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Which of the following is NOT considered a Category X drug?

  1. Misoprostol (Cytotec)

  2. Isotretinoin (Accutane)

  3. Finasteride (Proscar)

  4. Meperidine (Demerol)

The correct answer is: Meperidine (Demerol)

Category X drugs are those that have been shown to cause fetal abnormalities when administered to a pregnant person and are contraindicated in pregnancy. Misoprostol, isotretinoin, and finasteride are all classified as Category X due to their potential to cause significant harm to a developing fetus. For instance, misoprostol is used for medical abortions and can lead to uterine contractions that terminate pregnancy. Isotretinoin is known to cause severe birth defects and should never be used during pregnancy. Finasteride can affect the male fetus, leading to abnormalities in sex organ development. Meperidine, while it can have risks associated with its use in pregnancy, is not categorized as a Category X drug. It is an opioid analgesic often used during labor and delivery, indicating that it may be used under certain circumstances during pregnancy. Therefore, it does not fit into the Category X classification, making it the correct answer as the drug that is NOT considered a Category X drug. Understanding these drug classifications is crucial for safe prescribing practices, especially in populations where pregnancy is a consideration.