Codeine During Pregnancy

GIDEON KOREN Codeine during pregnancy is professor of pediatrics, pharmacy, pharmacology, medicine, and medical genetics at the University of Toronto. PHILADELPHIA -- A short course of a glucocorticoid provides rapid and sustained pain relief for painful uterine leiomyomas in pregnancy, according to a codeine during pregnancy chart review of six patients presented in poster form at the annual meeting of the American College of Obstetricians and Gynecologists. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs Codeine during pregnancy of hypoadrenalism. They found no excess of first-trimester DM use among the mothers of the children with congenital defects and concluded cough medicines containing DM do not increase the risk of these malformations (Teratology 63[1]:38-41, 2001). Additionally, patients should be advised codeine during pregnancy to avoid cough preparations that contain alcohol.
REFERENCES1. Moreover, there are approved infant cough and cold products codeine during pregnancy that contain DM. Some of these data came from the Boston Collaborative Perinatal Project, which prospectively followed more than 50,000 mother-child pairs. The retrospective chart review involved six consecutive patients with ultrasound-confirmed uterine leiomyomas, acute onset of abdominal pain, and tenderness directly over the leiomyoma. "The optimal dose of glucocorticoids for this indication has not been determined," he noted. With the larger sample size we still found no evidence that the rate of major malformations was increased in babies exposed to DM in the first Codeine during pregnancy trimester. Not every cough needs to be treated, but there are pregnant women who have severe coughs associated with conditions like pneumonia who do need treatment. "Prednisone is preferred over dexamethasone because it doesn't cross the placenta--other steroids will cross and include the ones used to induce fetal codeine during pregnancy lung maturity," he noted during the meeting. Eur J Respir Dis 1984;65:283-291. Dextromethorphan, the active ingredient in many over-the-counter cough and cold remedies, is probably the most widely used: anticoughing ingredient in the world. Two other surveillance studies assessing 241 and 141 newborns whose mothers ingested guaifenesin during the first trimester found no associations between guaifenesin use and congenital defects.
9,11CONCLUSIONThe use of dextromethorphan for codeine during pregnancy cough during pregnancy does not appear to produce an increased risk of congenital malformations in newborns. Although guaifenesin's mechanism of action is not completely known, it increases the volume and decreases the viscosity of respiratory tract secretions. 14,15 Guaifenesin is well-absorbed from the GI tract with approximately 60% of guaifenesin hydrolyzed in the blood. 14Peer-reviewed evidence codeine during pregnancy supporting the effectiveness of guaifenesin as an expectorant is limited. 15 One study evaluating the effectiveness of guaifenesin in patients with bronchitis found Codeine during pregnancy it ineffective. 16 A second study in patients with colds found that guaifenesin subjectively thinned mucus; however, the guaifenesin treatment dose was two times the recommended dose.
17Guaifenesin has a molecular weight codeine during pregnancy of 198 daltons, indicating possible placental transfer. In January, epidemiologists in Spain published the results of a retrospective, case-control study in which they asked mothers of children born with heart defects, neural tube defects, or other malformations and the mothers of children with no congenital codeine during pregnancy defects if they had taken drugs containing DM or other drugs during pregnancy. In response, we began our own study, as did other investigators. This is important information because millions of women take products with DM before they know they are codeine during pregnancy pregnant--almost half of all pregnancies are unintended. However, codeine during pregnancy in general, the use of drugs should be minimized whenever possible during pregnancy.