Monday, November 21, 2011

Pregnancy Meds

Disclaimer: I am in no way giving medical advice. I am not a medical doctor and have no medical knowledge other than what my doctors have told me. This is the interpretation of what I believe they told me and am not giving advice. Always talk to your own doctors before changing any of your medicines and always consult with a doc before getting pregnant with CFNow that nobody will sue me on with my docs opinions of CF meds and pregnancy.

I know as cysters wanting to have babies our biggest question is what meds are safe during pregnancy, which meds can we stay on, and how will we survive without some of the meds!?! I am going to share with you the opinions of both my high risk OB and my CF doc. They had slightly different opinions  which makes it a little confusing.

Prior to pregnancy I went to a high risk OB who looked over all my meds. My med list is as follows:
  1. Singulair (year round)
  2. Albuterol (2x/day via neb)
  3. Advair 500/50 (2x/day)
  4. Hypertonic Saline (2x/day)
  5. Pulmozyme (1x/day) I used to do 2, but I cut back recently
  6. Cayston (3x/day month on/month off)
  7. Azithromax (1x/day)
  8. Rhinoquart Aqua (2x/day)
  9. Enzymes (not a med, but whatever)
My high risk OB said all of my meds are fine to take during pregnancy. The Albuterol and Advair have the highest risk, but said she all her asthmatic patients are on them and it is more important for baby to get enough oxygen so she said it wasn't a problem. She said everything else was fine and that some were more that fine! HTS = salt water= perfectly safe. Enzymes= perfectly safe. 

Fast forward to my first CF clinic while pregnant. My CF doc told me that although the high risk OB said everything was fine, he is slightly more conservative. He told me to stop Azithromax for the 1st trimester because he didn't see it having an immediate effect on my lungs. He said only use Singulair when needed, same with the nose spray. He also lowered my Advair to 250/50. Everything else was fine in his opinion.

Huh. This left me in a predicament. Which doc do I follow? I want to protect my little baby, but I am also afraid of getting sick and needing IVs which would be much more powerful meds than what I take now. I figured that the High risk OB has the baby's interest in mind and would not allow me to take something that they knew would be too dangerous (even though there are always risks, just some meds have higher risks than others). The CF doc has my interest in mind so if he made the changes and had my best interest in mind then I could listen to him and should still be healthy.  For 3 weeks I stopped the allergy pills (but I usually get November allergies), I stopped Azithromax, and switched Advair with the lower dose prescription. This is what happened:

My allergies went crazy! I was so stuffy for 2 weeks that I could barely breath out of my nose, had post nasal drip which led to a morning cough and a sore throat. I was worried the post nasal drip and excessive mucus would effect my lungs. I decided to start the allergy pills again and the symptoms immediately disappeared. I figure after November I will try to get off them again because November and the spring are when my allergies are the worst. I feel okay with the lower dose Advair and will wait until my next clinic to see if my numbers are still doing okay. If they are I will stay on the low dose. Stopping Azithromax hasn't been a problem and I think I will wait until the baby is born to start again.

It is such a fine line between protecting your baby's exposure to meds in pregnancy and keeping yourself healthy enough to have a healthy baby. I knew parenting would be hard, but with CF the hard decisions start immediately after conception! 

Although I am not on any of these meds I was told that Tobi is usually avoided during pregnancy and that meds like Cipro and Levaquin are not safe. There is a window of opportunity that my high risk OB said Bactrim is safe, but other times in pregnancy that it is considered dangerous. My doctor said that in the case of a flare up there are some safe IV meds. My high risk OB said that Prednisone can be used, but my CF doc refuses to allow me to ever go on Prednisone (pregnant or not). I know it is a ton of info, but I hope that it gives you a little insight as to what you may or may not be able to take during pregnancy.


  1. Thank you so much for sharing. I'm so sorry that you had all the allergy symptoms, but I'm glad that you're feeling better now! I agree with you that it is such a fine line between the baby's health and your health.

  2. Thanks Inhaling Hope for sharing all this info. I just had this talk with my doctor two weeks ago and sounds pretty much the same as your CF doc. Now I am just looking forward to working on baby making :)

  3. Megan- I knew I would probably get symptoms because November is a bad allergy month for me, but thought I would try to go without. Oh well. But breathing much better these days :)

    JWags- Glad your doc and my doc seem similar. It is nice to get a "free second opinion" from another CF doc. The baby making is the fun part :)

  4. I would talk to your doctor about switching from Advair to Symbicort inhaler. That's what I use, and when I talked to my doctor and pharmacist about it they said that is actuallly what they switch their pregnant CF patients to! So I got the impression that they considered it the "safest" inhaled steroid for pregnancy.

  5. Thanks for the suggestion Cindy! My understanding was that Advair and Symbicort are both class C pregnancy drugs. Because Advair has worked very well for me in the past the doc decided to keep me on it rather than switch to another asthma med.

    However, I am seeing a new high risk OB (insurance reasons) so I will be sure to ask her opinion next Friday because of course I want to be on the safest meds possible. I will keep you updated. Thanks!