PARAMETHADIONE

Drugs in Pregnancy and Lactation.

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Name: PARAMETHADIONE
Class: Anticonvulsant
Risk Factor:    DM

Fetal Risk Summary

Paramethadione is an oxazolidinedione anticonvulsant used in the treatment of petit mal epilepsy. There have been three families (10 pregnancies) in which an increase in spontaneous abortion or abnormalities has been reported (1,2). Paramethadione is considered equivalent to trimethadione in regard to its fetal effects. In fact, one of the families described by German and colleagues (3) was included in the fetal trimethadione syndrome (see Trimethadione). This patient had one normal infant after anticonvulsant medications were withdrawn. Malformations reported in two additional families by Rutman (2) are consistent with fetal paramethadione-trimethadione syndrome. The malformations included tetralogy of Fallot, mental retardation, failure to thrive, and increased incidence of spontaneous abortions (2). Because paramethadione has demonstrated both clinical and experimental fetal risk greater than other anticonvulsants, its use should be abandoned in favor of other anticonvulsants for the treatment of petit mal epilepsy (see also Ethosuximide, Phensuximide, Methsuximide) (4,5 and 6).

Breast Feeding Summary

No data are available.

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References

  1. German J, Ehlers KH, Kowal A, DeGeorge PU, Engle MA, Passarge E. Possible teratogenicity of trimethadione and paramethadione. Lancet 1970;2:261–2.
  2. Rutman JT. Anticonvulsants and fetal damage. N Engl J Med 1973;189:696–7.
  3. German J, Kowal A, Ehlers KH. Trimethadione and human teratogenesis. Teratology 1970;3:349–62.
  4. National Institute of Health. Anticonvulsants found to have teratogenic potential. JAMA 1981;245:36.
  5. Fabro S, Brown NA. Teratogenic potential of anticonvulsants. N Engl J Med 1979;300:1280–1.
  6. Hill RM. Managing the epileptic patient during pregnancy. Drug Ther 1976:204–5.

Index