Propoxyphene and Acetaminophen

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Abstract
Propoxyphene (Darvon®) and acetaminophen (Tylenol®) are widely prescribed analgesic agents. Both can cross the placenta, and propoxyphene can produce serious withdrawal symptoms in newborns. Neither propoxyphene nor acetam inophen is considered a teratogen, yet, three malformed infants who were an tenatally exposed to propoxyphene have previously been reported. We report a fourth case of an infant, with withdrawal symptoms and cranial-facial and digital malformations, born to a woman who used propoxyphene and acetaminophen throughout her pregnancy. We suggest the possibility that the antepartum use of propoxyphene and acetaminophen, in combination, may be teratogenic.