Treating Asthma and Allergies During Pregnancy
Every pregnant mother worries about medication use during pregnancy. However, what if you have to take medication? Should you stop all medication and just take your chances? Isn’t that the best thing for your unborn baby?
Unfortunately, 40% of women with asthma will experience worsening of their symptoms due to the physiologic changes of pregnancy. 60% will stay about the same. And 20% of pregnant women experience an asthma exacerbation that may require urgent treatment or increased medication.
Fortunately, asthma medications are generally safe for use. Most asthma medications have been around for a long time and many pregnant women have taken them. There are no commonly used asthma medications that are contraindicated for use during pregnancy. Taking medication is always about benefit/risk assessment. The only thing unsafe in pregnancy is uncontrolled asthma. IF you are not breathing well or are uncomfortable, that is NOT good for you or your baby either.
Inhaled corticosteroids (Flovent, Qvar, Asmanex, Pulmicort), bronchodilators(albuterol), combination inhalers(Advair, Dulera, Symbicort), montelukast and even biologic injectable medications (Xolair, Nucala, Dupixent) all have significant experience in pregnant women who have taken them and there are no significant concerns about adverse effects. All medications should be reviewed with your doctor and preferably an asthma specialist. Asthma is often undertreated by doctors and spirometry (Pulmonary function testing) is important for optimal management.
Check out the asthma and pregnancy toolkit for more information:
Asthma and Pregnancy Toolkit (aaaai.org)
What about allergies? Should I just “deal with it”?
There is no reason to be uncomfortable if you are pregnant and have allergy symptoms.
Nasal steroid sprays are the first-line treatment for nasal allergies and are safe to use during pregnancy (fluticasone, budesonide). Saline is safe to use. Eye drops such as ketotifen and cromolyn are also safe to use.
IF you need something extra, add loratadine or cetirizine tablets. We advise that you avoid decongestants (pseudoephedrine) and older antihistamines like Benadryl that can cause sedation.
If you are on allergy shots (immunotherapy) they may be safely continued, but please inform your allergist about your pregnancy.
Health, safety, and comfort are the main priorities when pregnant. We hope this blog helps clarify some of the dos and don'ts of asthma and allergy treatment in pregnancy. If you have any further questions or are suffering from asthma and allergies please reach out to us at, Strauss Allergy & Asthma.
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