Oxprenolol is a cardioselective beta blocker licensed for the treatment of hypertension, angina pectoris, cardiac arrhythmias, myocardial infarction, adjunctive management of thyrotoxicosis, and prophylaxis of migraine.
There are no published data on overall rates of congenital malformation following oxprenolol use in pregnancy. A single case-control study found a possible association between first trimester oxprenolol exposure and cleft lip and/or palate. A further case-control study found no association between gestational oxprenolol use and neural tube defects. Both of these findings require ongoing research for confirmation. Limited data do not suggest that exposure to oxprenolol in utero adversely affects fetal growth or gestational length; however further studies are required as reduced fetal growth has been observed following gestational exposure to other beta blockers. Data are too limited to permit an evidence-based assessment of the risks of miscarriage, stillbirth, preterm delivery and adverse neurodevelopmental effects following gestational oxprenolol exposure.
Use of beta blockers near term may result in beta-adrenoceptor blockade, leading to neonatal bradycardia, hypotension and hypoglycaemia. However, there are no data on rates of these neonatal complications in oxprenolol-exposed infants and the absolute risk therefore remains unquantified. Assessment of the neonate for these effects is advised until more robust data become available.
Exposure to oxprenolol at any stage of pregnancy would not usually be regarded as medical grounds for termination. In pregnancies complicated by maternal hypertension and/or where oxprenolol has been administered, careful monitoring of fetal growth is advised. Other risk factors may also be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of considering such factors when performing case-specific risk assessments.
Related document: Use of beta blockers in pregnancy
This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to NHS health care professionals who are logged in.
If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.
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