Designing Pregnancy Centered Medications: Drugs Which Do Not Cross the Human Placenta

This review considers and evaluates the role of placental transporters (multidrug resistance proteins, P-glycoprotein and breast cancer resistance protein) in the uptake and efflux of drugs used in pregnancy. The effect of placental transporters in effluxing drugs such as glyburide and numerous protease inhibitors from the fetal circulation offers the potential to manipulate the passage of drugs across the placenta. The discovery of the interactions of these drugs with placental transporters may provide a novel framework for future drug development in which medications can be designed to control the degree of fetal exposure and thus prevent fetal risk.