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General Advice
Karen Schaefer
Medications.
It is generally recommended that medications should be
discontinued during pregnancy where possible. NSAIDS and opioids, including tramadol, should not be
used during pregnancy. Acetaminophen does seem to be relatively safe
during pregnancy. The use of TCA type antidepressants - Tofranil
(Imipramine), Elavil (Amitriptyline), Endep (Amitriptyline), Aventyl
(Nortriptyline), Zyban (Bupropion), Norpramin (Desipramine), Desyrel
(Trazodone), Sinequan (Doxepin), Asendin (Amoxapine), Dothep (Dothiepin),
Prothiaden (Dothiepin) and Anafranil (Clomipramine) – have not been
associated with any significant problems in pregnancy, but may interfere
with labour and should be discontinued about a week prior to due date.
Many medications are excreted in breast milk and you should check these
out with your doctor.
The
American Academy of Pediatrics provides this information about common
medications:
Usually Safe
Acetaminophen
Most nonsteroidal anti-inflammatory medications (NSAIDs), including
ibuprofen
Codeine
Tetracycline
Amoxicillin
Insulin
Thyroid medications
Lidocaine
Prednisone
Most antihistamines
Use With Caution
Prozac
Antianxiety drugs (like Xanax and Valium)
Avoid
Recreational drugs (like marijuana and cocaine)
Radioactive drugs (such as radioactive iodine, used to treat thyroid
disorders)
Anticancer drugs
Ergotamine (for migraines)
Aspirin
Lithium
Labor.
During birth your
obstetrician/midwife should consider the use of opioids or an epidural
anesthetic– as the heightened pain sensitivity of FM patients can be a
major problem to cooperation. Opioid medications,
such as Demerol, morphine etc. maybe be given in an IV or
intramuscularly into the buttock. They take the edge off contractions so
that, while you may still feel some pain, you won't care about it as
much. They often cause drowsiness and may also may cause nausea.
Although opioids cross the placenta, your liver removes most of the
medication from the baby's system before birth, so no harm is done.
Remissions. In my experience a
few patients have experienced a remission of several months after
giving birth; more have had a deterioration due to sleep loss and
repetitive strain due to moving their baby around.
Post Partum.
Hopefully you have a
supportive partner who can assist in the post partum period. You should
learn, from a physical therapist, how to minimize eccentric muscle
contractions when handling your baby.
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