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Asthma Medicine and Effects on Pregnancy |
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What asthma drugs are safe to use during pregnancy? If you have asthma and are considering becoming pregnant, shouldn't you know the answer?
Asthma is a chronic lung condition that is characterized by a difficulty in breathing. People with asthma have extra sensitive and/or hyper-responsive airways. Usually during an asthma attack, the airways become irritated and react by narrowing and constructing, causing increased resistance to airflow, and obstructing the flow of air to and from the lungs.
Here is short overview of the main medicines used in asthma.
Preventers
* Cromoglycate (Intal, Lomudal, Cromolyn etc.) and Nedocromil (Tilade, Tilarin, etc.)
These asthma preventers are not steroids. Their safety record is very good. No harmful effects on fetuses have been recorded though they have been in widespread use since 1968. They are excellent medicines for people in whom they prove sufficient.
* Steroid Inhalers based on Becotide (beclomethasone dipropionate, now a common drug under other names, too) and Pulmicort (budesonide).
These steroids have been used for decades and on a large scale, including a vast amount of use by women who were pregnant. There have been no evidence of harmful effects. In fact, in small doses these steroids are thought to offer additional protection from lack of oxygen to the baby.
* Theophylline (many trade names)
Unlike inhaled drugs, theophylline is taken orally, usually as tablets, and, unlike the inhaled steroids, it is not broken down slowly by the liver. Despite its widespread use, no harmful effects on fetuses have been described.
Relievers (bronchodilators)
* Salbutamol (Ventolin, many other brand names)
Salbutamol has been widely use since the 1960s. When given in large doses by infusion or injection near the baby's due date, it can delay birth, and in fact it has been used for this purpose. In doses in which it is inhaled for asthma it is harmless throughout pregnancy.
* Terbutaline (Bricanyl) is very similar to salbutamol. All the conclusions for salbutamol apply.
Long-Acting Relievers
These work in the same way as the ordinary relievers such as salbutamol and terbutaline, with the difference that they stick to the cells in the body on which they act, and work for much longer. The side-effects are the same, namely increased pulse rate, tremor, and palpitations (being able to feel your heart beating). They were introduced much more recently, but no hazards in pregnancy are known.
* Eformoterol (Foradil)
No harmful effects during pregnancy are known.
* Salmeterol xinafoate (Serevent)
No harmful effects during pregnancy are known.
Steroid Tablets or Injections
You should only need these for emergencies, such as a sudden bad asthma attack, or if your asthma is so bad all the time that you are one of the few people who does need them regularly. If so, your baby would be much worse off than if you did not take them. Such strong steroids do affect the fetus, but current knowledge of the effects seems to be that they are remarkably mild.
Always discuss the use of any treatment or medicine with your doctor, whether you are pregnant or not. Especially consider talking to an asthma specialist if you are using some of the drugs with more serious potential effects on your pregnancy.
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