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pregnancy and asthma (and advair in particular)



 
 
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  #1  
Old December 28th 03, 10:26 PM
Vicky Bilaniuk
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Default pregnancy and asthma (and advair in particular)

OK, I would love to know what you all think of pregnancy and asthma,
and, in particular, advair. When I talked to my doctor about pregnancy,
he never mentioned anything about the advair that I use, but I have
recently been wondering about it. I suffer from mild but persistent
side effects and have decided to go off of it (I've been toying with the
idea of going off of it for a long time, now, but being pregnant is what
finally did it). My asthma is actually not all that bad. I don't
suffer from classic attacks, so IOW, going off of the medication won't
be like welcoming death, or something. ;-) Going off of the drug will
just mean that I'll get a bit more, uh, phlegmy (yeah, TMI, I know).

One thing I worry about, though: I just read that advair is a class C
drug, meaning that effects have been observed on rat fetuses, but there
are insufficient data regarding the effects on human fetuses (i.e. there
have not been enough studies done - and in fact, one page I saw claimed
that there were no studies done regarding this at all, but I don't know
what is true, and it's hard to judge fact from fiction when the official
advair site has nothing on pregnancy at all (or maybe that should tell
me something)). Now, I have already decided to go off of this drug, so
once the medication is out of my system, I won't have to worry. ;-)
However, I'm curious, and I would like to know if anyone has any more
up-to-date info about known possible effects of advair on a fetus.

Thanks!

  #2  
Old December 29th 03, 07:22 AM
CY
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Default pregnancy and asthma (and advair in particular)

This is from Thomas Hales Medications & Mothers Milk (but which also talks
about pg'y):

Advair is a combination of product containing Fluticasone and Salmeterol
(Flovent & Serevent).

That's pretty much all it says re pregnancy unfortunately, but now that you
know the two ingredients you may have better luck googling. I did a quick
google and came up with this from
http://www.medicinenet.com/fluticaso...r/article.htm:

PREGNANCY: Adequate studies of fluticasone or inhaled salmeterol during
pregnancy have not been done. Fluticasone use during pregnancy should be
avoided unless the potential benefit justifies the potential but unknown
risk to the fetus. In some, but not all, pregnant animal models exposure to
very high doses of oral salmeterol has led to offspring with birth defects.
The concentrations of salmeterol in the blood after these very high doses,
however, were much higher than the concentrations observed after inhalation.
Salmeterol inhalation should be used during pregnancy only if the potential
benefit justifies the potential risk to the fetus.

and this from here http://health.yahoo.com/health/drug/500235/precaution:

Pregnancy - The combination of fluticasone and salmeterol has not been
studied in pregnant women. However, studies in animals have shown that the
fluticasone and salmeterol causes problems. Before taking this medicine,
make sure your doctor knows if you are pregnant or plan to become pregnant.

So your decision to stop is probably a wise one.



Sorry I didn't give you a whole lot more than you already knew!


CY

"Vicky Bilaniuk" wrote in message
...
OK, I would love to know what you all think of pregnancy and asthma,
and, in particular, advair. When I talked to my doctor about pregnancy,
he never mentioned anything about the advair that I use, but I have
recently been wondering about it. I suffer from mild but persistent
side effects and have decided to go off of it (I've been toying with the
idea of going off of it for a long time, now, but being pregnant is what
finally did it). My asthma is actually not all that bad. I don't
suffer from classic attacks, so IOW, going off of the medication won't
be like welcoming death, or something. ;-) Going off of the drug will
just mean that I'll get a bit more, uh, phlegmy (yeah, TMI, I know).

One thing I worry about, though: I just read that advair is a class C
drug, meaning that effects have been observed on rat fetuses, but there
are insufficient data regarding the effects on human fetuses (i.e. there
have not been enough studies done - and in fact, one page I saw claimed
that there were no studies done regarding this at all, but I don't know
what is true, and it's hard to judge fact from fiction when the official
advair site has nothing on pregnancy at all (or maybe that should tell
me something)). Now, I have already decided to go off of this drug, so
once the medication is out of my system, I won't have to worry. ;-)
However, I'm curious, and I would like to know if anyone has any more
up-to-date info about known possible effects of advair on a fetus.

Thanks!



  #3  
Old December 29th 03, 09:08 AM
Denise
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Posts: n/a
Default pregnancy and asthma (and advair in particular)


"Vicky Bilaniuk" wrote in message
...
OK, I would love to know what you all think of pregnancy and asthma,
and, in particular, advair.


Advair is prescribed to children with asthma, and for the most part, drugs
that are safe for pediatric use are safe for use in pregnancy. Advair is a
pregnancy risk C because of the lack of studies in pregnant patients.




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  #4  
Old December 29th 03, 02:30 PM
Hillary Israeli
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Default pregnancy and asthma (and advair in particular)

In [email protected],
CY wrote:

*So your decision to stop is probably a wise one.

Only with the ok of the pulmonologist.
About 1/3 of asthmatic women develop WORSE asthma while they are pregnant.

--
hillary israeli vmd http://www.hillary.net
"uber vaccae in quattuor partes divisum est."
not-so-newly minted veterinarian-at-large
  #5  
Old December 29th 03, 05:20 PM
Circe
external usenet poster
 
Posts: n/a
Default pregnancy and asthma (and advair in particular)

Vicky Bilaniuk wrote:
OK, I would love to know what you all think of pregnancy and asthma,
and, in particular, advair. When I talked to my doctor about
pregnancy, he never mentioned anything about the advair that I use,
but I have recently been wondering about it. I suffer from mild but
persistent side effects


Out of curiosity, what side effects? I have been using it for about 6 months
and haven't had any problems at all.

and have decided to go off of it (I've been
toying with the idea of going off of it for a long time, now, but
being pregnant is what finally did it). My asthma is actually not
all that bad. I don't suffer from classic attacks, so IOW, going off
of the medication won't be like welcoming death, or something. ;-)
Going off of the drug will just mean that I'll get a bit more, uh,
phlegmy (yeah, TMI, I know).

One thing I worry about, though: I just read that advair is a class C
drug, meaning that effects have been observed on rat fetuses, but
there are insufficient data regarding the effects on human fetuses
(i.e. there have not been enough studies done - and in fact, one page
I saw claimed that there were no studies done regarding this at all,
but I don't know what is true, and it's hard to judge fact from
fiction when the official advair site has nothing on pregnancy at all
(or maybe that should tell me something)). Now, I have already
decided to go off of this drug, so once the medication is out of my
system, I won't have to worry. ;-) However, I'm curious, and I would
like to know if anyone has any more up-to-date info about known
possible effects of advair on a fetus.

I'm an asthmatic and would not hesitate to take Advair during pregnancy.
Years before I had any children, I had an allergist who told me that inhaled
steroids (Salmeterol did not exist in those days) were FAR safer for a fetus
than having a mother who can't breathe, and I believe he's right.

That said, I never took steroids and Serevent consistently during any of my
pregnancies because my asthma is always mild during pregnancy. That said,
I'd take it now if I were ever pregnant again. Why? Because last July I
suffered a severe asthma attack that affected my large airways. I couldn't
breathe, my heart stopped, and I was resuscitated by CPR with only minutes
to spare before either death or brain damage would have been the result.
Under the circumstances, I think Advair is a LOT safer than the alternative!
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [a quarter to 2] mom)

This week's special at the English Language Butcher Shop:
"Custom fabracation" -- Auto body shop sign

Daddy: You're up with the chickens this morning.
Aurora: No, I'm up with my dolls!

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman


  #6  
Old December 29th 03, 10:25 PM
Vicky Bilaniuk
external usenet poster
 
Posts: n/a
Default pregnancy and asthma (and advair in particular)

Circe wrote:
Vicky Bilaniuk wrote:

OK, I would love to know what you all think of pregnancy and asthma,
and, in particular, advair. When I talked to my doctor about
pregnancy, he never mentioned anything about the advair that I use,
but I have recently been wondering about it. I suffer from mild but
persistent side effects



Out of curiosity, what side effects? I have been using it for about 6 months
and haven't had any problems at all.


Dry mouth, hoarse voice, increased heart rate, and I seem to suffer from
bronchitis and/or pneumonia more often while on the drug than while off
of it. Actually, these are symptoms from the inhaled steroid component
of the drug. I used to take Flovent (fluticasone by itself, basically),
and I had the same side effects. They are irritating. Actually, while
on Flovent, I also used to get candidiasis a lot, but luckily I don't
with Advair (I have been using a lower dose and have also learned to
rinse my mouth more thoroughly). I think it might also be affecting my
nose a bit, but it's hard to tell because my nose is always irritated by
*something*. ;-) If you haven't noticed any side effects yet, you're
probably lucky. I think that most people notice the side effects right
away, if they're going to suffer from any. (the only questionable one
is the lung infection one, which takes time) I can't remember if I
mentioned this in my original post or not, but... I've been on Advair
for as long as it's been on the Canadian market, which I think is about
2 or 3 years, now.


I'd take it now if I were ever pregnant again. Why? Because last July I
suffered a severe asthma attack that affected my large airways. I couldn't
breathe, my heart stopped, and I was resuscitated by CPR with only minutes
to spare before either death or brain damage would have been the result.
Under the circumstances, I think Advair is a LOT safer than the alternative!


Wow, scary stuff. I'm glad that you're OK. Did you ever suffer an
attack before? I've had asthma for most of my life, but I've never
suffered an actual attack (this made diagnosis kind of hard). I just
have constant inflammation and increased phlegm, but my airways tend to
stay open. (oh and whenever I get a case of bronchitis or pneumonia, I
tend to get some annoying drug resistant bug that tends to show up
mainly in asthmatics and other people with lung disease) I've spent
most of my asthmatic life unmedicated, because I just don't like taking
meds if the illness isn't that bad (and in my case, it isn't). I've
only recently been taking meds because of the introduction of new
products such as advair. IOW, I'm willing to give new stuff a try. ;-)
I still would prefer to be drug free, though.

  #7  
Old December 29th 03, 11:01 PM
Circe
external usenet poster
 
Posts: n/a
Default pregnancy and asthma (and advair in particular)

Vicky Bilaniuk wrote:
Circe wrote:
Out of curiosity, what side effects? I have been using it for about
6 months and haven't had any problems at all.


Dry mouth, hoarse voice, increased heart rate, and I seem to suffer
from bronchitis and/or pneumonia more often while on the drug than
while off
of it. Actually, these are symptoms from the inhaled steroid
component
of the drug. I used to take Flovent (fluticasone by itself,
basically),
and I had the same side effects. They are irritating.


Inhaled steroids have never caused me any problems. I guess I'm lucky!

I'd take it now if I were ever pregnant again. Why? Because last
July I suffered a severe asthma attack that affected my large
airways. I couldn't breathe, my heart stopped, and I was
resuscitated by CPR with only minutes to spare before either death
or brain damage would have been the result. Under the circumstances,
I think Advair is a LOT safer than the alternative!


Wow, scary stuff. I'm glad that you're OK.


Oh yes, me too!

Did you ever suffer an attack before?


Oh, yes, certainly. I was diagnosed asthmatic at around 2.5yo. I just took
it for granted that I'd have an asthma attack every few days, treat it with
albuterol, and move on. What happened to me that was "special" on that
occasion was that my large airways were inflamed to the point where I could
not get in any air at all. Asthma is typically a disease of the small and
medium-sized airways, but in rare cases, the large airways are affected.
It's these type of attacks that lead to most asthma deaths, by the way, and
some people have them quite suddenly without much warning.

In retrospect, I had been becoming more symptomatic during the 17 months
since my last baby was born and that should have been my cue to treat my
asthma more aggressively. But, you know, three kids, full-time job, one
thing and another! But the attack that actually almost killed me was quite
sudden and I really had NO warning--I woke up with a little trouble
breathing, took my albuterol, it didn't work, took down the nebulizer, that
didn't work, called 911, woke up my husband and then spent the next 10-15
minutes waiting for the ambulance while slowly dying. I don't really
remember much after I woke my husband and called 911.

If we knew then what we know now, we wouldn't have waited for the ambulance.
At the time, I thought they'd be able to DO something for me on the way to
the hospital. As it turned out, they really couldn't do much and the time we
spent waiting for them to arrive was the time it took my to go into cardiac
arrest, such that, ironically, waiting for the ambulance was what almost
killed me. If something similar were to happen again, my husband would throw
me in the car and drive me to ER straightaway.

I've had asthma for most of my life, but I've never
suffered an actual attack (this made diagnosis kind of hard). I just
have constant inflammation and increased phlegm, but my airways tend
to
stay open. (oh and whenever I get a case of bronchitis or pneumonia,
I
tend to get some annoying drug resistant bug that tends to show up
mainly in asthmatics and other people with lung disease) I've spent
most of my asthmatic life unmedicated, because I just don't like
taking
meds if the illness isn't that bad (and in my case, it isn't). I've
only recently been taking meds because of the introduction of new
products such as advair. IOW, I'm willing to give new stuff a try.
;-) I still would prefer to be drug free, though.


Well, I hear ya. I'd be drug-free, too, if I could. But given my little
episode, I've decided that's not safe for me.

Besides, since I've been on the Advair, my husband says I breathe like a
normal person for the first time in the 15 years he's known me.

I guess for me, the bottom line is that asthma no longer seems like a
relatively benign condition any more. I got complacent about it after living
with it for 35+ years and almost paid for the complacency with my life. It's
not a mistake I'll be making again!
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [a quarter to 2] mom)

This week's special at the English Language Butcher Shop:
"Custom fabracation" -- Auto body shop sign

Daddy: You're up with the chickens this morning.
Aurora: No, I'm up with my dolls!

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman


  #8  
Old December 30th 03, 03:13 AM
Vicky Bilaniuk
external usenet poster
 
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Default pregnancy and asthma (and advair in particular)

Wow, again, I have to say that I'm glad you're OK after that experience!
I totally agree that someone in your shoes should not go off of their
advair during pregnancy. I hope you don't experience something like
that again.

  #9  
Old December 31st 03, 09:04 PM
Vicky Bilaniuk
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Posts: n/a
Default pregnancy and asthma (and advair in particular)

Vicky Bilaniuk wrote:

Circe wrote:

Vicky Bilaniuk wrote:

OK, I would love to know what you all think of pregnancy and asthma,
and, in particular, advair. When I talked to my doctor about
pregnancy, he never mentioned anything about the advair that I use,
but I have recently been wondering about it. I suffer from mild but
persistent side effects




Out of curiosity, what side effects? I have been using it for about 6
months
and haven't had any problems at all.



Dry mouth, hoarse voice, increased heart rate, and I seem to suffer from
bronchitis and/or pneumonia more often while on the drug than while off
of it. Actually, these are symptoms from the inhaled steroid component
of the drug. I used to take Flovent (fluticasone by itself, basically),


Oops - just remembered that the increased heart rate is a side effect of
the bronchodilator. The rest are side effects of the steroid. Just
wanted to clarify for any lurkers who are interested in this topic.

 




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