Medicines and pregnancy:
If you are concerned about taking medications while you are pregnant, the information contained in this brochure may answer some of your questions. When we talk about drugs, it includes:
Medicines prescribed by doctors
Medications purchased over the counter at the pharmacy, such as pain killers, cough and cold medicines, and laxatives and herbal medicines and vitamins (e.g. from a health food store)
Alcohol, cigarettes and illegal drugs
It is important to ask your doctor, pharmacist or health professional whether the prescribed medication is safe for you to take during pregnancy
It is not always possible for women to avoid taking medications during their pregnancy. Some women have conditions such as astham, diabetes, epilepsy and high blood pressure, which need continued treatment. Others may develop or experience morning sickness or heartburn, which may also require treatment.
Your doctor, local pharmacist and The Royal Women's Hospital Drug Information Centre can assist you in making decisions regarding the safety of medications during pregnancy.
Of the most concern are medications taken in the first three months of pregnancy, due to potential interference with the baby's organ development. After this period, the risk is smaller, however all drugs and chemicals should only be taken on the advice of a pharmacist or doctor. Some drugs should also be avoided closeto the time of delivery. Please consult your pharmacist or doctor for further advice.
Treating morning sickness
Uncontrolled nausea and vomiting can be very inconvenient and potentially hazardous for both mother and her unborn baby. Your doctor or obsttrician may prescribe one or more preparations to control this condition.
The most commonly prescribed drugs are pyridoxine (Vitamin B6), metoclopramide and antihistamines (e.g. promethazine)
Despite media publicity questioning the safety of antihistamines during pregnancy, these drugs have been widely used by many pregnant women to treat their morning sickness. They have not been associated with causing birth defects or other harmful effects in the unborn baby. Antihistamines are also used to treat allergic conditions such as hayfever and astha. It is obviously important not to 'double up' on the use of antihistamines for treating allergies as well as morning sickness.
Ginger tablets at a dose of 400mg three times a day and products that contain Zingiber officnale are also safe to take for morning sickness.
Laxative preperations
Laxatives that soften (e.g. docusate) or add bulk to the bowel contents (e.g psyllium) are safe to use in pregnancy. However, it is always better to try adding fibre to the diet or consulting a dietician before taking laxatives. If you do require a laxative, your doctor or pharmacist will advice you on the most suitable preperation to use. Laxatives that are absorbed or have a direct stimulant effect on the bowel (e.g. senna, epsom salts and liquid paraffin emulsions) should be avoided during pregnancy if possible.
Cough and cold medications
During pregnancy, the common cold or fly is best treated by individual symptom rather than with multi-ingrediant products. Use appropriate pain killers from aches and pains and a simple cough suppressant (e.g. pholcodine linctus or choline theophyllinate for a dry cough) or expectorant (e.g. guaiphenesin for a chesty cough). Try inhalations (e.g. eucalyptus and menthol oil in hot water) or a nasal spray for nasal congestion. These products are considered safer than those containing pseudeophedrine or combination products.
Pain killers or analgesics
Paracetemol alone or in combination with codeine may be used safely during pregnancy to treat headache, toothache, muscular pains, or to reduce fever.
Aspirin is an ingrediant of many pain killer products. It may be harmful to the foetus if taken in large amounts during pregnancy without medical supervision. Onther anti-inflammatory products (e.g. ibuprofen, naproxen, diclofenax and ketoprofen) should only be taken under medical supervision. If taken during the last stage or pregnancy, or during the week before delivery, labour may be delayed and the infant may be affected.
Antibiotics and anti-infective drugs:
Commonly prescribed antibiotics such as the penicillins (e.g. amoxycillin) erythomycin and cephalosporins (e.g. cephalexin or cefactor) are all safe to take during pregnancy. If you are more than three months pegnant, the tetracycline group of antibiotics (e.g. doxycycline) should be avoided as they may interfere with the development of one and teeth and may result in the baby having permanetly stained teeth.
If you are in the later stages of pregnancy, you need to avoid the sulphonamide antibiotics. These drugs can pass across the placenta, and reamin in the infant for some time after birth as their liver and kidneys cannot efficently break them down. Throughout pregnancy, the quinolone antibiotics (e.g. norfloxacin and ciproflaxcin) should be avoided. It is safe to use all the anti thrush creams and pessaries avaiable, even if the cream or pessaries need to be inserted into the vagina using an applicator (e.g. clotrimazole, miconazole and nystatin).
Sedatives, tranquillizers and hypnotic drugs
Diazepam, oxazepan, nitrazepam and temazepam are used to treat anxiety, depression and to aid sleep. These agents have not been shown to cause abnormalities in the unborn baby. However, if they are taken regularly in high doses later in pregnancy, they can affect the newborn baby's muscles and nerves. If you need these type of drugs while you are pregnant, make sure that your obstetrician knows you are taking them.
Weight loss preperations
These preperations should not be used during pregnancy, unless suggested by your doctor and approved by your obstetrician.
Isotretinoin and tretinoin
Vitamin A derivatives (e.g. acitretin, isotretnoin and tetinoin) are prescribed for treating severe acne or psoriais. These drugs should not be used during pregnancy because they have been associated with birth defects. Pregnancy should not be planned immediately after discontinuation of therapy (you need to wait at least two years in the case of acitretin). Consult your doctor immediately if you are pregnant or planning a pregnancy and taking these products.
Minerals, vitamins and herbal preperations
Usually, a well balanced diet consisting of fruits and vegetables will provide sufficent vitamins and minerals for both mother and baby. However, some women become anaemic during pregnancy and their doctor may prescribe iron tablets to help restore an adquate supply of healthy red blood cels. Folic acid should be taken by women contemplating pregnancy for at least one month before conception and for the first three months of pregnancy to help prevent the occurance of neural tube defects (e.g. spina bifida). Thse tablets are avaiable from your local pharmacy andthe recommended dose is 0.5mg daily. Women taking antiepileptic medication or those who have a family history of spina bifida or who have had a previous baby with a neural tube defect should take a daily dose of 5mg.
Many women become quite tired during pregnancy and vitamin supplements containing B-group and little vitamin C may be beneficial. You can contact a dietician or the pharmacy department at the Royal Women's Hospital for further details. Multi vitamin preperations should be avoided in they contain high doses of vitamin A and iodine (or kelp or seaweed) as these ingrediants can harm an unborn baby.
High doses of Vitamin C (more than 1000mg daily) should be avoided since it can lead to a type of vitamin C deficiency in the newborn when the infant is no longer exposed to high levels.
There is a lack of safety data on the use of herbal preperations during pregnancy. It is always best to check with a doctor or pharmacist before taking them.
Socially used 'drugs'
Tobacco - regular nicotine intake restricts the oxygen supply to the developing infant. Babies born to mothers who smoke heavily are often smaller, less well developed and have poorer health than babies born to non smokers. It is best to try to give up smoking while you are pregnant, however if you cannot, ask your doctor for a safer alternative to smoking.
Alcohol - it is well established that regular use of large quantities of alcohol may lead to physical and mental abnormalities, as well as growth retardation in a baby. You should limit your intake of alcoholic beverages to no more than one glass per week.
Caffeine - tea, coffee, and cola should be taken in moderation during pregnancy. A safe amount would be two weak cups of coffee, or four cups of tea, or 1 litre of cola per day.
Illegal drugs and methadone
These include marijuana (cannabis), cocaine, amphetamines, hallucinogens and ecstasy. If you are pregnant are using any of these drugs it is best to seek further information on the effects of these agents from your obstetrician. In the case of heroin (and other narcotics including pethidine and morphine), changing to methadone maintenance therapy is recommended as the safest option in pregnancy rather than stopping abruptly or detoxing. Stopping suddenly can increase the likelihood of miscarriage or premature birth.
Methadone maintenance therapy gives the best chance of a normal pregnancy and healthy baby. Pregnancy is not the time to be coming off a Methadone Program.
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2006-06-07 00:45:51
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answer #4
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answered by Jade 5
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