Is Claritin Safe To Take While Pregnant – Although there are no randomized controlled trials guiding the use of over-the-counter medications during pregnancy, women often use them for skin, allergy, respiratory, and gastrointestinal conditions in addition to general analgesia. All physicians who care for women of reproductive age should be familiar with the indications, risks, and benefits of over-the-counter medications in pregnancy. Given the limited data on the variety of over-the-counter medications available, clinicians should inform pregnant women of the potential risks, and it is useful to discuss all over-the-counter medications that the patient is taking at the preconception visit and of all the others. routine visits. Table 1 lists online resources for more information on the use of over-the-counter medications during pregnancy.
Acetaminophen alone does not increase fetal risk in any trimester and is considered safe for use in pregnancy.
Is Claritin Safe To Take While Pregnant
Taking NSAIDs during pregnancy has potential risks. The risk-benefit ratio is best determined in consultation with a doctor.
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Http://www.cdc.gov/pregnancy/meds (patient information sheets; link to LacMed, a database of medications that can be used while 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 continued criticism of the confusing and simplistic nature of this system, the FDA proposed a new labeling rule in 2011 to provide more detailed safety data on use in pregnancy and, subsequently, improve clinical decision-making. .
The new rule divides the information into pregnancy and lactation categories, each with subcategories summarizing risk, clinical considerations, and data. Currently there is a five letter system and a new system.
Obstetrics And Gynecology, Appleton Wi & Fox Valley
Controlled studies in pregnant women have shown no risk to the fetus in the first trimester, there is no evidence of risk in the following trimesters, and the possibility of harm to the fetus seems remote.
Either animal reproduction studies have shown no risk to the fetus, but there are no controlled studies in pregnant women, or animal reproduction studies have shown an adverse effect (besides reduced fertility) that has not been confirmed in controlled studies in women in the first. trimester (and there is no evidence of risk in subsequent trimesters).
Either animal studies have revealed adverse effects on the fetus (teratogenic or embryocidal or others) and there are no controlled studies in women, or no studies in women and animals are available. Medications should only be given if the potential benefit justifies the potential risk to the fetus.
There is positive evidence of risk to the human fetus, but the benefits of use in pregnant women may be acceptable despite this risk (for example, if the drug is needed in a life-threatening situation or for an illness serious for which they cannot use safer drugs. 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 or may be pregnant.
Over-the-counter drugs that are not available by prescription often do not receive a safety evaluation, and the FDA’s website is often not updated after the product is initially approved. Many websites and databases with conflicting data make counseling women difficult. A reasonable approach is to use the lowest dose for the shortest possible time and try to avoid taking the medication during the first trimester.
Studies have always shown no significant risk of fetal malformations with first-generation antihistamines, and these agents are considered safe.
The second-generation antihistamines loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra) do not appear to increase the overall fetal risk. Four studies (n = 1,290) did not find a significant risk for the fetus with cetirizine.
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A slightly higher incidence of hypospadias with loratadine was shown 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 pregnancy. 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 on the safety of topical antihistamines in pregnancy are limited to a single study of the ophthalmic drug pheniramine, which is included in many OTC combinations with naphazoline. No significant malformation was observed in 831 women who took the drug in the first trimester.
There are no data for other topical antihistamines, such as those in anti-itch creams; however, significant risk to the fetus is unlikely due to insufficient systemic absorption. Table 3 summarizes the safety of antihistamines in pregnancy.
Medicine During Pregnancy: Which Ones Are Really Safe?
Buy over 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 a stuffy nose caused by an upper respiratory infection, allergic rhinitis or the common phenomenon known as the pregnancy cold.
The safety of oral phenylephrine in pregnancy has not been established. Data, now about ten years old (n = 2,730), show an increased risk of congenital malformations (relative risk = 0.6 to 1.2) and malformations of the eye, ear and small limbs (ris relative = 2.7) with the use of phenylephrine during pregnancy.
Pseudoephedrine was previously considered of low risk in pregnancy based on older cohort studies (n = 1,724) that did not show significant teratogenicity.
Can Breastfeeding Women Take Claritin?
However, its safety has been questioned after recent case-control studies observed 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. The risk of ventricular septal defects or limb malformations has been observed with decongestants but not proven.
Two studies (n = 5,400) show a reduced risk of premature birth, low birth weight and premature birth in women who used various oral decongestants during pregnancy.
There are only a few studies on the safety of topical decongestants (nasal and ophthalmic), none of which show an increased risk for the fetus.
Over The Counter Medications In Pregnancy
In general, the available evidence suggests that decongestants (and combination products) should be used sparingly in pregnancy, especially in the first trimester; however, more study is needed. Saline nasal sprays and adhesive nasal strips are safe non-prescription alternatives to treat nasal congestion. Table 3 summarizes the safety of decongestants in pregnancy.
Few studies have studied the safety of using cough medicines during pregnancy. The expectorant guaifenesin has been 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 if the potential benefits do not outweigh the risks.
Dextromethorphan is a non-narcotic antitussive isomer of codeine that has been found to be teratogenic in chick embryos. However, an epidemiological study in humans and a smaller controlled trial did not show an increased risk of congenital malformations.
There are no prospective randomized controlled trials to determine the safety of acetaminophen, ibuprofen, or naproxen use in pregnancy. At least two-thirds of women use acetaminophen during pregnancy, and half of these women use it in the first trimester.
Common Non Prescription Medications In Pregnancy
Animal studies suggest that acetaminophen can reduce the diameter of the ductus arteriosus, but experimental conditions prevent 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 prospective population-based study (n = 88, 142) showed that the risk ratio for birth defects was 1.01 in 26,424 women who used acetaminophen in the first trimester.
In a subsequent analysis, the hazard ratio for cryptorchidism was 1.38, but only with more than four weeks of regular use of acetaminophen in the first and second trimester.
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Other more recent cohort studies have addressed the possible association 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, did not find an increased risk of birth defects with the use of acetaminophen. Women who take acetaminophen specifically for febrile illness have a reduced risk of various cranial and facial defects and gastroschisis; Acetaminophen can be protective 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. At six weeks of age, the newborns have no signs of liver or kidney disease.
Many studies study acetaminophen in combination with cold medications, rather than as a single agent, making causality difficult. The available information on the use of acetaminophen does not demonstrate fetal risks; therefore, as a stand-alone product, it is safe for 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 widely studied as a treatment for many
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