7 Interactions found for:

The following applies to the ingredients: Prednisone

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This drug should only be used during pregnancy only if the benefit outweighs the risk to the fetus.

AU TGA pregnancy category: A
US FDA pregnancy category: Not assigned

Risk summary: Available data suggest a small but inconsistent increased risk of orofacial clefts with corticosteroid use during the first trimester. Intrauterine growth restriction and decreased birth weight have also been reported with maternal use of corticosteroids during pregnancy, but the underlying maternal condition may have contributed to these risks.

Comments:
-Women who become pregnant while using this drug should be apprised of the potential fetal risks.
-Observe for signs and symptoms of hypoadrenalism in infants exposed to this drug in utero.
-The short-term use of corticosteroids antepartum for the prevention of respiratory distress syndrome does not seem to pose a risk to the fetus or newborn infant.

Animal studies have revealed evidence of teratogenicity at a maternal dose equivalent to 100 mg in a 60 kg human based on body surface area (BSA); fetolethality and fetotoxicity were observed at a maternal dose equivalent to 290 mg in a 60 kg human based on BSA; constriction of the fetal ductus arteriosus has also been observed. There are no adequate and well controlled studies in pregnant women. However, placental and birth weights have been reduced in humans after long term treatment with corticosteroids. Maternal pulmonary edema with inhibition of uterine contractions and fluid overload has also been reported with corticosteroids. Additionally, adrenal cortex suppression may occur in newborns with long term maternal corticosteroid use.

Menstrual irregularities and altered motility and number of spermatozoa have been reported with clinical use of corticosteroids. Animal studies with corticosteroids have revealed impaired male fertility.

AU TGA pregnancy category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

The following applies to the ingredients: Levothyroxine (found in Synthroid)

Professional Content

Use is considered acceptable.

AU TGA pregnancy category: A
US FDA pregnancy category: Not Assigned

Risk summary: No increased rates of major birth defects or miscarriages have been reported with use during pregnancy; untreated maternal hypothyroidism during pregnancy is associated with a higher rate of complications, including spontaneous abortion, gestational hypertension, pre-eclampsia, stillbirth, and premature delivery, as well as potential adverse effects on fetal neurocognitive development.

Comments:
-Thyroid replacement therapy should not be discontinued during pregnancy; hypothyroidism diagnosed during pregnancy should be promptly treated.
-Monitor TSH levels and adjust doses as needed.
-According to some authorities, combination therapy with antithyroid agents for hyperthyroidism is not recommended during pregnancy due to the risk of fetal hypothyroidism from higher doses of antithyroid agents crossing the placenta.

Animal studies have not been conducted. There is a long history of using this drug in pregnant women and this experience has not shown increased rates of fetal malformations, miscarriages or other adverse maternal or fetal outcomes. Hypothyroidism during pregnancy is associated with a higher rate of complications, including spontaneous abortion, pre-eclampsia, stillbirth and premature delivery. Maternal hypothyroidism may have an adverse effect on fetal neurocognitive development. Pregnant women taking this drug should have their TSH measured during each trimester and dose adjusted as appropriate. Patients will generally return to their pre-pregnancy dose after delivery. There are no controlled data in human pregnancy.

AU TGA pregnancy category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

The following applies to the ingredients: Levothyroxine (found in Synthroid)

Professional Content

Use is considered acceptable

Excreted into human milk: Yes

Comments:
-Levothyroxine (T4) is a normal component of human milk; limited data on exogenous replacement doses during breastfeeding have not shown an adverse effect in nursing infants.
-Levothyroxine dose requirements may be increased in the postpartum period compared to prepregnancy requirements in patients with Hashimoto's thyroiditis.
-The presence of thyroid hormone in breast milk does not appear to interfere with neonatal thyroid screening.

The following applies to the ingredients: Prednisone

Professional Content

This drug should be used only if clearly needed

Excreted into human milk: Yes

Comments:
-If this drug is necessary, the lowest dose should be prescribed; theoretically, if high maternal doses are necessary, the dose the infant receives may be minimized by avoiding breastfeeding for 4 hours following dosing and using prednisolone instead of prednisone.

Amounts of glucocorticoids excreted into breast milk are low with a total infant daily dose calculated to be up to 0.23% of the maternal daily dose. For doses up to 10 mg/day, the amount of drug an infant receives via breast milk is undetectable; however the milk/plasma ratio increases with doses above 10 mg/day (e.g., 25% of the serum concentration is found in breast milk when dose is 80 mg/day). If this drug is necessary, the lowest dose should be prescribed as high doses of corticosteroids for long periods could produce infant growth and development problems and interfere with endogenous corticosteroid production. High doses might occasionally cause temporary loss of milk supply.