Women

Your Pregnancy After 35 : Your Current Medical Condition and Medications (part 2) - Prescription Medication Use during Pregnancy

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Prescription Medication Use during Pregnancy

Some prescription medications are more common than others; the discussion below includes common substances many women must take during pregnancy. Please note: This information does not take the place of talking with your healthcare provider.

Allergy Medication

If you use allergy medication, don’t assume it’s safe to take during pregnancy. Some types of allergy medication may not be advised, such as avoiding Sudafed during the first trimester. Many are combinations of several medicines you should be careful about using during pregnancy. Ask your doctor about your medicine, whether prescription or nonprescription, including nasal sprays.

Medications that are OK to use during pregnancy include antihistamines and decongestants. Claritin and Zyrtec are believed to be safe during pregnancy. Ask your doctor which brands are safest for you to use if your allergy problems interfere with your normal lifestyle. Under your doctor’s supervision, you can continue taking allergy shots, but don’t start them during pregnancy.

My healthcare provider has prescribed some medications that I take regularly. I’m not sure if I can take them during pregnancy. Should I stop taking them now or wait to talk about it at my first prenatal visit next week?

Call your healthcare provider’s office and talk to the nurse. Some medications, such as thyroid medicine, are very important during pregnancy. Stopping them could cause problems.

Antidepressants

If you’re being treated for depression when you become pregnant, it’s important to continue treatment. Treating depression during pregnancy is as important as treating any other problem.

If you take antidepressants, don’t stop unless advised to do so by your healthcare provider. There is a higher risk in abruptly stopping antidepressants. In addition, studies show that up to 70% of women who take antidepressants during pregnancy relapse into depression if they stop their medication.

Depression can be difficult to manage without using drug therapy. Medication you take is probably necessary for your good health and the good health of your baby. Left untreated, depression can contribute to premature birth, IUGR, low birthweight, stillbirth and low Apgar scores in baby after birth.

Stopping your medication can raise your stress hormones, which increases your risks of complications and problems. The risks to you and your baby may be greater than your risk of taking antidepressants.

There may be a very small increased risk of birth defects with some medications taken during the first trimester. You may benefit by switching to an antidepressant that has been shown to be relatively safe during pregnancy, including fluoxetine (Prozac), citalopram and escitalopram (Lexapro). Pregnancy may affect your body’s ability to metabolize lithium. Talk to your healthcare provider as soon as you confirm your pregnancy.

If you take an SSRI, your dose may need to be increased during the third trimester to maintain your normal mood. There may be a small increased risk of persistent pulmonary hypertension in babies born to women who take SSRI antidepressants after 20 weeks of pregnancy.

There is continued concern about the safety of Paxil during pregnancy. Research suggests exposure to the drug in the first trimester of pregnancy may be associated with an increased risk of heart birth defects. If you’re pregnant, do not stop taking your antidepressant medication without first consulting your healthcare provider.

Hormone-Replacement Therapy (HRT)

Today, the average age of menopause is 51. At menopause, you stop ovulating (necessary for conception) and stop having periods. The change is usually gradual, occurring over years, but it may be sudden. If you still have menstrual periods, you can probably still get pregnant.

In the past, women didn’t start taking hormones (hormone-replacement therapy or HRT) until their periods stopped and they were certain of menopause. Today, more women start HRT at younger ages.

If you become pregnant while taking HRT, tell your healthcare provider immediately. There are minor risks associated with pregnancy if you have been taking female hormones.

Incontinence Medications

Incontinence may be more of a problem for women over 35. Do you take medicine to treat an overactive bladder?

The problem of overactive bladder occurs when the brain tells nerves in the bladder there’s a need to urinate even if the bladder isn’t full. Symptoms include going to the bathroom more than 12 times a day, getting up two or more times at night and a sudden, immediate need to go. You may also leak urine.

Medicines to treat the problem work by relaxing muscles. Some commonly prescribed medications include Ditropan, Detrol LA, Sanctura and Enablex. If you take any of these medications, you need to talk to your healthcare provider before pregnancy or as soon as you find out you’re pregnant. He or she can advise you about continued use of your medicine during pregnancy.

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