Question:
Has anyone received any advice on taking allergy medication while
pregnant? I am specifically interested in advice regarding prescription
allergy medication like the decongestant "guaifed" (pseudoephedrine) and
the nasal spray "beclomethasone" (nasal corticosteroid).
Answer:
Before you talk to your allergist or ob/gyn about what's safe, you'll feel
better if you do a bit of reading beforehand. The only "popular" pregnancy
book I've ever found that explained teratogenicity and ranked allergy
medications is a book by Shapiro...don't have the title. One could find original journal articles about specific new antihistamines
and decongestants. I highly recommend doing your own research at a library,
devote a Saturday afternoon to it. Are there med schools or nursing schools
near where you live? But with newer drugs, don't expect to find a sweeping
endorsement of its safety for pregnant/nursing women.
I should say that I am allergic to cats, dust mites, and pollen. I have no
cats or upholstery (Try it sometime! It's REALLY hard to do without the
upholstery...). I took allergy shots for over a year before getting pregnant
because I didn't want to have to do any drugs at all. Sure enough, I got
pregnant, didn't take any drugs at all, developed a terrible allergic reaction
to god-knows-what in the middle of winter, which turned into a sinus infection,
and I miscarried. I'll never know how much the infection and the miscarriage
were related, maybe NOT AT ALL (my health insurance doesn't cover "why"), but
I am bound and determined not to get so sick in my current pregnancy.
I considered the risk I was willing to take for us, and made a list of
antihistamines with teratogenicity level B. There are none at level A.
When I talked to my allergist and asked what was safe, he made his disclaimers
then said "Benadryl". I said "How about X?" and he said "That's fine too." When
I talked to my ob/gyn, she said "We recommend Sudafed". I said "I'm taking Y"
and she said "That's fine too." Neither doctor asked me anything about dosage.
Obviously I'm trying to minimize how much I take and how often.
It was really important for me to find out my own alternatives to talk about
with my doctors. At least I got the benefit of their saying "That's fine too."
We'll see what happens in February!
I was taking a prescription allergy med but when we
(hubby & I) went to the doctor for a "preconception
consultation" she said I should really get off of them,
especially if they are sustained released and suggested
sudafed and benedryl
We're lucky enough in Toronto to have a resource called Mother Risk
through the Hospital for Sick Children. You can basically call
them up, free of charge, and find out what is safe and what isn't.
I have accute allergies, so, of course, I asked about allergy
medication. Reactine is safe in the recommended dosage. I take
half a pill and, if it doesn't work, I take the other half about
an hour later.
I don't take it every day (although Mother Risk said I could),
just when I need it.
I have had a prescription for beclomethasone-based nasal spray (Beconase
or Vancenase brands) for some time. I have not been able to identify any
specific allergens through testing, so shots were not a viable option.
When I began trying to get pregnant, I stopped taking any kinds of
medication. By week 8 of my pregnancy, I had a full-blown sinus
infection and, after consultation with my OB and internist, I took a
course of antibioitics. To avoid repeating this pattern, we agreed that
the best option would be go back to using the nasal spray. The rationale
included these factors: (a) the Physician's Desk Reference (PDR) info
basically says this type of corticosteroid applied as a nasal spray has
not been specifically tested on pregnant women, so it gets (I think) a
"C" rating because of the lack of testing. (b) in certain
medical conditions, pregnant women are prescribed oral steroids, which
would result in much higher levels blood levels of the steroid than the
nasal spray, and though this is not routine, it can be done without harm
to the fetus. (c) one of the OBs mentioned that the nasal steroid is very
similar to inhalant medications that are given to premature infants with
underdeveloped lungs, to assist with breathing. (d) For me, the tradeoff
seemed to be an unknown/small risk vs. the almost sure repeat of an
infection and systemic antibiotics
