View Full Version : Pregnancy and medications.
11-08-2012, 08:55 PM
I was wondering if anyone had gone through a pregnancy still taking their daily medications and what if any complications they saw from that.
l suspect that I may be pregnant. I know Yay, babies. But aside from a lot of the emotional things I'm feeling. ( am I being selfish bringing a child into this world with my horrible genetics?) I'm really worried about the medication side effects.
I spoke with my doctor and the Lyrica Is believed to cause birth defects. The plaquenil is apparently not a huge risk. Not a huge risk....isnt any risk big enough? It seems that no one has the answers.
I know that we aren't doctors and that I really can't expect many answers from this post but I just wanted to vent about how horrible this is. Without the plaquenil, 2 weeks in and I'm going to flare horribly. Without the Lyrica I could potentially have a seizure if I just stop it, best case scenario I'll feel like a double serving of poo.
I just don't like not knowing what to do. They say if the risk to the mother is greater than the risk to the baby you take your medicine. Well what risk is too much for my potential baby?
Where should I dry the line? Did you draw one at all?
11-14-2012, 10:37 AM
I am looking into the same things. I am looking at having a second child. My first son is a happy, healthy 4 year old wtih no signs of anything auto-immune having been passed to him (yet at least).
I was diagnosed with SLE when he was 2 though so although I was sick when pregnant with him, I wasn't on the meds.
I have met with my GP and a high risk ob-gyn in prep of getting pregnant. So far I am staying on Plaquinil and prednisone. I meet with my rheumy in a couple of weeks to get his opinion too. To be honest Lupus Canada and the American version both say those are both still "safe" in pregnancy. I suspect they are class c drugs. Class A (absolutely does no harm...doesn't really exist, I don't think), Class B is Tylenol where they have done lots and lots of studies and are reasonably sure that they are fine and therefor often given in pregnancy.. Class C is we haven't found any direct link.....Different doctors are going to have different opinions but for a baby to grow well, Mommy also has to be healthy. I have personally discontinued two other drugs already out of my daily doses but am keeping these as I am reasonably convinced they are safe. I will ask my rheumy too and see what he says. The high risk OB/GYN (Who I didn't like) thought I should consider going off all meds...but he also said a lot of other stuff which had me thinking he didn't know that much about lupus....My GP has also talked on the phone to my rheumy since our visit and he didn't tell me to discontinue anything at that time. I think it is a hard decision to make though and would love to know if others were pregnant while on their meds.
11-14-2012, 12:05 PM
We have several members here who have gone through pregnancy and given birth to healthy children.
The standard is that doctors encourage patients to wait until their symptoms are not overly active to get pregnant. Some Lupus medications are safe during pregnancy.
"It is always unwise to take unnecessary medications during pregnancy. However, necessary medications should not be discontinued. Most medications commonly taken by those with SLE are safe to use during pregnancy: prednisone, prednisolone, and probably methylprednisolone (Medrol) do not get through the placenta and are safe for the baby. But others, specifically dexamethasone (Decadrol, Hexadrol) and betamethasone (Celestone) do reach the baby and are used ONLY when it is necessary to treat the baby as well. For example, these medications might be used to help the lungs mature more rapidly if the baby will be premature. A small dose of aspirin is safe. Most physicians now hold that azathioprine (Imuran) and hydroxychloroquine (Plaquenil) do not harm babies, but the final word is not yet in on these. Cyclophosphamide (Cytoxan) and methotrexate are definitely harmful if taken during pregnancy." Lupus Foundation of America
I hope that this has been helpful to you :-)
Peace and Blessings
11-20-2012, 11:38 AM
I personally am feeling better and better and hoping to come completely off prednisone...not sure what to do about plaquinil but I will ask my rheumy when I see him next. So far the other docs tell me to stay on it for now.
the wingless one
11-25-2012, 02:49 PM
I'm currently a little over 28 weeks pregnant for the first time and as far as meds go, my doctors (rheumy, nephro, OB and MFM) have all said they are very comfortable with the use of prednisone during pregnancy. Particularly in small doses they said the potential harm to the baby is low (low incidence of cleft palate I believe). I've been on 5mg through the entire pregnancy so far and the plan is to stay on it.
As for plaquenil, I'm not taking it but have been told by my team of doctors that it is also considered safe to use in pregnancy. In fact, they briefly considered putting me on it but I wasn't using it before I got pregnant and was hoping to reduce my meds not increase them while pregnant.
Before getting pregnant I was also on a couple blood pressure meds and they wanted to switch me to one that is considered pregnancy safe (one that they give to pregnant ladies who have pregnancy induced hypertension) but my bp's were so well controlled that I decided just to ditch them altogether and since my bp's stayed low my nephro was perfectly fine with that. He said if I start to get higher bp's at any point during the pg they would just put me on the med they consider safe to use.
The biggest challenge medication wise is that since I was diagnosed I was always on Cellcept which is a Class D drug and associated with a high chance of birth defects (I've read mainly related to the baby's hearing). I had tried to wean off Cellcept altogether a couple years earlier so we could start trying and ended up with a terrible flare so this time my doctors had me transition to Imuran which is a Class C drug but has a long history of being used in pregnant kidney disease/transplant patients. From what I've read the baby lacks a certain liver enzyme that breaks down this drug so even though it crosses the placenta it's not believed to actually be processed by the baby which is why they feel comfortable using it in cases like mine. I would definitely prefer it if I could be med free for this pregnancy but after a lot of discussion with my team, I've come to peace with the fact that I've cut down my meds as much as possible and what I'm still on presents a low risk to my baby.
I've learned through this process how important it is to work with your doctors before you get pregnant if possible so you can work through all these concerns and figure out the best course of action for your pregnancy. I totally get the frustration of having to have all these extra worries and thoughts about things that most pregnant women will never have to think about and if anyone ever wants to email me to vent about it, I'm totally open to that!
Other things to think about before getting pregnant, I have slightly elevated ssa's and ssb's and because of that I've had bi-monthly ultrasounds starting at week 18 that will continue to week 32 to check the baby's heart and make sure it's developing properly. I also had a fetal ECG at 22 weeks. I've seen one of my four docs or had an ultrasound basically every week for this entire pregnancy starting at 4 weeks! It's a much more "intense" pregnancy, filled with a lot more worries than my other "normal" pregnant friends have had to deal with but if my baby and I come out of this healthy it will be 100% worth it. And let's be honest, having so many ultrasounds is one of the few perks of having lupus and being labeled high risk :) I have so many amazing 4D videos of my baby already!