MEDICATION SAFETY PROFILE: A CASE REPORT OF FIRST TRIMESTER PREGNANCY PATIENTS WITH DEEP VEIN THROMBOSIS DIAGNOSIS ACCOMPANIED BY COMORBIDITY
DOI:
https://doi.org/10.32734/idjpcr.v8i02.21822Keywords:
Deep Vein Thrombosis, Medication, Pregnancy, SafetyAbstract
Pregnancy is a hypercoagulable state that elevates the risk of Deep Vein Thrombosis (DVT). The selection of pharmacological interventions for DVT during pregnancy necessitates rigorous consideration of both maternal and fetal safety. Management becomes increasingly complex when the condition is accompanied by comorbidities, which often lead to polypharmacy and a higher potential for drug-drug interactions. This case report discusses a 33-year-old pregnant woman in her first trimester diagnosed with DVT in the left lower extremity, complicated by secondary hypertension, type 2 diabetes mellitus, and fever. The therapeutic regimen comprised 13 medications, including anticoagulants, antibiotics, analgesic-antipyretics, antiemetics, antihypertensives, and antidiabetic agents. Medication safety profiles were evaluated based on FDA pregnancy categories and other peer-reviewed references. Potential drug interactions were analyzed using the UpToDate® Lexicomp™ database. The study identified two drugs in category A, five in categories B and C, respectively, and one agent for which data was unavailable. Four potential drug interactions were identified, ranging from moderate to minor severity. All prescribed drugs demonstrated an adequate safety profile supported by current clinical literature. This study emphasizes the critical importance of a thorough risk-benefit analysis. Stringent monitoring is essential to ensure both the safety and efficacy of the treatment.
Downloads
References
[1] Bereda G. Risk Factors, Diagnosis, Pathophysiology and Management of Deep Vein Thrombosis. J Clin Med Images Case Rep. 2022;2. DOI: 10.55920/2771-019x/1200.
[2] Devis P, Knuttinen MG. Deep venous thrombosis in pregnancy: Incidence, pathogenesis and endovascular management. Cardiovasc Diagn Ther. 2017;7:S300–S319.
[3] Schünemann HJ, Cushman M, Burnett AE, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: Prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv. 2018;2:3198–3225.
[4] Ferracini AC, Rodrigues AT, Visacri MB, et al. Potential Drug Interactions and Drug Risk during Pregnancy and Breastfeeding: An Observational Study in a Women’s Health Intensive Care Unit. Rev Bras Ginecol Obstet. 2017;39:258–264.
[5] Khan F, Vaillancourt C, Bourjeily G. Diagnosis and management of deep vein thrombosis in pregnancy. BMJ. 2017;357:j2216.
[6] Lim W, Le Gal G, Bates SM, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: Diagnosis of venous thromboembolism. Blood Adv. 2018;2:3226–3256.
[7] Wiffen P, Mitchell M, Snelling M, et al. Oxford Handbook of Clinical Pharmacy. 3rd ed. Oxford: Oxford University Press; 2017.
[8] Food and Drug Administration. Medication Guide. Silver Spring: FDA; 2016. p. 1–23.
[9] American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 201: Pregestational Diabetes Mellitus. Obstet Gynecol. 2018;132:e228–e248.
[10] Lexidrug U. Methyldopa: Drug information. In: Lexicomp. Hudson, Ohio: Wolters Kluwer Health, Inc; 2025.
[11] American Diabetes Association. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S282–S294.
[12] Bahri N, Dashti S, Mohammadzadeh A, et al. Relationship Between Amoxicillin Use in Pregnancy and Congenital Anomalies: A Systematic Review. Curr Drug Res Rev. 2023;15:170–176.
[13] Niromanesh S, Alavi A, Sharbaf FR, et al. Metformin compared with insulin in the management of gestational diabetes mellitus: a randomized clinical trial. Diabetes Res Clin Pract. 2012;98:422–429.
[14] Thélin CS, Richter JE. Review article: the management of heartburn during pregnancy and lactation. Aliment Pharmacol Ther. 2020;51:421–434.
[15] Queensland Clinical Guidelines. Maternity and Neonatal Clinical Guideline: Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium. Queensland Government; 2014. p. 1–25.
[16] Dreier JW, Andersen AM, Berg-Beckhoff G. Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring. Pediatrics. 2014;133:e674–e688.
[17] Kilcoyne KR, Mitchell RT. Assessing the impact of in-utero exposures: Potential effects of paracetamol on male reproductive development. Arch Dis Child. 2017;102:1169–1175.
[18] Bandoli G, Palmsten K, Forbess Smith CJ, et al. A Review of Systemic Corticosteroid Use in Pregnancy and the Risk of Select Pregnancy and Birth Outcomes. Rheum Dis Clin North Am. 2017;43:489–502.
[19] Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Care Res (Hoboken). 2020;72:461–488.
[20] Elsayed NA, Aleppo G, Aroda VR, et al. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2023. Diabetes Care. 2023;46(Suppl 1):S254–S266.
[21] Lexidrug U. Domperidone: Drug information. In: Lexicomp. Hudson, Ohio: Wolters Kluwer Health, Inc; 2025.
[22] Lexidrug U. Drug Interactions. In: Lexicomp. Hudson, Ohio: Wolters Kluwer Health, Inc; 2025.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Indonesian Journal of Pharmaceutical and Clinical Research

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to Indonesian Journal of Pharmaceutical and Clinical Research (IDJPCR) and Faculty of Pharmacy as well as TALENTA Publisher Universitas Sumatera Utara as publisher of the journal.
Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media. The reproduction of any part of this journal, its storage in databases and its transmission by any form or media, will be allowed only with a written permission from Indonesian Journal of Pharmaceutical and Clinical Research (IDJPCR).
The Copyright Transfer Form can be downloaded here.
The copyright form should be signed originally and sent to the Editorial Office in the form of original mail or scanned document.







