Monitor
|
Pregnancy safety
First-trimester embryopathy risk; specialist risk-benefit choice
Lactation
Discuss maternal dose and infant monitoring using RCOG guidance
Manufacturer / emccheckedIN REVIEW
PropranololEMERGENCY KITNonselective beta-blocker
Indications: Adrenergic control only in haemodynamically stable patients without significant ventricular dysfunction
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Adrenergic control only in haemodynamically stable patients without significant ventricular dysfunction | The consensus lists 60–80 mg every 4 hours; assess cardiac function first and consider a lower initial dose because beta-blockade can precipitate collapse | Oral or NG with protected airway | Every 4 hours with reassessment before doses | Only while required for acute thyrotoxicosis; taper/change as control improves · Immediate-release tablets, with exact mg prescribed; do not substitute sustained-release tablets or give this as an IV dose
| Listed oral schedule totals 360–480 mg/day; this is a specialist ICU regimen, not a routine pregnancy symptom-treatment dose | Monitor
|
Pregnancy safety
Storm treatment requires ICU cardiac assessment; prolonged pregnancy exposure needs fetal review
Lactation
Maternal indication and infant bradycardia/feeding monitoring matter
HydrocortisoneEMERGENCY KITSystemic glucocorticoid
Open Hydrocortisone reference →
Indications: Glucocorticoid component of ICU storm treatment
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Glucocorticoid component of ICU storm treatment | 100 mg IV loading, then 50 mg every 6 hours | Slow IV injection | Load once, then every 6 hours | Stop/review when stable if no accompanying adrenal insufficiency; the ongoing plan depends on cause and duration · For the cited 100 mg powder vial add up to 2 mL sterile water for injections; if prepared with 2 mL, concentration is approximately 50 mg/mL: 100 mg=2 mL, 50 mg=1 mL. Give slowly over at least 1 minute and verify the actual product
| 2026 joint-statement schedule: 100 mg load plus 200 mg/day maintenance, not a blended older 300 mg loading schedule | Monitor
|
Pregnancy safety
Treat a life-threatening indication promptly; monitor glucose and infection
Lactation
Short emergency treatment and longer courses require different feeding review
Potassium iodide (SSKI)EMERGENCY KITIodine / antithyroid adjunct
Open Potassium iodide (SSKI) reference →
Indications: Short-course endocrine/ICU therapy after thionamide in hormone-synthesis-driven storm
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Short-course endocrine/ICU therapy after thionamide in hormone-synthesis-driven storm | SSKI 5 drops every 6 hours, starting at least 1 hour AFTER the antithyroid drug | Oral or NG | Every 6 hours | Stop once stabilised/hormone levels controlled; prolonged iodine exposure in pregnancy can affect the fetal thyroid · Use the pharmacy-verified SATURATED potassium iodide solution (SSKI, 1 g/mL), its calibrated dispenser and prescribed drop volume; dilute in milk/juice before oral/NG administration. Lugol solution is a different formulation and has a different drop prescription
| 5 calibrated drops per dose in this regimen; never substitute an arbitrary dropper, radioactive-emergency tablets or Lugol drops | Monitor
|
Pregnancy safety
Short specialist storm treatment; prolonged exposure risks fetal thyroid suppression
Lactation
Iodide reaches milk; endocrine/neonatal advice and infant thyroid planning are needed
Oral iron and folic acidHaematinic
Open Oral iron and folic acid reference →
Indications: Confirmed iron deficiency with anaemia; exclude haemoglobinopathy/other causes and assess urgency · Routine pregnancy supplementation, particularly high-anaemia-burden settings · Diagnosed postpartum iron-deficiency anaemia after haemorrhage is controlled and outpatient oral treatment is suitable
Regimens checked: 2026-10-18. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Confirmed iron deficiency with anaemia; exclude haemoglobinopathy/other causes and assess urgency | 120 mg ELEMENTAL iron per day (WHO treatment dose), with 400 micrograms folic acid daily | Oral | Daily; divide the elemental-iron dose if needed for tolerability | Until Hb normalises, then return to the preventive antenatal dose; continue the documented postnatal/repletion plan rather than stopping after an arbitrary pack · Count ELEMENTAL iron, not total salt mass. A tablet containing 60 mg elemental iron gives 120 mg with two tablets; check combined-tablet folate content separately. Separate from calcium by several hours and from levothyroxine by 4–5 hours
| 120 mg/day elemental iron in this WHO treatment regimen; extra OTC iron can duplicate treatment | Monitor
|
Routine pregnancy supplementation, particularly high-anaemia-burden settings | 60 mg ELEMENTAL iron +400 micrograms (0.4 mg) folic acid | Oral | Once daily | Throughout pregnancy, beginning as early as possible; document any national postpartum continuation separately · Choose a product labelled with these elemental-iron/folate amounts; no dilution. Check other prenatal supplements to avoid duplication; separate calcium and levothyroxine
| WHO preventive range is 30–60 mg elemental iron/day; this card selects 60 mg. Do not treat established IDA with the preventive dose alone | Monitor
|
Diagnosed postpartum iron-deficiency anaemia after haemorrhage is controlled and outpatient oral treatment is suitable | 120 mg ELEMENTAL iron plus 400 micrograms folic acid per day | Oral | Daily; tailor administration for tolerance without accidentally changing the prescribed total | WHO postpartum anaemia treatment: until Hb normalises. Then document any continuing preventive/repletion course and review; the preventive 6–12-week recommendation is a different indication. · Use the product’s ELEMENTAL iron content, not salt weight: two tablets each containing 60 mg elemental iron provide 120 mg. Check the combined-tablet folate separately. Separate iron from calcium by several hours and levothyroxine by 4–5 hours.
| 120 mg/day elemental iron in this WHO treatment schedule; do not add duplicate antenatal/OTC iron or overlap oral and IV courses without an explicit plan. | Monitor
|
Pregnancy safety
Dose ELEMENTAL iron; distinguish treatment from prevention
Lactation
Compatible with indicated maternal supplementation
WHOsummary checkedIN REVIEW
Oral calciumMineral supplement
Indications: WHO prevention of pre-eclampsia in populations with low dietary calcium intake
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
WHO prevention of pre-eclampsia in populations with low dietary calcium intake | 1.5–2 g ELEMENTAL calcium per day; a practical 1.5 g schedule is 500 mg three times daily | Oral | Three divided doses, preferably with meals | During pregnancy; starting time and postpartum continuation should be documented for the national programme used · Read elemental calcium on the label: salt weight is not elemental calcium. Use 500 mg elemental-calcium tablets for the example schedule; separate iron by several hours and levothyroxine by 4–5 hours
| 2 g/day supplemental elemental calcium in this WHO regimen; count all supplements and assess renal/stone risk | Monitor
|
Pregnancy safety
WHO low-intake population recommendation; assess renal/stone risk
Lactation
Assess diet and total supplemental dose
WHOsummary checkedIN REVIEW
PromethazineSedating antihistamine antiemetic
Indications: First-line antihistamine option in RCOG HG guidance
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
First-line antihistamine option in RCOG HG guidance | 12.5–25 mg | Oral | Every 4–8 hours as prescribed; use the lowest effective frequency | Review daily during acute illness; reduce/stop as symptoms and oral intake improve · Use oral tablets/liquid of a verified strength; 12.5 mg requires a suitable product rather than assuming every tablet can be split
| The listed 25 mg every 4 h schedule totals 150 mg/day; this is a regimen bound, not a target, and sedation may require much less | Monitor
|
Pregnancy safety
RCOG first-line NVP/HG option with sedation precautions
Lactation
Review repeated sedating doses, infant alertness and feeding
RCOG / BJOGcheckedIN REVIEW
MetoclopramideDopamine antagonist antiemetic
Open Metoclopramide reference →
Indications: RCOG second-line antiemetic after assessing hydration and prior treatments
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
RCOG second-line antiemetic after assessing hydration and prior treatments | 5–10 mg | Oral | Every 8 hours; leave at least 6 hours between any two doses even if vomiting | At most 5 days in the product safety restriction; reassess rather than issuing an indefinite repeat · 5 or 10 mg oral formulation; check strength. Do not automatically repeat a vomited dose before the minimum interval
| Lower of 30 mg/day or 0.5 mg/kg/day | Monitor
|
Pregnancy safety
RCOG second-line option with neurological/short-course precautions
Lactation
Review infant effects and maternal adverse reactions; avoid prolonged unnecessary use
Manufacturer / emccheckedIN REVIEW
Ursodeoxycholic acidBile acid treatment
Open Ursodeoxycholic acid reference →
Indications: Maternal itching in confirmed intrahepatic cholestasis; not a substitute for bile-acid-based birth planning
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Maternal itching in confirmed intrahepatic cholestasis; not a substitute for bile-acid-based birth planning | Start 10–15 mg/kg/day in 2–3 divided doses; adjust to symptoms with specialist review | Oral | Twice or three times daily | Until birth with symptom/liver-test review; confirm postnatal resolution · Prescribe mg from maternal weight and available capsule/tablet strength. Example 60 kg at 10 mg/kg/day =600 mg/day, e.g. 300 mg twice daily if that formulation is available
| SMFM permits escalation up to 21 mg/kg/day for persistent symptoms; do not increase indefinitely | Monitor
|
Pregnancy safety
Used for maternal ICP symptoms; does not replace fetal-risk planning
Lactation
Review ongoing need after birth; persistent disease requires a new diagnosis
SMFM / ACOG endorsedcheckedIN REVIEW
AcyclovirAntiviral
Indications: First clinical genital-herpes episode · Recurrent genital herpes in pregnancy: CDC suppression from 36 weeks
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
First clinical genital-herpes episode | 400 mg | Oral | Three times daily | 7–10 days; extend if healing remains incomplete after 10 days · 400 mg tablet (or two 200 mg tablets); maintain hydration and check renal function; not an IV prescription
| 1200 mg/day for this schedule; adjust with renal impairment | Monitor
|
Recurrent genital herpes in pregnancy: CDC suppression from 36 weeks | 400 mg | Oral | Three times daily | From 36 weeks until birth; reassess delivery route if lesions/prodrome occur · 400 mg tablet (or two 200 mg tablets); maintain hydration and check renal function; not an IV prescription
| 1200 mg/day for this schedule; adjust with renal impairment | Monitor
|
Pregnancy safety
CDC considers acyclovir usable in all trimesters when indicated
Lactation
CDC considers acyclovir compatible with breastfeeding
CDC · 2021 STI guidelinecheckedIN REVIEW
Levonorgestrel IUS 52 mgIntrauterine progestogen
Open Levonorgestrel IUS 52 mg reference →
Indications: Heavy menstrual bleeding after evaluating uterine/cervical/endometrial pathology · Contraception after pregnancy exclusion and eligibility assessment
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Heavy menstrual bleeding after evaluating uterine/cervical/endometrial pathology | One 52 mg intrauterine system | Intrauterine | One insertion by a trained clinician | 5 years for HMB, then reassess symptoms; replace/remove if bleeding returns · Sterile, single-use Mirena system and inserter; aseptic insertion after assessment of uterine position/cavity and infection/pregnancy exclusion. Record insertion date and indication-specific removal date
| One device; contraception duration (8 years) must not be applied to HRT endometrial protection (4 years in the UK label) | Monitor
|
Contraception after pregnancy exclusion and eligibility assessment | One 52 mg intrauterine system | Intrauterine | One insertion by a trained clinician | Up to 8 years for contraception with this specific Mirena 52 mg product · Sterile, single-use Mirena system and inserter; aseptic insertion after assessment of uterine position/cavity and infection/pregnancy exclusion. Record insertion date and indication-specific removal date
| One device; contraception duration (8 years) must not be applied to HRT endometrial protection (4 years in the UK label) | Monitor
|
Pregnancy safety
Exclude pregnancy before insertion; assess postpartum timing and perforation risk
Lactation
Assess insertion timing and product-specific postpartum precautions
Bayer / emccheckedIN REVIEW
LetrozoleAromatase inhibitor
Indications: Anovulatory PCOS infertility after assessment of pregnancy, tubal/semen factors and counselling about off-label use
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Anovulatory PCOS infertility after assessment of pregnancy, tubal/semen factors and counselling about off-label use | 2.5 mg daily on cycle days 2–6 | Oral | Once daily for 5 consecutive days per prescribed cycle | Initial monitored cycle, with review of ovulation/response before changing dose or repeating a course · One 2.5 mg tablet daily; day 1 is the first day of fresh menstrual bleeding. Exclude pregnancy before another cycle if no period
| 2.5 mg/day in this named NHS starting regimen; dose escalation requires a new fertility prescription, not automatic self-escalation | Monitor
|
Pregnancy safety
Exclude existing pregnancy before ovulation induction; do not give during pregnancy
Lactation
Not for use during breastfeeding
Ethinylestradiol / levonorgestrelCombined hormonal contraception
Open Ethinylestradiol / levonorgestrel reference →
Indications: Eligible nonpregnant patient seeking contraception or PCOS cycle control after BP/VTE/migraine assessment
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Eligible nonpregnant patient seeking contraception or PCOS cycle control after BP/VTE/migraine assessment | One active tablet containing ethinylestradiol 30 micrograms +levonorgestrel 150 micrograms daily for 21 days, followed by the 7 inactive tablets in the cited 28-day pack | Oral | One tablet at the same time daily, including inactive tablets; start the next pack immediately after day 28 | Ongoing while eligible, with periodic BP/risk review; stop and assess new contraindications · Check the pack has 21 active +7 inactive tablets of the stated formulation. Other pill formulations and extended regimens need their own schedule
| One scheduled tablet/day; missed-pill/vomiting instructions are a separate decision pathway, not a reason for indefinite extra dosing | Monitor
|
Pregnancy safety
Not a pregnancy treatment; postpartum eligibility depends on VTE risk and timing
Lactation
Oestrogen may reduce milk supply; assess breastfeeding/postpartum eligibility
MSFcheckedIN REVIEW
Estradiol transdermal HRTOestrogen replacement
Open Estradiol transdermal HRT reference →
Indications: Menopausal symptoms after individual assessment; intact uterus also needs adequate progestogen
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Menopausal symptoms after individual assessment; intact uterus also needs adequate progestogen | One patch releasing 50 micrograms per 24 hours | Transdermal | Replace twice weekly, every 3–4 days | Use the lowest effective dose with regular benefit/risk review; review new bleeding promptly · Apply to clean dry intact abdominal skin, never the breasts; rotate sites, avoid waistline and do not cut the patch. Remove the old patch when replacing
| This starting example is 50 micrograms/24 h; higher strengths require reassessment and proportionate progestogen | Monitor
|
Pregnancy safety
Not indicated in pregnancy
Lactation
Not indicated during breastfeeding
Novartis / emccheckedIN REVIEW
Micronised progesterone for HRTProgestogen / endometrial protection
Open Micronised progesterone for HRT reference →
Indications: Endometrial protection with standard-dose systemic oestrogen in a patient with a uterus · Endometrial protection with standard-dose systemic oestrogen in a patient with a uterus
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Endometrial protection with standard-dose systemic oestrogen in a patient with a uterus | 200 mg at bedtime for 12–14 days in each 28-day/monthly cycle | Oral | Nightly on the prescribed 12–14 days each cycle | For as long as systemic oestrogen is used with an intact uterus; review bleeding and increase protection if oestrogen dose increases · Use oral micronised-progesterone capsules: 200 mg =two 100 mg capsules where that is the available strength. Do not substitute an unverified compounded or vaginal product
| This standard-dose-oestrogen schedule is 200 mg cyclic OR 100 mg daily, not both; high-dose oestrogen needs a revised progestogen prescription | Monitor
|
Endometrial protection with standard-dose systemic oestrogen in a patient with a uterus | 100 mg at bedtime every day | Oral | Every night continuously | For as long as systemic oestrogen is used with an intact uterus; review bleeding and increase protection if oestrogen dose increases · Use oral micronised-progesterone capsules: 200 mg =two 100 mg capsules where that is the available strength. Do not substitute an unverified compounded or vaginal product
| This standard-dose-oestrogen schedule is 200 mg cyclic OR 100 mg daily, not both; high-dose oestrogen needs a revised progestogen prescription | Monitor
|
Pregnancy safety
These are menopause HRT regimens, not miscarriage/luteal-support doses
Lactation
HRT schedules are not indicated during breastfeeding
British Menopause SocietycheckedIN REVIEW
Anti-D immunoglobulinHuman immunoglobulin
Open Anti-D immunoglobulin reference →
Indications: Non-sensitised RhD-negative pregnancy with an indication for routine antenatal prophylaxis · Non-sensitised RhD-negative mother after an RhD-positive birth
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Non-sensitised RhD-negative pregnancy with an indication for routine antenatal prophylaxis | 300 micrograms (1500 IU) | IM or IV for this Rhophylac product only | Once at 28–30 weeks | One routine antenatal dose; sensitising events and birth are assessed separately · Ready-to-use prefilled syringe 300 micrograms/2 mL (1500 IU/2 mL); bring to room temperature and give slowly. Verify product, RhD status and antibody screen; do not confuse with newborn vitamin K
| One 300-microgram syringe covers approximately 15 mL fetal RhD-positive red cells; additional dose depends on measured FMH, not an arbitrary universal ceiling | Monitor
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Non-sensitised RhD-negative mother after an RhD-positive birth | 300 micrograms (1500 IU); increase if testing shows a larger fetomaternal haemorrhage | IM or IV for this Rhophylac product only | Once as soon as possible, ideally within 72 hours of birth | Postnatal episode; if >72 hours have elapsed, do not withhold—give as soon as possible and obtain specialist advice · Ready-to-use prefilled syringe 300 micrograms/2 mL (1500 IU/2 mL); bring to room temperature and give slowly. Verify product, RhD status and antibody screen; do not confuse with newborn vitamin K
| One 300-microgram syringe covers approximately 15 mL fetal RhD-positive red cells; additional dose depends on measured FMH, not an arbitrary universal ceiling | Monitor
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Pregnancy safety
For eligible non-sensitised RhD-negative mothers; never a universal injection for every pregnancy
Lactation
Postnatal maternal prophylaxis is used when indicated
CSL Behring / emccheckedIN REVIEW
NitrofurantoinUrinary antibacterial
Open Nitrofurantoin reference →
Indications: Culture-guided asymptomatic bacteriuria/cystitis; not pyelonephritis
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Culture-guided asymptomatic bacteriuria/cystitis; not pyelonephritis | 100 mg modified release twice daily; if unavailable, 50 mg immediate release four times daily | Oral | Use ONE formulation-specific schedule | 7 days · Take with food using the specified modified-release capsule or immediate-release product; do not exchange frequency between formulations
| 200 mg/day in either cited pregnancy lower-UTI regimen | Monitor
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Pregnancy safety
Avoid at term and with G6PD deficiency; lower-UTI use only
Lactation
Assess infant age/G6PD status and the actual product guidance
NICEcheckedIN REVIEW
CefalexinCephalosporin antibacterial
Indications: NICE second-choice lower-UTI option when suitable for culture results/allergy history
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
NICE second-choice lower-UTI option when suitable for culture results/allergy history | 500 mg | Oral | Twice daily | 7 days · 500 mg capsule/tablet; swallow with water. If a suspension is used, verify its concentration and measure the prescribed mg
| 1000 mg/day in this uncomplicated lower-UTI regimen; other infections have different schedules | Monitor
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Pregnancy safety
Pregnancy lower-UTI option selected by culture/allergy context
Lactation
Monitor infant for GI effects or sensitisation
NICEcheckedIN REVIEW
Benzathine penicillin GLong-acting IM penicillin
Open Benzathine penicillin G reference →
Indications: Primary, secondary or early latent syphilis after staging · Late latent syphilis or unknown duration without neurosyphilis
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Primary, secondary or early latent syphilis after staging | 2.4 million units | Deep IM ONLY | One initial dose; in pregnancy CDC permits an additional 2.4-million-unit dose one week later | Initial episode; document any indicated extra dose and follow-up · Use a product labelled penicillin G BENZATHINE alone, e.g. the full prefilled Bicillin L-A syringe labelled 2.4 million units (nominal 4 mL presentation); no dilution. Powder products require their own manufacturer reconstitution, and overfill means the prefilled presentation is not a universal units/mL recipe
| 2.4 million units per dose; do not substitute benzathine for neurosyphilis therapy | Monitor
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Late latent syphilis or unknown duration without neurosyphilis | 2.4 million units | Deep IM ONLY | Every 7 days for 3 doses | Three-weekly-dose course; >9 days between doses in pregnancy requires restarting the full course · Use a product labelled penicillin G BENZATHINE alone, e.g. the full prefilled Bicillin L-A syringe labelled 2.4 million units (nominal 4 mL presentation); no dilution. Powder products require their own manufacturer reconstitution, and overfill means the prefilled presentation is not a universal units/mL recipe
| 7.2 million units total across three correctly timed doses | Monitor
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Pregnancy safety
Stage-appropriate penicillin treats maternal infection and prevents fetal disease
Lactation
Maternal treatment is used when indicated; assess infant exposure and congenital infection risk
Clotrimazole vaginalTopical azole antifungal
Open Clotrimazole vaginal reference →
Indications: Symptomatic confirmed/suspected vulvovaginal candidiasis; reconsider other diagnoses with persistent symptoms
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Symptomatic confirmed/suspected vulvovaginal candidiasis; reconsider other diagnoses with persistent symptoms | 5 g of 1% vaginal cream (50 mg clotrimazole) | Intravaginal | Once daily, usually at bedtime | 7 days in pregnancy · Use a product intended for VAGINAL use with a measured 5 g dose; 1% cream is not interchangeable with a 2% three-day course or external vulval cream. Discuss insertion technique in pregnancy using the actual product instructions
| One 5 g application/day for this regimen; persistent/recurrent disease needs assessment rather than repeated blind treatment | Monitor
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Pregnancy safety
Use the seven-day topical pregnancy course
Lactation
Local treatment has limited systemic exposure; avoid infant contact with treated skin
CDCcheckedIN REVIEW
DinoprostoneProstaglandin E2 for induction
Indications: Hospital induction in an eligible unscarred uterus after cervical/fetal assessment; alternative to other ripening medicines
Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Hospital induction in an eligible unscarred uterus after cervical/fetal assessment; alternative to other ripening medicines | 3 mg vaginally; if labour is not established, one further 3 mg tablet after 6–8 hours | Vaginal posterior fornix | Initial dose, then at most ONE repeat at 6–8 hours if eligible | One induction course, with reassessment after the maximum; stop further dosing for labour/hyperstimulation or fetal concern · Use the specific Prostin E2 3 mg VAGINAL TABLET, inserted high in the posterior fornix by trained staff. Gel and controlled-release inserts have different strengths/schedules
| 6 mg total; wait at least 6 hours after dinoprostone before oxytocin | Monitor
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Pregnancy safety
Specialist hospital induction after contraindication assessment
Lactation
Short intrapartum use; reassess ongoing maternal treatment after birth
Pfizer / emccheckedIN REVIEW
Paracetamol (acetaminophen)Analgesic / antipyretic
Open Paracetamol (acetaminophen) reference →
Indications: Short-term maternal postoperative/postpartum pain or other mild pain after assessment; adult ≥50 kg
Regimens checked: 2026-10-18. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Short-term maternal postoperative/postpartum pain or other mild pain after assessment; adult ≥50 kg | 1 g (two 500 mg tablets) per dose | Oral | Every 6–8 hours when needed; maximum 4 doses in 24 hours | According to clinical response: reduce/stop as pain improves. Record the prescribed supply and review date; persistent or increasing pain needs reassessment rather than an automatic repeat course. · Check tablet strength: two 500 mg tablets = 1 g. Count paracetamol in every combination/OTC product towards the total; this is not an IV preparation.
| 4 g in 24 hours for the stated adult population. Lower weight, hepatic impairment or other risk factors require an individual reduced prescription; do not automatically use this maximum. | Monitor
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Pregnancy safety
No pregnancy contraindication in the MSF oral monograph; use the appropriate dose.
Lactation
Compatible with indicated short-term maternal use.
Adverse effects
Hepatotoxicity in overdose; check duplicate products.
IbuprofenNSAID analgesic
Indications: Short-term pain relief after birth or gynaecological surgery when NSAIDs are appropriate; not an antenatal regimen
Regimens checked: 2026-10-18. Each indication has its own preparation, limits and safety checks.
| Indication | Dose | Route | Frequency | Duration / preparation | Maximum | Monitoring / cautions |
|---|---|---|---|---|---|---|
Short-term pain relief after birth or gynaecological surgery when NSAIDs are appropriate; not an antenatal regimen | 200–400 mg per dose | Oral | Every 8 hours when prescribed; reduce/stop as symptoms improve | Shortest course needed for recovery; MSF postoperative reference maximum 8 days. Record the actual stop/review date; ongoing or increasing pain needs clinical review. · Check 200 mg or 400 mg tablet strength. Take with food; do not combine with another NSAID or duplicate OTC ibuprofen.
| 1,200 mg in 24 hours in this pain regimen; do not import higher anti-inflammatory schedules into a discharge prescription. | Monitor
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Pregnancy safety
This reference is postpartum/nonpregnant only; do not use it as an antenatal prescription.
Lactation
Compatible with indicated short-term maternal use.
Adverse effects
GI ulceration/bleeding, renal injury, hypersensitivity/bronchospasm.