Which antifungal is typically avoided in pregnancy due to safety concerns?

Fluconazole is typically avoided in pregnancy due to safety concerns. Research has demonstrated that high doses of fluconazole during the first trimester of pregnancy may be associated with an increased risk of congenital malformations, including issues such as craniofacial abnormalities and other developmental anomalies. Given these potential risks, many clinicians opt for alternative antifungal treatments that are considered safer for use during pregnancy.

In contrast, other antifungal agents listed have different risk profiles when it comes to pregnancy. Griseofulvin, while not routinely used during pregnancy, is not as frequently associated with major teratogenic effects as fluconazole. Terbinafine has limited data on its effects in pregnancy, but it is generally only used if the benefits outweigh the risks. Caspofungin is another antifungal that has not shown significant safety concerns during pregnancy, though it is typically reserved for more serious fungal infections.