Drugs in Pregnancy and Lactation: Tenth Edition

CAMPHOR

Antipruritic/Local Anesthetic

PREGNANCY RECOMMENDATION: Compatible (Topical)

BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible

PREGNANCY SUMMARY

Limited data suggest that the topical use of camphor during gestation is of low risk.

FETAL RISK SUMMARY

Camphor is a natural product obtained from the subtropical tree Cinnamomum camphora in the form of D-camphor; it is also produced synthetically in the optically inactive racemic form. In reproductive studies in rats and rabbits with oral doses, no evidence of embryotoxicity or teratogenicity was observed even at maternally toxic doses (1).

No reports linking the use of topically applied camphor with congenital defects have been located. Camphor is toxic and potentially a fatal poison if taken orally in sufficient quantities. Four cases of fetal exposure after accidental ingestion, including a case of fetal death and neonatal respiratory failure, have been reported (25). The drug crosses the placenta (3). A 1997 case report described a 16-year-old girl at 6 weeks’ gestation who ingested 30 g of camphor dissolved in 250 mL of wine in an unsuccessful attempt to induce abortion (6). After successful treatment of the symptoms of camphor poisoning, her pregnancy was electively terminated a few weeks later. An autopsy of the embryo was not done.

The Collaborative Perinatal Project monitored 50,282 mother–child pairs, 168 of whom had 1st trimester exposure to topical camphor (7, pp. 410–412). No association was found with congenital malformations. For use anytime during pregnancy, 763 exposures were recorded and, again, no relationship to defects was noted (7, pp. 444, 499).

BREASTFEEDING SUMMARY

Although there are no reports describing the use of topical camphor during lactation, its use probably is harmless for a nursing infant.

References

1.Leuschner J. Reproductive toxicity studies of D-Camphor in rats and rabbits. Arzneim-Forsch/Drug Res 1997;47:124–8.

2.Figgs J, Hamilton R, Homel S, McCabe J. Camphorated oil intoxication in pregnancy. Report of a case. Obstet Gynecol 1965;25:255–8.

3.Weiss J, Catalano P. Camphorated oil intoxication during pregnancy. Pediatrics 1973;52:713–4.

4.Blackman WB, Curry HB. Camphor poisoning: report of case occurring during pregnancy. J Fla Med Assoc 1957;43:99.

5.Jacobziner H, Raybin HW. Camphor poisoning. Arch Pediatr 1962;79:28.

6.Rabl W, Katzgraber F, Steinlechner M. Camphor ingestion for abortion (case report). Forensic Sci Int 1997;89:137–40.

7.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977.