Can acetaminophen be taken during pregnancy
pregnancy and breast feeding period
But Paracetamol's image has been cracking recently. Based on recent studies from Scandinavia, England and North America, a discussion has broken out among experts as to whether paracetamol has not been used too carelessly during pregnancy. It has long been known that the substance in higher doses has side effects such as liver damage and high blood pressure. What is relatively new, however, is the suspicion that paracetamol, if taken during pregnancy, can lead to incorrect testicles in the male unborn child. Those affected can later suffer from reduced fertility and an increased risk of developing malignant testicular tumors. In addition, several recent studies suggest that children are more likely to develop asthma if they were exposed to the substance while they were still in the womb or when they were young children.
The fact is that the suspicions are currently being scrutinized by the European Medicines Agency (EMA). As far as the use during pregnancy is concerned, the Drugs Commission of the German Pharmacists (AMK) sees no reason to reassess the approval-compliant use until then. The prescription requirement for packs containing more than 10 grams of active ingredient, which was introduced some time ago, was welcomed unreservedly.
What does this mean for advice in the pharmacy? "In view of the many years of experience with paracetamol, there is no need for scare tactics or exaggerated fear," says Professor Dr. Hartmut Morck, drug expert and former editor-in-chief of the Pharmazeutische Zeitung. »As before, there is nothing wrong with taking paracetamol for short periods of time in the event of acute pain or fever. This applies to small children as well as to use during pregnancy. It is still one of the first choice remedies. Towards the end of pregnancy, when the due date is approaching, paracetamol - like other pain relievers - should not be used. "
Think about possible prophylaxis
If the migraine attack is accompanied by nausea and vomiting, the symptoms during pregnancy can be alleviated with dimenhydrinate in suppository form. Metoclopramide and domperidone are not used in pregnancy. This also applies to triptans; the data on safety aspects is too incomplete. Prophylaxis with 300 to 600 mg magnesium or 200 mg metoprolol daily is possible. For tension headaches, it is worth trying 20 mg fluoxetine daily.
After pregnancy, migraines often return with full force. Then breastfeeding attacks can be intercepted with paracetamol, ibuprofen or diclofenac. For the treatment of nausea, drops containing domperidone or dimenhydrinate can be used as suppositories; Both drugs are only excreted in breast milk to such an extent that it does not harm the unborn child. Metoclopramide, on the other hand, is not suitable.
Triptans may only be used during breastfeeding after carefully weighing the risks and benefits. After that, a break from breastfeeding of at least 8 hours must be taken. Only then is the triptan largely broken down and the breast milk can be given to the child again, write Professor Dr. Stefan Evers, Neurology at Münster University Hospital, and Dr. Astrid Gendolla, headache clinic of the West German Headache Center at the University of Essen, in her guide for the Migraine League Germany. It is therefore advisable to take a break from breastfeeding or to express breast milk beforehand.
Beta blockers, valproic acid (up to about 600 mg daily) and magnesium have proven effective for migraine prophylaxis. A pronounced tension headache can be dealt with by amitriptyline (up to about 50 mg daily).
In principle, the following applies: Before taking drugs during pregnancy and breastfeeding, those affected should always consult their gynecologist first. If you have any questions in the pharmacy, it is always worth consulting the Pharmacovigilance and Advice Center for Embryonic Toxicology in Berlin (www.embryotox.de)./
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