Pregnancy And Inhalers: Evaluating The Safety Of Seretide In Early Trimesters

Seretide is a combination of two medicines: fluticasone propionate, a corticosteroid, and salmeterol, a beta2-agonist. While there are no controlled data in human pregnancy, studies in animals have shown that this combination can be teratogenic even at relatively low doses. In mouse reproduction assays, the combination of fluticasone and salmeterol produced cleft palate, fetal death, increased implantation loss, and delayed ossification. In rats, the combination resulted in decreased fetal weight, umbilical hernia, delayed ossification, and changes in the occipital bone. Therefore, the use of Seretide during early pregnancy should be carefully considered and discussed with a healthcare professional. It is important to note that the benefits of controlling asthma symptoms during pregnancy may outweigh the potential risks associated with Seretide. Well-controlled asthma can reduce the need for higher doses of inhaled corticosteroids and decrease the risk of adverse pregnancy outcomes.

Seretide is a combination of fluticasone propionate and salmeterol

Fluticasone propionate is a glucocorticoid anti-inflammatory that reduces swelling and irritation in the lungs. Salmeterol xinafoate is a long-acting beta-2 adrenoceptor agonist that dilates the airways in the lungs, keeping them open and allowing easier breathing.

Seretide is available in different dosages and formulations, including the Seretide Accuhaler DPI, Seretide Evohaler, and Seretide Diskus. The recommended dose for adults (including children over 12 years) with asthma is one inhalation twice daily. It is important to note that Seretide is not meant to provide relief during acute asthma attacks.

Regarding pregnancy, Seretide is classified as an ADEC Pregnancy Category B3 drug. While animal studies have shown no effects of fluticasone propionate or salmeterol on fertility, there are limited data in pregnant women. Administration during pregnancy should be carefully considered, weighing the expected benefits against any potential risks to the foetus or child.

Breastfeeding women should also consult their doctors before using Seretide, as it is unknown whether salmeterol and fluticasone propionate are excreted in human milk. Studies in lactating animals have detected low drug concentrations in milk, but the potential impact on breastfed infants remains uncertain.

Fluticasone propionate is a corticosteroid

Inhalation of corticosteroids, such as fluticasone propionate, is the preferred long-term treatment for asthma during pregnancy. This is because uncontrolled asthma or asthma exacerbations during pregnancy can increase the risk of various complications, including preterm delivery, low birth weight, and small for gestational age neonates. Proper patient education on the correct administration and adherence to the prescribed treatment regimen is crucial, especially during the first trimester.

Research has shown that fluticasone propionate crosses the placenta following subcutaneous administration to mice and rats and oral administration to rabbits. However, it was not associated with decreases in pup weight and had no observable effects on developmental landmarks, learning, memory, reflexes, or fertility at doses up to 0.5 times the maximum recommended human daily inhalation dose (MRHDID).

In animal studies, fluticasone propionate, when combined with salmeterol, resulted in adverse effects such as cleft palate, fetal death, increased implantation loss, and delayed ossification in mice and decreased fetal weight, umbilical hernia, and changes in the occipital bone in rats. These observations are consistent with the effects of glucocorticoids. However, no developmental toxicity was observed when fluticasone propionate was administered alone at lower doses.

In summary, while fluticasone propionate is generally considered safe during pregnancy, it is always advisable to consult a healthcare professional before taking any medication, especially during pregnancy. The benefits and risks of continuing or discontinuing the medication should be carefully weighed, and proper patient education and adherence to the treatment plan are essential.

Salmeterol is a beta2-agonist

While there are no controlled data in human pregnancy, it is important to note that there is a potential risk to the fetus. Therefore, this drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. It is recommended that patients contact their physician if pregnancy occurs while taking this medication. If needed, the lowest effective dose should be used, and pregnant patients should be closely monitored to adjust medications and optimize asthma control.

It is worth mentioning that most asthma medicines are generally safe during pregnancy, and if asthma is well-controlled, there is little to no risk for the mother or the baby. However, discontinuing asthma medication during pregnancy can lead to adverse perinatal consequences, such as decreased birth weight and length. Thus, it is crucial for pregnant women with asthma to continue their prescribed treatments and consult their healthcare providers for advice on managing their asthma effectively during pregnancy.

Seretide is not recommended during pregnancy unless the benefits outweigh the risks

Seretide is a combination of two medicines: fluticasone propionate, a synthetic corticosteroid, and salmeterol, a long-acting beta2-agonist bronchodilator. While Seretide is used to effectively treat asthma and chronic obstructive pulmonary disease (COPD), there are important considerations regarding its use during pregnancy.

The safety profile of Seretide during pregnancy has not been extensively studied in humans. Animal studies, however, have shown that corticosteroids and beta2-agonists can be teratogenic when administered systemically, even at relatively low doses. In animal models, the combination of fluticasone propionate and salmeterol resulted in adverse effects such as cleft palate, fetal death, increased implantation loss, and delayed ossification.

Therefore, Seretide is not recommended for use during pregnancy unless the potential benefits outweigh the risks. If a pregnant woman is taking Seretide, it is crucial that she consults her doctor to assess the risks and benefits for her specific situation. The doctor will consider the severity of the patient's asthma or COPD, the stage of pregnancy, and the potential impact on both maternal and fetal health.

For pregnant women with asthma, it is generally recommended to continue taking prescribed asthma treatments throughout the pregnancy. Well-controlled asthma can reduce the need for higher doses of medication and decrease the risk of adverse pregnancy outcomes. However, it is important to note that uncontrolled asthma or asthma exacerbations during pregnancy can increase the risk of complications, including preterm delivery and low birth weight.

In summary, while Seretide may be necessary for some pregnant women, it should be used cautiously and only if the benefits are deemed to outweigh the potential risks to both mother and fetus. Close monitoring by healthcare professionals is essential to ensure optimal asthma control and the best possible outcome for both mother and baby.

Asthma symptoms may vary during pregnancy

Pregnancy can cause hormonal changes that impact both the nose and sinuses and the lungs. An increase in estrogen can contribute to congestion and a stuffy nose, especially during the third trimester. Additionally, a rise in progesterone may cause a feeling of shortness of breath. These hormonal changes can also lead to respiratory alkalosis, with decreased arterial partial pressure of carbon dioxide, decreased bicarbonate, and increased pH.

The growing uterus can push upwards on the diaphragm, reducing functional residual capacity. This, along with the increased metabolic rate and oxygen consumption during pregnancy, can lead to hyperventilation and shortness of breath.

Changes in maternal immunity during pregnancy, with a shift from Th1-type to Th2-type immune responses, may also play a role in asthma exacerbations. Mucosal and laryngeal edema, mediated by estrogen hormones, can lead to rhinosinusitis in about 20% of pregnant women.

It is important to note that uncontrolled asthma during pregnancy can lead to serious complications for both the mother and the unborn baby. These include high blood pressure, toxemia, premature delivery, and, rarely, death for the mother. For the baby, complications include an increased risk of stillbirth, low birth weight, and poor growth. Therefore, it is crucial to work with healthcare providers to manage asthma during pregnancy effectively.

To manage asthma during pregnancy, it is recommended to:

• Continue taking prescribed asthma treatments and do not stop without consulting a healthcare professional.
• Monitor asthma symptoms closely and adjust medications as needed.
• Avoid asthma triggers and take medications as directed.
• Control allergic reactions and hay fever.
• Get the flu jab and other recommended vaccinations.
• Do not smoke during pregnancy, as it is harmful to both the mother and the unborn baby.

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