Citation-first clinical tool

Pregnancy & Lactation Safety Lookup (PLLR + LactMed)

The Pregnancy & Lactation Safety Lookup summarises the FDA Pregnancy and Lactation Labeling Rule (PLLR) narrative and the NIH LactMed entry for a medication. Output is structured by trimester considerations, known fetal risks, data limitations, lactation excretion in breast milk, infant effects, and commonly considered alternatives. Pregnancy and lactation prescribing remains a clinician decision; specialty input (maternal-fetal medicine, teratology specialists, lactation consultants) is commonly appropriate for high-risk situations.

This tool is for educational and decision-support use only. It does not replace independent clinical judgement. Always verify against the current guideline, FDA label, or specialty reference cited below before acting. Do not enter patient identifiers (name, MRN, dates of service).

FDA PLLR + NIH LactMed (2024) — FDA / NIH — read source Primary publication: FDA PLLR (2015); NIH LactMed (continually updated)

Who this is for

Primary care clinicians and APPs
Obstetric and emergency clinicians
Pharmacists supporting maternal medication review

Frequently asked questions

Does the tool give me a pregnancy category?

No. The PLLR replaced A/B/C/D/X letter categories in 2015 with a narrative summary. The tool reflects the modern narrative format.

Is LactMed authoritative?

LactMed is the U.S. National Library of Medicine's curated lactation database and is widely considered authoritative for U.S. practice.

Are there safer alternatives recommended?

When LactMed or PLLR identifies commonly considered alternatives, the tool surfaces them. Always verify against the current LactMed entry.

When should I refer to MFM or teratology?

High-risk medications (teratogens, complex polypharmacy, first-trimester exposure questions) commonly warrant specialty consultation. The tool flags this in the response.

Does it cover paternal exposures?

Most pregnancy/lactation guidance focuses on maternal exposure. Paternal-exposure concerns require a different evidence base; consult MotherToBaby or specialty resources.

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