Conference moira::parenting

	Sheryl,

	I have an 8month old daughter.  When I was pregnant my doctor
	gave me a list of medications I could take if I had a cold.
	Sudafed was okay, so was plain Rubitussin (with no letters in the name)
        and Tylenol Cold.  Tavist D wasn't on the list then, but things
        could have changed since then.  Maybe they discoved that Tavist D
	is a little better.

	I wouldn't worry about what you've already taken.  I took Sudafed
	a few times while I was pregnant and had a perfectly healthy
	baby.  But I'd follow your doctors guidelines if you get another
	cold (hope not).  Maybe your doctor will be able to explain
	why it changed.  I've found at our doctor's office that the
	nurses don't aways know WHY, but our doctor aways gives me a
	satifactory answer.  Maybe at your next appointment you can
	ask the doctor and get this clarified.

	Best of luck with your pregnancy!
	Karen T.

Sudafed (pseudoephedrine hcl) will raise your own blood pressure ... which I 
would guess would be the nurse's concern but the decongestant in Tavist-D
will also bump b.p., so this doesn't make a great deal of sense.

Also worth noting, sudafed, and the decongestant in Tavist-D, are actually
not recommended at all in the UK, as they are considered of dubious
efficay (fitness for purpose).  They can also disturb sleep at night
and "wire" you during the day.  Often, just an anti-histamine will achieve
what you want to do.  

For an anti-histamine in the US, Tavist-1 (Clemastine fumarate) (not
'D') would probably be recommended, because it has few side effects, amd
in particular, drowsiness, which would be best when pregnant.  Now available
by prescription only in the US (available OTC in Canada) is Claritin 
(loratidine) which works extremely well and is definitely non-drowsy.
(Advantage to Claritin is you only take 1 per day ... Tavist-1 is twice
daily ... Worth noting though is that there are generic Tavist-1 tablets
coming on the market.

My wife has had on again off again sinus problems all this year and has
sworn by Claritin.  We're now tryring Tavist to see how that goes.

Stuart

Don't know if this will make you feel better, but I took sudafed when
I was pregnant in 1992.  At that time, sudafed was my doctor-approved
decongestant.  I don't know if they've changed their recommendation since...

Re: Claritin

I tried this and, for my purposes, it may as well been a sugar pill.  Absolutely
no antihistaminic action whatsoever.  Seldane has been on the market for
a number of years (and in the US, its patent just expired); it works somewhat
and for many people doesn't make them drowsy.  But it isn't as effective
as some of the more traditional products.

I don't see why Claritin is even on the market.  If you read its product
literature closely, it's less effective than Seldane and has more side effects.

				Steve

>Re: Claritin
>
>I tried this and, for my purposes, it may as well been a sugar pill.  Absolutely
>no antihistaminic action whatsoever.  Seldane has been on the market for
>a number of years (and in the US, its patent just expired); it works somewhat
>and for many people doesn't make them drowsy.  But it isn't as effective
>as some of the more traditional products.
>
>I don't see why Claritin is even on the market.  If you read its product
>literature closely, it's less effective than Seldane and has more side effects.
>
Interesting Steve, I know a lot of people for whom Claritin was very effective.
In fact I use it myself for mosquitos and it is every bit as effective as
Benadryl or Seldane.

Seldane has recently been discovered as causing heart problems.  In Canada,
where Seldane is available OTC, it was pulled from the open shelves and
put behind the pharmacists counter and must be requested.

Stuart

    
    	Sheryl,
    
    	Perhaps we use the same practice, but this was the exact
    information I was given by my doctor's office at the start of this
    (my second) pregnancy.  They gave me a list of "approved" medications,
    and pointed out that the only change was the removal of Sudafed.
    
    Sudafed never did anything for me anyway, so the change did not affect
    me.
    
    I wouldn't be concerned with having taken it already, I'd just
    discontinue using it for the duration of the pregnancy.
    
    	Karen
    

    I agree with Karen - no harm done; its a matter of consistency.
    I know a lot of people who took strong medication and/or a lot
    of alcohol before they knew they were pregnant, without side effects.
    Regardless of the Preference-of-the-Month at the doctor's office,
    you're okay.
    I would look into non-drug ways in which to make you feel better 
    (as I sit at home with my chest cold!) There are a few hints in
    the "What to Expect when you are Expecting" my husband has even
    tried a few since he has on-going sinus problems.
    
    re: effectiveness
    The thing about cold/allergy medications of ALL kinds is that each
    person seems to react different to them. On some, some brands have
    little or no effect, on others they may have severe side effects.
    (after a few days of taking dimetapp in allergy season my hands
    shake if I have even one cup of coffee in the morning - my husband
    on the other hand has ZERO side effects and this is his allergy 
    medication of choice.
    Finding the most effective for you (when NOT pregnant) can be a bit
    of a chore. 
    
    So far I've used the vicks chest rub and a humidifier by the bed
    for me. Think I am going to fill that antibiotic perscription
    though....
    
    Monica

    My doctor recommended a prescription nose spray for me while I was
    pregnant, it was a mild steroid.  Before I filled it I had a lengthy
    conversation with the pharmacist (who IMHO has a much better handle on
    medications and their effects than the Docs).  He had REAL concerns
    with pregnant women taking anything.  Why ?  because he said so many
    times in his career things have been on the approved list for pregnant
    women and then a few years later they come off because some significant
    side effect or long term damage to the fetus is discovered.  His
    recommendation, unless you absolutely cannot stand the pain, use
    Tylenol only.  If you were in a situation where the pain was actually
    unbearable (after childbirth almost any pain is bearable !!!) then take
    one of the recommended medications as few times as possible.
    
    The conversation was much more lengthy of course and he gave me four
    examples of medications which were once approved and now have been
    banned as prescription drugs all together.
    
    Best wishes for your pregnancy.

    
    	One of the midwives that I used worked with me in using herbal
    medications during pregnancies. I have used Valarian for muscle cramps
    and pain and I have used a few other herb for colds, and nerve pain.
    
    	After deliever, I have used herbal and homeopathic remedies with
    great success (surprises even me - the doubting Thomas). 
    
    	This is not somthing that I would reccommend to anyone without the
    advice of a Doctor but for me it was a very effective method of dealing
    with some problems that arose.
    
    
    				Wendy

                     <<< Note 653.1 by PCBOPS::TERNULLO >>>
                       -< Sudafed - okay 8months ago... >-


	Sheryl,

	I have an 8month old daughter.  When I was pregnant my doctor
	gave me a list of medications I could take if I had a cold.
	Sudafed was okay, so was plain Rubitussin (with no letters in the name)
        and Tylenol Cold.  Tavist D wasn't on the list then, but things
        could have changed since then.  Maybe they discoved that Tavist D
	is a little better.

	I wouldn't worry about what you've already taken.  I took Sudafed
	a few times while I was pregnant and had a perfectly healthy
	baby.  But I'd follow your doctors guidelines if you get another
	cold (hope not).  Maybe your doctor will be able to explain
	why it changed.  I've found at our doctor's office that the
	nurses don't aways know WHY, but our doctor aways gives me a
	satifactory answer.  Maybe at your next appointment you can
	ask the doctor and get this clarified.

	Best of luck with your pregnancy!
	Karen T.

    Does anyone know WHY Sudafed was taken off the list?
    I have severe allergies and while pregnant with my first
    I went through extreme lengths to make sure sudafed was
    okay to take.  Even though it was on the recommended list
    by the OB, I called the Pregnancy Hotline that the March of
    Dimes sponsers and they also said it was approved and sent
    me alot of literature.
    
    Now pregnant with my 2nd, I didn't even think to ask if
    sudafed was still approved.  I've taken it several times
    for colds and allergies during this pregnancy. 
    
    ...also,  what is the difference between plain Robitussin
    and Robitussin DM?  What are the risks of taking Robitussin
    DM?
    
    RE:  A few back, when we were trying for #2 and I was seeing
    	an allergist, I stopped taking the nasal spray they recommended.
    	The pamphlet that came with the spray had a list of possible
    	birth defects that could result from taking the spray...I'm
    	surprised that doctor recommended something with steriods.
    
    		Linda

re .9:

>    	One of the midwives that I used worked with me in using herbal
>    medications during pregnancies.

Herbal medications can also cause fetal damage or even miscarriage.  As with
non-herbal meds, you have to know what you're doing.

    I am 29 wks. pregnant, and just came down with a terrible sinus, ear
    and throat infection.  My doctor gave me a list with things that I
    could take, and sudafed was on the list.  I ended up going to the
    regular doctor on Saturday because my throat was so swollen that I
    couldn't swallow, and he put me on Amoxicillan and told me to take the
    sudafed also.  I was worried about the antibiotic, but the doctor said
    it was ok.  I didn't even worry about the sudafed, until I read this
    note.  I figured it was ok since it was on the list that the doctors
    office gives to all the pregnant women.  Do I have cause to worry?  
    
    Cheryl

    
    My son just turned 5 mos. old a few days ago.  While I was pregnant
    with him, I had a major sinus infection that went into my teeth.
    I was hurting pretty bad.  My doctor told me that I could take
    Sudafed OR Chlor-Trimaton (sp).  I took Sudafed (which did nothing
    for me) and that was just a short time ago.  My son was a big, strong,
    healthy baby.  
    
    I am not a doctor but if I were you, I wouldn't worry about having
    taken a Sudafed (especially if they told you that you could take
    Sudafed).  Call you dtr's office and ask them about it if it really
    bothers you and hopefully you will feel a lot better after talking
    to them.   
    
    Just my .02
    Chris

Sudafed (pseudoephedrine) is, amongst other things, a stimulant, and will
definitely raise your blood pressure.  It is also supposed to be a decongestant,
that is, it is supposed to shrink swollen, inflamed, nasal passages.  How
effective it is at doing that is very questionable ... for some it works
well, but for others, myself included, it is useless, and wires me ... I
can't sleep if I take it at night.

Pseudoephedrine is a major ingredient in tons of cough syrups and cold
pills etc.

There is another common decongestant, used in Dimetapp, also a stimulant
that I can't remember its name for sure (I think it is phenylpropanolamine).

These two are the MAJOR ingredients in the ND (Non-Drowsy products).  In
some, they are combined with the newer non-sedating antihistamines ... which
is what you get with Tavist-D.  The stimulating effects are offset in the
more traditional cold products (Contac etc) when combined with a sedating
anti-histamine ... (triprolodine in Actifed or more commonly chlorpheniramine,
in Chlortrimeton (Chlortripolon in Canada, Piriton in the UK))

So, I would worry a bit about the use of decongestants when pregnant,
especially if you're Blood pressure is up a bit already.

On the other hand, *if* a decongestant works for you, then it is probably
better that you take it if it prevents an on-going sinus infection that
requires vigorous anti-biotic treatment.

Note that you may see subtly different chemical names ... like brompheniramine
instead of chlorpheniramine ... they are essentially the same drug, one
bound on bromine instead of chlorine.  This affects the uptake and or
elimination rate which can determine how effective the drug is for you.
Also, you'll see things like maleate, or sulfate, or politrex etc.  These
are again the way the drug has been compounded, and again effect the
uptake and elimination rates.  Polistrex drugs are time release over usually
12 hours.

DM (and in prescription DH) is Dextromethorphan Hydrobromide which is a
cough supressant.  Essentially, it is a codeine derived narcotic which is both
non-sedating, and non-habit forming.  Narcotics are, in spite of what the
TV drug enforcement might have you believe, a class of drugs which induce
narcosis ... viz sleep!  Included are the drugs you might expect like
codeine and morphine, but also included are many tranquilizers and sleeping
tablets.  In this class, by derivation rather than because it is a true
narcotic, is DM.  DM is therefore considered relatively safe and somewhat
effective for adults and children.

Of all the drugs in cold medications I'd be most concerned about are the
decongestants because of their stimulating and blood pressure increasing
effects.

Sorry this ended up so long ...

Stuart

    Thank you for the explanation Stuart!
    
    	Linda

slight nit re .15:

>DM (and in prescription DH) is Dextromethorphan Hydrobromide which is a
>cough supressant.  Essentially, it is a codeine derived narcotic which is both
>non-sedating, and non-habit forming.

I heard a story on NPR about school kids who are addicted to Robitussin DM.

    Gerald,
    
    There is also alcohol in many cough syrups ... particularly the store
    brand generics ... but I believe Robitussin still uses alcohol ...
    what an alcohol / DM combination will do is anybody's guess.
    
    DM of itself is *generally* considered non-habit forming at normal
    doses.  If abused ... ie overdosed who knows!?!?!
    
    Stuart

    
    I too have recently taken Sudaphed for a stuffy nose because it was on
    the "okay to take" list. I took it plenty of times while pregnant with
    my daughter and she's fine. After reading this discussion today I
    called up the nurse at my ob-gyn office and asked her. She said it
    is still on the "okay to take" list. Just another point on the chart.
    
    Patty

    Since I am at home, I took the opportunity to confirm what Stuart
    said about the ingredients in Dimetapp. Note, this is the Canadian
    ingredients, which are generally stronger than the american over-
    the-counter versions.
    
    Dimetapp: Medical Ingredients: Each extendtab contains
    phenylpropanolamine HCl 15 mg, phenylephrine HCl 15 mg and
    brompheniramine maleate 12 mg. Non medical ingredients: gluten.
    
    I also stress what another person mentioned about herbal remedies.
    There are lists available of herbs not to be taken during pregnancy
    as they may cause, among other things, early labour. A lot of 
    literature at the health food store will actually suggest that pregnant
    women do not take a particular herb/herbal remedy. For instance
    there is a remedy available here (haven't tried it yet) that is said
    to help with migraines. It's main ingredient is feverfew (which I have
    read in various places, is used to combat migraines). The literature
    for this remedy specifically states not to use it during pregnancy.
    
    Monica

    
    
    	When I mentioned the herbal remedies, I (thought) that I mentioned
    that you should only use them on the advice of someone who is skilled
    in the area.
    
    	I worked with an herbalist, documentation, and with the midwife who
    was interested in herbal medications.
    
    	Herbs are medicines and are not to be taken lightly.
    
    				Wendy

Hi Everyone,

	Happy New Year--I just wanted to take a second to tell you all 
	what I found out about this Sudafed business--this is from
	the practice I go to and is not necessarily all doctors opinions,
	i'm sure...

	Anyway, I finally called because I was so miserable I knew I would
	be sick for a long time and I wanted to know what was the best 
	thing (safest) for me to take while I am pregnant.

	I told my doctor that I was alarmed about what the nurse said
	about Sudafed no longer being on the "safe to take" list.  He
	immediately relaxed me by explaining that "they" whoever "they"
	is ...have just recently found out that Tavist-D is a "hair" 
	safer than Sudafed, but not to worry in the least that I had
	already taken Sudafed.  He said they are very close.  The Tavist-
         D is supposed to be taken every 12 hours, but he recommended
	I just take it once a day. (At night so I can sleep).   It
	really helped to make me comfortable and I ended up taking
	it for four days...

	Please check with your individual doc's, cuz like I said this
	is just my practice's opinion.

Thanks,
Sheryl

I read some detailed drug manufacturer's info on a couple of related
products that contain time release pseudoephedrine or phenylpropanolamine.

In both cases, the info stated that neither was recommended for nursing
mothers because both will cause an increase in Blood Pressure.  Under
Pregnancy, it was less clear, because extensive studies have not been
carried out. The general recommendation was avoid if possible.

Bottom line, consult with your Dr.  Many people have taken both products
for years, and there has been no correlation yet evident between problems
and these two meds.

I would presume that Tavist-D is safer only because the medication is on
a 12 hour time release.

Stuart

    All the info. in this note relates to cold-type medication -
    does anyone have any info. or experience on prescription type
    medication for 'other' things while pregnant?  I've seen info.
    in a previous note on Synthroid for Thyroid, but wondered if
    anyone has ever been on Zantac or Librax while pregnant?  I
    take both for Cholitis, and have been told by both by g.p. and
    my ob/gyn that they have no known effects on a fetus and that
    it would cause more problems for me to try and go off them -
    but I'm very concerned about their effects even though I have
    the same answer from both doctors.  Should I call a pediatrician
    and ask the same question?

re: .24

You may want to get a Physicians Desk Reference, or some such reference book, 
or find one in a library and look up the medications in question.  Who 
prescribed the medications?  Other than you yourself, that's the person who 
has the most to lose (and very little to gain) by incorrectly prescribing 
medication that is not suitable for preganant women.  I doubt that a 
pediatrician would be better informed on this issue than an ob/gyn.

Clay

>    but I'm very concerned about their effects even though I have
>    the same answer from both doctors.  Should I call a pediatrician
>    and ask the same question?


For some of the drugs they may go on their own experiences, but in most
cases, doctors go on the drug company's literature most of which is included
in the PDR (Physicians' Desk Reference) or in Britain the BNF (British
National Formulary).  So, asking a different doctor will probably only give
you another response based on the same source, with their own personal
weighting.

Synthroid I have no idea about.

Tagamet decreases acid production in the stomach in a mechanism related to
Anti-histamines, and I've heard of no *major problems* with anti-histamines and
pregnancy.

Librax is a combination of Librium (tranquilizer) and from what I remember
tagamet, or a tagamet like medication.  Librium has a long track record of
prescription and so if it was particularly harmful, then it would be known.
On the other hand, the withdrawal symptoms of Librax, especially if you've
been taking it for some time may be quite risky to you and the fetus.

As a general comment, you may want to discuss the use of Librax with your
Dr. if you have been taking it for a long time.  Generally, the body's
ability to metabolize benzodiazepene tranquilizers like Librium and Valium
increases with time, so they become less effective.  (I found Librax
personally to be virtually useless when I took it many years ago.)


Stuart

    re: .24
    
    According to the 1992 PDR under LIBRAX:
    	Usage in Pregnancy:  An increased risk of congenital malformations
    associated with the use of minor tranquilizers (chlordiazepoxide,
    diazepam, and meprobamate) during the first trimester of pregnancy has
    been suggested in several studies.  Because use of these drugs is
    rarely a matter of urgency, their use during this period should almost
    always be avoided...
    
    Dan

    re last few...
    
    before taking Librax I suffered chronic diarreah.  I used to take
    something else (dicyclomine), but that didn't help so was switched
    to Librax one year ago.  This was discussed and prescribed by by
    g.p. and agreed upon to by my Gastrointerologist.
    I asked the ob/gyn if I should try to start weaning myself off it
    now (I am not pregnant YET) and he said that would do me more harm
    than good, and I should just stay on what I'm taking.  He said
    once I do get pregnant he may try to decrease the amount I take,
    but that if it caused any problem he would put it right back to
    the levels I'm at now.
    I also have to occasionally use Lomotil, Imodium AD or Pepto
    but have already been told I will have to cease use of these 3
    completely during pregnancy.
    
    The info in .27 has me VERY concerned..

    I've had a nasty cough for the last several days. What have other
    people taken for coughs while pregnant? Any good old family remedies
    out there. I've been drinking mint teas during the day, but I cough all
    night long.
    
                                        Alice

	My doctor recommended Robitussin DM 4 times a day when I
	got bronchitis while pregnant.  (I also ended up on antibiotics...)

	I had a list of approved medications from my OB, but called
	anyway before taking it.

	Karen

    My husband used to mix me this concoction of lemon juice and honey that
    he warmed for me and I drank. That helped me to sleep at night, and was
    tasty.

    RE -1
    
    Do you know the proportions of the lemon juice and honey?

   Barring straight lemon juice and honey, which sounds like it could be
   pretty tough for some stomachs (mine, anyway) to take without
   something else added, I've done the following:
   
   - your favorite tea
   - lemon & honey to taste - that amounts to a spoonful or two or three
     of both lemon and honey.  It doesn't sound like much, but too much
     more than that may be hard to stomach
   
   Regards,
   
   - Tom

    My father in-law made me a tea of garlic and ginger that works
    wonders.  Tastes aweful though.
    
    All you do is get a pan of water and add 4 or 5 cloves of garlic
    and about 3 quarter size slices of ginger.  Boil for about 15
    minutes.
    
    Pam

    A relative is wondering if it's OK to take over-the-counter travel
    sickness meds while pregnant?  She's waiting for a call-back from the
    doc, but this file is usually faster : )
    Sarah

    OOOOPS! Should have made it clear, it's for a one-time trip, not a
    routine treatment for morning sickness!
    Sarah
    

    Dramamine was on the list of prohibited drugs the last time I checked. 
    My sister recommends the funny wristband thingies that use accupressure
    for motion sickness.  Works for her with the exception of very rough
    seas in very small boats.  
    
    meg

	My sister-in-law is pregnant and gets car sick anyways, she just 
	drove up from DC and wore the wristband thingies, so I guess their
	okay.  I didn't ask her if she checked it out with her doctor, but
	I did ask her if they worked and she said "Yes, they definitely did the
	job - she had a pleasant ride"

	Karen T.

    Oh wow, the wristbands really work?  I get terribly car sick, can't 
    ride any amusement park rides either.  Maybe I'll give it a try?  
    And keeping on topic, I'll let her know about the dramamine (and 
    I'm assuming all others of that ilk like bonine would be in the same 
    category?). 
    Thanks,
    Sarah 

    When I was pregnant with my son and needed to fly, my doctor
    recommended Benadryl. You might want to check , although I 
    think that I like the ideas around the wristbands. The less
    chemicals the better for the baby.
    
    Sharon