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What asthma medicines are safe to use during pregnancy? If you have asthma and are considering becoming pregnant, shouldn’t you know the response?

Asthma is a chronic lung condition that is characterized by breathing difficulties.  Persons with asthma have extra sensitive and/or hyper-responsive airways. Normally during an asthma attack, the airways become irritated and react by constricting, and thus narrowing, causing increased resistance to airflow, and obstructing the flow of air to and from the lungs.

Here is a short overview of the major medicines used by people with asthma:

Preventers

*  Cromoglycate (Intal, Cromolyn, Lomudal,  etc.) and Nedocromil (Tilarin,, Tilade,  etc.)

Generally, these asthma preventers are not steroids. Plus, their safety record is very good. No dangerous effects on fetuses have been recorded though they have been in widespread use since 1968. They are excellent drugs for people in whom they prove sufficient.

*  Steroid Inhalers based on Becotide (beclomethasone dipropionate, now a common medicine under other names, too) and Pulmicort (budesonide).

These steroids have been used for decades and on a large scale, including an enormous amount of use by women who were pregnant. There have been no evidence of dangerous effects. In small doses, in fact, these steroids are thought to offer additional protection from lack of oxygen to the baby.

*  Theophylline (many trade labels)

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Unlike inhaled medicines, theophylline is taken orally, usually as tablets, and, unlike the inhaled steroids, it is not broken down slowly by the liver. Despite its widespread use, no harmful results on unborn children have been described.

Relievers (bronchodilators)

*  Salbutamol (Ventolin, many other brand labels)

Since the 1960s, Salbutamol has been widely used. When given in large doses by injection or infusion near the baby’s due date, it can delay birth, and in fact it has been used for this purpose.   In doses in which it is inhaled for asthma, it is harmless during pregnancy.

*  Terbutaline (Bricanyl) is very similar to salbutamol.  All the conclusions for salbutamol apply.

Long-Acting Relievers

These work in the same manner as the ordinary relievers such as salbutamol and terbutaline, with the difference that they stick to the cells in the body on which they act, and work for much longer. The side-effects are the same, namely tremor, increased pulse rate and palpitations (being able to feel your heart beating). They were introduced much more recently, but no dangers in pregnancy are known.

*  Eformoterol (Foradil)

No harmful effects during pregnancy are reported.

*  Salmeterol xinafoate (Serevent)

No harmful effects during pregnancy are reported.

Steroid Injections or Tablets

You should just need these for emergencies, such as a sudden bad asthma attack, or if your asthma is so bad all the time that you are one of the few people who does require them regularly. If so, your child would be much worse off than if you did not take them. Such strong steroids do affect the fetus, but recent knowledge of the effects seems to be that they are remarkably mild.

Always discuss the use of any medicine or treatment  with your doctor, whether you are pregnant or not.  Especially consider talking to an asthma specialist if you are using some of the medicines with more serious potential effects on your pregnancy.

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Filed under: Asthma