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Pregnancy and meds, which ones are the better choices

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Crohn's Disease
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Posted 12/21/2008 1:02 AM (GMT 0)
Hello everyone :)

I'm wondering if anyone has any idea of what drugs that are the most safe while pregnant? 

Planning to get pregnant around June or July and need some ideas to talk to the doc about. I was pretty much drug free for my first pregnancy and that wasnt so good :)

 

Posted 12/21/2008 2:03 AM (GMT 0)
The mother's health is most important. Most GIs will tell you that the drugs you should be on while pregnant, are whatever drugs it takes to keep you in remission when you're not pregnant.

The only drug my GI considers off-limits during pregnancy is methotrexate.
Posted 12/21/2008 4:22 AM (GMT 0)
Ah...that question...
I've heard about a million different answers just from the few people in my GI's office. Some wanted me on humira, some wanted me off medicine, some wanted etc. etc. etc.
Definitely speak with your doctor and decide what's best for you based on past experiences with medications. There has been some research done on teratogenic effects of various meds so keep those in mind.

Your health and that of your child's are definitely the most important thing though.
Posted 12/21/2008 6:48 AM (GMT 0)
It's not just your doctor, but your pharmacist. Docs aren't always up on the latest and greatest when it comes to side-effects; that's the pharm's job.

You can do your own research as well. Look for the specific "Pregnancy Category" into which drug falls:

http://en.wikipedia.org/wiki/Pregnancy_category

Category A is best, B is second best, C is iffy, D is for use only in dire cases, and X means stuff like thalidomide, where the kids will be born with flippers (amelia) or worse. So, for example, you can construct a Google search like this:

Lialda "pregnancy category"

And the search results include stuff like how Lialda (mesalamine) is a Pregnancy Category B drug meaning animal studies show it is safe in lab animals, but has not been tested in pregnant humans. The same search for azathioprine (Imuran), on the other hand, shows it is a Pregnancy Category D drug.

Don't expect to see any class "A" meds for Crohn's. Most will be B, a few will be C (like prednisone) or D.
Posted 12/21/2008 7:19 AM (GMT 0)
Many docs will say you are safe in Imuran. I suggest you speak with a high-risk ob/perinatologist about these drugs because a regular ob/gyn is likely to tell you NO drugs are safe while pregnant. A high-risk ob/peri/MFM are a little more on the liberal side and research into studies.

Before this recent flare, I delved into the possibility of Imuran AND Remicade while pregnant (did Remi the first pregnancy and all was fine with it). My MFM was fine with it, my GI was fine with it, but my RE (Reproductive Endocrinologist was NOT okay with it).

Everyone's opinions will differ, but there are MANY pregnancies on Imuran, Remicade, etc that have been successful with no effects. My daughter is a VERY active toddler. The ONLY effect I ever remember while pregnant with my girls was when they gave me benadryl to pre-treat (they ok'd this too), it made Addy quite hyper! But, she has tested fine and I might get some immunity testing on her in the future just for my own comfort sake, but the studies all show all is well...

Just remember that a HEALTHY mom = a HEALTHY baby. You should be watched carefully for growth restriction (because we don't always absorb all our nutrients) and pre-term labor (my pre-term labor felt JUST like a Crohn's attack..I delivered less then 4 hours later!). This should only requre extra ultrasounds and I really recommend a perinatalogist from the get-go. Just let them be the sole source of your care. Or at the very least have them work with your ob.

GL! Email me with any other questions...
Posted 12/23/2008 1:12 AM (GMT 0)
I was in remission when I got preg and stayed on just pentasa the whole way through. No problems at all. Just talk to some docs you trust to help you make your decision. As for preterm (which is a risk if CD is not in control), that wasn't an issue either. My girl went the full 42 weeks (2 weeks past due date) and had to be induced!
Posted 1/2/2009 5:59 AM (GMT 0)
it's such a touchy subject it seems.  there are so many different opinions, Dr to Dr.  but like others say, a healthy mom = a healthy baby.  my dr. believes that it's more important for me to stay on my current meds than to risk getting sick while pregnant (btw, i'm not pregnant yet).  i had my first baby on 6MP.  i quit taking 6MP in order to nurse and when my baby was 8 months old i flared up and then again when he was 13 months old.  so that's when i started on the remicade. 

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