Pregnancy and Asthma

[becca_howell]

Has anyone used Advair through their pregnancy? I've heard different people say different things. Some say their doctors didn't have a problem with it, some said their doctors took them off of it. My doctor had taken me off of it with both pregnancies. This is my third and I can't handle it anymore!! I am using my rescue inhaler on a daily basis. Chiropractic care has helped, but not enough to make me comfortable.

[coyotemist]

I think if you need your rescue inhaler daily Advair would be a safer choice. 

Safefetus.com states no risk data available for Serevent (they have the drugs listed seperately)

http://www.safefetus.com/DrugDetail.asp?DrugId=568&TradeName=Serevent%20Diskus-Inhalor&TradeId=643

It shows Flovent in a category C, associated with cleft palate, however, if you are past the first trimester, that would no longer be a concern.  Uh oh, reading further there are other concerns

• In animals , systemic corticosteroid therapy is associated with congenital malformations mainly cleft palate.
• No adequte human data but reported possible association between systemic maternal corticosteroid therapy and cleft palate, growth retardation, neonatal cataract and adrenal suppression of the exposed infants in utero.
• No data about topical corticosteroids in pregnancy.

Although, the med is an inhaler, very little goes into your system, most of it stays in your lungs and does it's action there.   It's not a systemic drug.

I'm not sure what to suggest, do the benefits outweigh the risks?  Maybe you need to see a pulmonologist.

[javilu]

I'm on Asmanex, but I still need to use my albuterol inhaler, so I think my doctor might put me on a combined inhaler like Advair.  With my son, I didn't get on asthma meds (I hadn't had asthma in years, but baby-growing has brought it back with a vengeance and it never went away after I had him) until I was to the point of having to go to urgent care and have nebulizer albuterol, so I am really vigilant about my asthma this time around and feel okay about being on meds for it during pregnancy, knowing how bad asthma during pregnancy can get (I was *this* close to going to the ER).  The inhaled medications are much less systemically active than oral drugs and my doctor actually likened the Asmanex to a topical application (which isn't to say none of it absorbed, but it has a largely localized effect).

[Mommel]

I am also on Advair for maintenance of severe chronic asthma, and I'm okay with the risks, which are very small, considering that if I wasn't on it, I would also have to use my rescue inhaler daily and probably end up with a bacterial infection due to the resulting weakness in immunity of my lungs... then end up on antibiotics, which I definitely don't want to take if at all possible to avoid.

This study published by the US National Library of Medicine: http://rx.searchmedica.com/Page.aspx?menuid=mng&name=Advair+Diskus+Powder&brief=true&CTRY=US indicates that rodents are far more prone to problems with birth defects from corticosteroids than humans and that the doses given to rodents in these studies have been administered subcutaneously (under the skin) and not inhaled, as well as in much larger doses than in humans... I am comfortable with this and feel that the risks FAR outweigh the benefits.