Can A Pregnant Woman Take Allergy Medicine

Can A Pregnant Woman Take Allergy Medicine – Although there are no randomized controlled trials to guide the use of OTC medications during pregnancy, women often use them for skin, allergic, respiratory, and gastrointestinal disorders in addition to general analgesia. All physicians caring for women of reproductive age should be familiar with the indications, risks, and benefits of OTC medications during pregnancy. Given the limited data on the various OTC medications available, physicians should counsel pregnant women about the potential risks, and it is helpful to discuss any OTC medications the patient is taking during preconception visits and all other routine visits. Table 1 lists online resources for more information on the use of OTC medications during pregnancy.

Acetaminophen as a single agent does not increase fetal risk in any trimester and is considered safe for use in pregnancy.

Can A Pregnant Woman Take Allergy Medicine

The use of NSAIDs during pregnancy carries potential risks. Best to determine the risk-benefit ratio in consultation with a doctor.

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Http:// (patient information sheet; link to LacMed, database of medications that can be used during breastfeeding)

Since 1979, a standard five-letter nomenclature developed by the US Food and Drug Administration (FDA) has been used to assign a pregnancy risk category to prescription and over-the-counter drugs (Table 2).

In response to ongoing criticism of the confusing and simplistic nature of this system, in 2011, the FDA proposed a new labeling rule intended to provide more detailed safety data on use in pregnancy and in turn improve clinical decision making.

The new rule divides information into pregnancy and breastfeeding categories, each with subcategories summarizing risks, clinical considerations, and data. The five-letter system and the new system are now available.

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Controlled studies in pregnant women show no risk to the fetus in the first trimester, no evidence of risk in later trimesters, and the potential for harm to the fetus is small.

Either animal reproduction studies have shown no risk to the fetus, but no controlled studies in pregnant women, or animal reproduction studies have shown an adverse effect (other than reduced fertility) that has not been confirmed in controlled studies in first-trimester women there. (and no evidence of risk in later trimesters).

Either animal studies have revealed adverse effects on the fetus (teratogenic or embryocidal or other) and no controlled studies in women or no studies in women and animals are available. Medicines should be given only if the potential benefit justifies the potential risk to the fetus.

There is positive evidence of fetal risk in humans, but the benefits of use in pregnant women may be acceptable despite the risk (e.g. if the drug is needed in a life-threatening situation or for a serious illness for which the drug is most security cannot be used or are ineffective).

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Animal or human studies have shown fetal abnormalities or there is evidence of fetal risk based on human experience, or both, and the risk of using the drug in pregnant women clearly outweighs any potential benefit. The drug is contraindicated in women who are pregnant or may become pregnant.

OTC drugs that are not available by prescription often do not receive safety evaluations, and the FDA website is often not updated after a product receives initial approval. Many websites and databases with conflicting information make it difficult to counsel women. Using the lowest dose for the shortest possible period and trying to avoid medication during the first trimester is the reasonable approach.

Studies have consistently shown no significant risk of fetal malformations with first-generation antihistamines, and these drugs are considered safe.

The second-generation antihistamines loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) do not appear to increase fetal risk. Four studies (n = 1,290) found no significant risk to the fetus with cetirizine use.

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A slightly higher incidence of hypospadias was reported with loratadine in one study (n = 1,700), but not in others (n = 2, 147).

Fexofenadine has been associated with early pregnancy loss in animal studies, but has not been studied in human pregnancies. Fexofenadine is a metabolite of terfenadine, which was withdrawn from the market in 1998 due to the risk of cardiotoxicity. Studies (n = 2, 195) on the safety of terfenadine in human pregnancy have not shown a significant risk of congenital malformations.

Data regarding the safety of topical antihistamines in pregnancy are limited to a study of the ophthalmic drug pheniramine, which is found in various OTC combinations with naphazoline. No significant malformations were observed in 831 women who used the drug in the first trimester.

There are no data for other topical antihistamines, such as those in anti-itch creams; however, significant fetal risk is unlikely due to lack of systemic absorption. Table 3 summarizes the safety of antihistamines in pregnancy.

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Shopping behind the counter; possible association with gastroschisis, small bowel atresia and hemifacial microsomia; should be avoided in the first trimester

Almost one in four pregnant women seek relief from nasal congestion caused by an upper respiratory infection, allergic rhinitis or the common condition known as pregnancy rhinitis.

The safety of oral phenylephrine in pregnancy has not been established. Data from about ten years ago (n = 2,730) show an increased risk of congenital malformations (relative risk = 0.6 to 1.2) and malformations of the eyes, ears, and lower limbs (relative risk = 2.7) with phenylephrine use. during pregnancy.

Pseudoephedrine was previously considered a low risk in pregnancy based on older cohort studies (n = 1,724) that showed no significant teratogenicity.

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However, its safety has been questioned after recent case-control studies found small associations between pseudoephedrine and birth defects, including gastroschisis, small bowel atresia, and hemifacial microsomia.

Studies are limited by small sample sizes; retrospective analysis; and the potential for confounding factors, such as recall bias. A risk of ventricular damage or limb malformation and decongestion has been observed, but has not been proven.

Two studies (n = 5,400) show a reduced risk of preterm birth, low birth weight, and preterm birth among women using various oral decongestants in pregnancy.

There are only a few studies on the safety of topical (nasal and ophthalmic) decongestants, none of which show an increased risk to the fetus.

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In general, the available evidence suggests that decongestants (and combination formulations) should be used sparingly in pregnancy, especially in the first trimester; however, further studies are needed. Saline nasal sprays and nasal strips are safe OTC alternatives to treat nasal congestion. Table 3 summarizes the safety of decongestants in pregnancy.

Some studies have looked at the safety of using cough medicine during pregnancy. Guaifenesin in expectorants is weakly associated with neural tube defects and inguinal hernias. However, the evidence is not enough to determine its safety in pregnancy. It may be wise to avoid this drug in the first trimester unless the potential benefits outweigh the risks.

Dextromethorphan is a non-narcotic antitussive isomer of codeine that has been found to be teratogenic in chick embryos. However, a human epidemiological study and a smaller controlled study did not show an increased risk of congenital malformations.

There are no randomized controlled trials to determine the safety of acetaminophen, ibuprofen or naproxen in pregnancy. At least two-thirds of women use acetaminophen during pregnancy, and half of these women use it in the first trimester.

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Animal studies suggest that acetaminophen can reduce the diameter of the ductus arteriosus, but experimental conditions preclude reasonable extrapolation to humans.

More recent studies have looked at chronic acetaminophen use during pregnancy and the risk of tetralogy of Fallot, but no definitive link has been made.

A Danish population-based study (n = 88, 142) showed that the hazard ratio for congenital defects was 1.01 for 26,424 women who took acetaminophen in the first trimester.

In a follow-up analysis, the hazard ratio for cryptorchidism was 1.38, but only with more than four weeks of regular acetaminophen use in the first and second trimesters.

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Other more recent cohort studies have looked at the possible relationship between acetaminophen use and attention deficit/hyperactivity disorder and other hyperkinetic disorders.

The National Birth Defects Prevention Study (NBDPS), which analyzed data from 16,110 children in the United States exposed to acetaminophen in utero, found no increased risk of birth defects with acetaminophen use. In women who used acetaminophen specifically for febrile illness, there was a reduced risk of various cranial and facial defects and gastroschisis; Acetaminophen may protect because fever increases the risk of these defects.

A case series of 300 acetaminophen overdoses in pregnant women found no increased risk of birth defects, stillbirth, or miscarriage, regardless of trimester. After six weeks of life, the newborns had no signs of liver or kidney disease.

Many trials looked at acetaminophen in combination with cold medications rather than as a single agent, which makes causality difficult. The available information on the use of acetaminophen does not establish the risk to the fetus; Therefore, as a single agent, it is safe to use during any trimester, especially as a single dose without routine use.

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A meta-analysis of aspirin use in the first trimester did not show an increased risk of congenital anomalies, except for gastroschisis (odds ratio [OR] = 2.37).

Early use of aspirin at the time of conception or in the first weeks of pregnancy does not increase the risk of miscarriage.

Aspirin has been studied extensively as a treatment for many people

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