Which of the following medications can cause birth defects to a developing fetus?

Dutasteride, finasteride, bosentan, and ambrisentan are medications known for their potential teratogenic effects, which means they can cause birth defects in a developing fetus.

Dutasteride and finasteride, specifically, are 5-alpha reductase inhibitors that are primarily used to treat benign prostatic hyperplasia and male pattern baldness. These drugs can interfere with the normal development of male genitalia and other fetal structures when taken during pregnancy. Bosentan and ambrisentan are endothelin receptor antagonists used for pulmonary arterial hypertension; they can also have harmful effects on fetal development.

In contrast, the other medication groups listed do not share the same high risk for teratogenic effects. While nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin can pose risks during pregnancy, particularly in the third trimester, they do not have the same level of established risk for causing birth defects as the drugs in the correct answer. Likewise, antibiotics such as amoxicillin, ciprofloxacin, and azithromycin while requiring caution in pregnancy, are not primarily known to cause birth defects. Prednisone, hydrocodone, and tramadol also require careful consideration due to their effects on pregnancy