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Remin­der on the contrain­di­ca­tion of all NSAIDs from the begin­ning of the 6th month of pregnancy

Health secu­ri­ty & vigilance

upda­ted : Janua­ry 9, 2004

See also CRAT press release : CYTOTEC ® (miso­pros­tol) in the 1st tri­mes­ter of pre­gnan­cy : a mal­for­ma­tive effect ? [Read]

I’m pre­gnant : what you need to know about nons­te­roi­dal anti-inflam­ma­to­ry drugs (NSAIDs)

From the begin­ning of the 6th month of pre­gnan­cy (in other words after the date of 5 com­ple­ted months) you should never use a non-ste­roi­dal anti-inflam­ma­to­ry drug (NSAID), even on an ad hoc basis.

 

  1. Which drugs are affec­ted by this information ?

All non-ste­roi­dal anti-inflam­ma­to­ry drugs are affec­ted by this infor­ma­tion, i.e.:

clas­sic NSAIDs

aspi­rin from 500 mg/d

Be care­ful, some com­mon drugs are not cal­led « aspi­rin », but may contain it, whe­ther or not asso­cia­ted with other sub­stances. Read the lea­flets care­ful­ly and, if in doubt about the nature and use of a medi­cine, talk to your doc­tor or pharmacist.

cyclooxy­ge­nase 2 inhibitors

All of these NSAIDs (see list below) represent a vast class of drugs, all having the same mode of action.

2. In which cases could an NSAID be pres­cri­bed to me ?

NSAIDs are used in a large num­ber of condi­tions, to relieve and/or treat :

fever,rheu­ma­tism, joint pain, lum­bar pain,muscle trauma,pain and inflam­ma­tion of the nose, throat and ears,dental,pain and inflam­ma­tion, hemor­rhoi­dal pain and inflammation,gynecological pain,headache head, migraines,… and in many other cases.

If you are in one or the other of these cases, never take a medi­cine without having spo­ken to your doc­tor or your pharmacist.

3. Are NSAIDs only avai­lable by prescription ?

No, there are NSAIDs, com­mon­ly used to treat pain of various ori­gins and fever, which are sold over the coun­ter in pharmacies.

This is the case for aspi­rin (most medi­cines contai­ning it are avai­lable without a prescription)
and cer­tain medi­cines containing :

keto­pro­fen  :

or  ibu­pro­fen : (Toprec)

(Advil, Algi­fene, Anad­vil, Anad­vil cold, Anta­rene, Clip­tol, Doctril, 
Ergix pain and fever, Expan­fen, Gelufene,
Hema­gene Tai­lor, Ibual­gic, Ibu­pro­fen, Ibu­top, Intral­gis, Nureflex, 
Nuro­fen, 
Rhi­nad­vil,
 Rhi­na­thiol cold, Rhi­nu­re­flex, Solu­fen, Spe­di­fen, Syn­to­fene, Tibu­ron, Upfen, Vicks Cold).

 

Also be care­ful with NSAIDs which are avai­lable as eye drops, oint­ment, cream or gel for topi­cal appli­ca­tion. Although the doses used are gene­ral­ly lower, these drugs must be sub­ject to the same pre­cau­tions for use as other NSAIDs

Care­ful­ly read the ins­truc­tions for the medi­cines in your medi­cine cabi­net and, if in doubt, talk to your doc­tor or phar­ma­cist before using them.

4. What are the risks for my baby with this fami­ly of drugs ?

It is the action of these drugs on pros­ta­glan­dins that is res­pon­sible for the effects on the fetus or newborn.
These effects relate to :

the heart with the risk of heart failure,
the kid­ney with the risk of renal failure,

and can lead to the death of the baby before or after birth.

5. Do these effects occur at any time of pre­gnan­cy / at any dose ?

No, this risk appears from the begin­ning of the 6th month of pre­gnan­cy. The risk of occur­rence of these effects is then all the more impor­tant as the dose is close to the expec­ted date of deli­ve­ry, even if it is a very occa­sio­nal dose.

What should I do if I took an NSAID when I star­ted my 6th month of pregnancy ?

1°- You must imme­dia­te­ly stop taking the medi­cine concerned.

2° – Even if you have only taken the medi­cine once, noti­fy and consult your gyne­co­lo­gist or your atten­ding phy­si­cian very qui­ck­ly, because he alone can judge what action to take.

In very spe­ci­fic and very rare situa­tions, your gyne­co­lo­gist, your car­dio­lo­gist or your doc­tor may pres­cribe this type of medi­cine for you. In this case, strict­ly fol­low the pres­crip­tion (treat­ment and moni­to­ring) of your doctor.

6. I am less than 5 months pre­gnant and I have not star­ted my 6th month of pre­gnan­cy : is there a risk for the baby if I have taken one of these medicines ?

before 12 weeks of ame­nor­rhea (2 com­ple­ted months of pregnancy):
There is no risk that these effects will be obser­ved. Howe­ver, you must refer to the ins­truc­tions for the medi­cine you have taken/are taking.

bet­ween 12 and 24 weeks of ame­nor­rhea (bet­ween 2 months and 5 com­ple­ted months of pregnancy):
A spe­ci­fic treat­ment seems without harm­ful conse­quences. On the other hand, it is not recom­men­ded to take long-term NSAIDs.

Howe­ver, if you have to use this type of medi­cine, it is best to talk about it befo­re­hand with your gyne­co­lo­gist, your doc­tor or your phar­ma­cist, who are able to take into account :the type of NSAID,
the dose,
the dura­tion of treatment.

They may also offer you other types of medi­ca­tions to relieve your symptoms.

But, in any case, you should no lon­ger take NSAIDs after the end of the 5th month of pregnancy.

NB : The list below is given for infor­ma­tion only (medi­cines mar­ked with an aste­risk may be mar­ke­ted under dif­ferent brand names) and concerns medi­cines mar­ke­ted on Decem­ber 15, 2003 ; if in doubt about the com­po­si­tion of an older medi­cine, which has, for example, been kept in your medi­cine cabi­net, ask your phar­ma­cist for advice.

Nom com­mer­cial

Type of drug

Nom com­mer­cial

Type of drug

ACETYLSALICYLIC ACID*

aspi­rin

INDOBIOTIC

Clas­sic NSAIDs

TIAPROFENIC ACID* Clas­sic NSAIDs INDOCID Clas­sic NSAIDs
ACTRON aspi­rin INDOCOLLYRE Clas­sic NSAIDs
ACULAR Clas­sic NSAIDs INFLACED Clas­sic NSAIDs
ADVIL Clas­sic NSAIDs INTRALGIS Clas­sic NSAIDs
AFEBRYL aspi­rin KARDEGIC aspi­rin
ALEVE Clas­sic NSAIDs KETOPROFENE * Clas­sic NSAIDs
ALGIFENE Clas­sic NSAIDs ketum Clas­sic NSAIDs
ALGO-NEVRITON aspi­rin LODINE Clas­sic NSAIDs
ALKA-SELTZER aspi­rin METASPIRINE aspi­rin
ANADVIL Clas­sic NSAIDs MIGPRIV aspi­rin
ANTADYS Clas­sic NSAIDs MINALFENE Clas­sic NSAIDs
ANTARENE Clas­sic NSAIDs MOBIC Clas­sic NSAIDs
ASPIRIN ANTI-GRIP aspi­rin NABUCOX Clas­sic NSAIDs
APRANAX Clas­sic NSAIDs NALGESIC Clas­sic NSAIDs
ARTHROCINE Clas­sic NSAIDs NAPROSYNE Clas­sic NSAIDs
ARTOTEC Clas­sic NSAIDs NAPROXENE* Clas­sic NSAIDs
ASPEGIC aspi­rin NEXEN Clas­sic NSAIDs
ASPIRIN* aspi­rin NOVACETOL aspi­rin
ASPIRISUCRE aspi­rin NIFLOWLE Clas­sic NSAIDs
ASPRO aspi­rin NIFLURIL Clas­sic NSAIDs
ASPROACCEL aspi­rin NUREFLEX Clas­sic NSAIDs
BIPROFENID Clas­sic NSAIDs NUROFEN Clas­sic NSAIDs
BREXIN Clas­sic NSAIDs OCUFEN Clas­sic NSAIDs
CALL Clas­sic NSAIDs I WILL BE Clas­sic NSAIDs
BUTAZOLIDINE Clas­sic NSAIDs OPALGYNE Clas­sic NSAIDs
CALMADERM Clas­sic NSAIDs PARFENAC Clas­sic NSAIDs
CARDIOSOLUPSAN aspi­rin PIROXICAM* Clas­sic NSAIDs
CATALGINE aspi­rin POLYPIRINE aspi­rin
CEBUTID Clas­sic NSAIDs PONSTYL Clas­sic NSAIDs
CEFAPYRINE aspi­rin PROFENID Clas­sic NSAIDs
CELEBREX cyclooxy­ge­nase 2 inhibitor PROXALYOC Clas­sic NSAIDs
CEPHALGAN aspi­rin RHINADVIL Clas­sic NSAIDs
CEPHYL aspi­rin RHINATHIOL RHUME Clas­sic NSAIDs
CHRONO INDOCID Clas­sic NSAIDs RHINUREFLEX Clas­sic NSAIDs
CLARAGINE aspi­rin RUMICINE aspi­rin
CLIPTOL Clas­sic NSAIDs SALIPRAN aspi­rin
CYCLADOL Clas­sic NSAIDs SEDASPIR aspi­rin
DETOXALGINE aspi­rin SOLARAZE Clas­sic NSAIDs
DEXTRARINE PHENYLBUTAZONE Clas­sic NSAIDs SOLUFEN Clas­sic NSAIDs
DICLOFENAC* Clas­sic NSAIDs SOLUTION aspi­rin
DOCTRIL Clas­sic NSAIDs SHIPPING Clas­sic NSAIDs
TASTE Clas­sic NSAIDs SURGAM Clas­sic NSAIDs
DOLGIT Clas­sic NSAIDs SYNTOFENE Clas­sic NSAIDs
DOLODERM Clas­sic NSAIDs TIBURON Clas­sic NSAIDs
ERGIX PAIN AND FEVER Clas­sic NSAIDs TILCOTIL Clas­sic NSAIDs
EXPANFEN Clas­sic NSAIDs POT A Clas­sic NSAIDs
FELDENE Clas­sic NSAIDs TOPREC Clas­sic NSAIDs
FLANID Clas­sic NSAIDs UPFEN Clas­sic NSAIDs
FLECTOR Clas­sic NSAIDs VEGADEINE aspi­rin
FLEXIROX Clas­sic NSAIDs VICKS RHUME Clas­sic NSAIDs
FLUNIR Clas­sic NSAIDs VIOXX cyclooxy­ge­nase 2 inhibitor
MONEY Clas­sic NSAIDs VOLDAL Clas­sic NSAIDs
GELUFEN Clas­sic NSAIDs VOLTAMICINE Clas­sic NSAIDs
HEMAGENE TAILOR Clas­sic NSAIDs VOLTARENE Clas­sic NSAIDs
IBUALGIC Clas­sic NSAIDs XENID Clas­sic NSAIDs
IBUPROFENE * Clas­sic NSAIDs ZOFORA Clas­sic NSAIDs
IBUTOP Clas­sic NSAIDs

 

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