Colleen wrote:
I have just become pregnant and have been using Advair for
the last
year. Since the last posting to this the kids.pregnancy
and
support.asthma groups in December 2003, has anyone else
gained
first-hand experience or solid information regarding the
use of Advair
either before or during pregnancy?

There is not much data to support a decision. There have
been several small studies specifically looking at
salmeterol in pregnancy and no evidence of birth defects has
been noted. There also has been no concerns raised by
routine surveilance of women taking the drug while pregnant.

There is absolutely no data in breast feeding. Because of
this many experts recommend against breastfeeding while
using it. However, when you consider that albuterol is
considered safe to give in oral form to infants (read: high
serum concentrations) and that the serum concentrations of
salmeterol in patients using it are extremly low (hence
probably also low in breast milk - but known for certain) it
is hard to imagine that significant harm is likely.

The common advice for inhaled steroids is to stay on them
for both pregnancy and breast feeding. Of course, if the
dose of medications can be lowered it should be,
pregnant/breastfeeding or not. So in the end one would have
to weigh the proven benefits of breast feeding to the baby
and the presumed benefit of salmeterol to the mother (if
you do not presume she needs it then she should stop it)
against the unlikely but unknown risk of the salmeterol to
the baby. It is completely a judgment call.

--
CBI, MD