Class C Drug

Jennylou0604 · February 2014

My doctor prescribed me propranolol in hopes to slow down my heart beat. My heart beat has been averaging 90bpm-125bpm which is pretty fast considering it's not going to get any better the further along I get. The medication is a beta blocker and from what I researched all are considered category C drugs.

When I went to pick up my prescription the first time, my pharmacist would not give me the medication because she said I absolutely should not be taking this while pregnant. She told me to call my doctor, which I did, and tell him to call the pharmacy directly to tell them it was okay for me to take it. My doctor called, they lowered the original dosage, but still prescribed me the medication. My doctor said the "benefits outweigh the risks".

I go to pick up my medication this morning and the pharmacist, even after talking to my doctor, is still very reluctant to give me the medication. I told her I was not going to take the meds until I talked to my doctor face to face at my appointment on Monday. I also told her I think I'd rather be put on bed rest if I had to...I didn't come this far to chance hurting my baby girl.

So ladies, what would you all do in this situation?

tbmadeamistake · February 2014

I agree with your plan of waiting to talk to your doctor. However, with two opinions on such opposite ends of the spectrum, I'd be inclined to ask another doctor what they think. A second opinion couldn't hurt and if it's that bad a drug, should be expected. As for alternatives, like bed rest or other restricitions. That's a heavy response to get from a pharmacist.

lest12 · February 2014

Agreed - I would need a tie-breaker.

If you're gut is telling you that you would rather bed-rest than the medication, I would have a very in-depth conversation with your dr as well.

mrscbrad · February 2014

I would also read the research for myself. Granted I do drug research as it relates to birth defects for a living, but a quick PubMed search will likely give you some information. Please do keep in mind that often times the timing of the use of the drug in pregnancy is a big factor. Some drugs are teratogens (meaning they are toxic to growth of one body part or the fetus entirely) and some drugs can merely bring risk factors for after the birth of the baby like higher likelihood of disease. You will likely want to know what the potential risks are for your time point in gestation.

Mztwilson · February 2014

I would defiantly bring this up with your dr in depth. Class c is normally considered unknown if it's safe or is known to cause birth defects in animal studies in high doses. I'd be cautious of it.

Jennylou0604 · February 2014

MegK82 said:

I think the other ladies have given you good advice.

I get how you feel, though. I was just diagnosed with an arrhythmia and it thankfully is one that will not harm me or the baby....but if it gets to the point where I am having palpitations and my heart racing too often that it is interfering with my daily life, the doctor thinks I should do medication (he said probably a BP med) to help control it. He says the medication would be safe for the baby, but I side eye most medications during pregnancy and am not sure how I would feel about taking medication if it's not truly needed.

I'm on a class B blood pressure med now. It's Aldomet (also known as Methyldopa), but apparently it only helps with my BP and not my heart rate. I took Aldomet when pregnant with my DS, too, and he is just fine. Why can't my pregnancies just be simple?!

(

MrsCase1 · February 2014

I am torn on this. ALL medications are poison. Your doctor is 100% correct that you need to weight the benefits versus the risks. It is not a black and white scenario, I'm afraid. I agree with talking it over with him further but I wouldn't entirely discount the pharmacist, either. They are the best source on medications. Their entire education is on medicines, whereas doctors get a few semesters in medical school.

b48kate · February 2014

Just a couple questions...

Is this sinus tachycardia
How are your blood pressures?
Are you having symptoms (shortness of breath, dizziness, fainting)?
Does your heart rate change with activity?

Jennylou0604 · February 2014

Internationalkate said:

Just a couple questions... Is this sinus tachycardia How are your blood pressures? Are you having symptoms (shortness of breath, dizziness, fainting)? Does your heart rate change with activity?

They haven't diagnosed me with sinus tachycardia. I go to an internist who's run an EKG and did an ultrasound of my heart and from what she's told me in the past, everything looked good.

I do get winded very easily, even by just picking up my son. Sometimes I get dizzy, but I've never fainted and yes my heart rate does change with activity. It also tends to beat pretty hard when I lie down. My resting heart rate is around 90-96 bpm. I usually take my pressure after I shower in the morning or after I'm finished getting ready and my heart rate is around 115-125 bpm.

My pressures are actually good so far. Sometimes low...my BP machine showed 96/48 the other day which is extremely low for me. It usually stays around the 125/60 range.

jshrop · February 2014

The thing is, pharmacists are the experts on the Drugs. Dovtors are the experts on the disorders. Did your pharmacist have any other recommendations? Also, the prescribing doc-- was it your OB or a specialist? If the latter, have they been in contact with your OB? Best of luck

Jennylou0604 · February 2014

jshrop said:

The thing is, pharmacists are the experts on the Drugs. Dovtors are the experts on the disorders. Did your pharmacist have any other recommendations? Also, the prescribing doc-- was it your OB or a specialist? If the latter, have they been in contact with your OB? Best of luck

She had no other recommendations, just that it was a good idea to sit down and talk with my OB and lay out all other options available other than taking the meds.

It was my OB that prescribed the medication, not a specialist. My OB's nurse is the one that's been calling me and talking to me. They even called my internist and my internist told them to prescribe what they thought was best for me and baby.

jshrop · February 2014

Yikes, then I'd talk to her/him about all the options

lifeisbetteronthered · February 2014

I would speak to your doctor +/- Ob. They have weighed the risks and benefits and can explain them to you. The pharmacist may know drugs, but they don't know disorders, or you.

Truthfully, I'd be super annoyed if I was that doctor (at the pharmacist, not you). It's one thing for then to check that there wasn't a mistake, and another to continue to refuse to dispense it.

The big risk of rapid heart rate (other then heart attack from having too high of demand... Which is unlikely in an otherwise healthy young person), is that the heart isn't able to refill with blood and so isn't able to pump enough. This leads to poor perfusion to everywhere... Most importantly your brain (which is why you would feel dizzy or light headed)... And your uterus (potentially leading to problems with baby)... And everywhere else, which is why you would be tired/winded easily.

Most drugs are class B or C in pregnacy, as they are rarely tested in pregnant women for ethical reasons. For example: Tylenol is class B but is routinely recommended.

flerlgirl · February 2014

Lilygrace48 said:

I agree with your plan of waiting to talk to your doctor. However, with two opinions on such opposite ends of the spectrum, I'd be inclined to ask another doctor what they think. A second opinion couldn't hurt and if it's that bad a drug, should be expected. As for alternatives, like bed rest or other restricitions. That's a heavy response to get from a pharmacist.

wss

quinnlucas6118 · February 2014

My primary care MD is a huge advocate with getting second opinions when it comes to making decisions on your children's health. The only reason he isn't my OB is because I don't want to deliver at the small local hospital. I would get a second opinion and have they done anything like a 24 hour holter monitor to know more accurately what it is during sleep/resting/activty/etc.? As a nurse I would honestly want this information before taking anything for my heart whether it be for pregnancy or not.

Jennylou0604 · February 2014

quinnlucas6118 said:

My primary care MD is a huge advocate with getting second opinions when it comes to making decisions on your children's health. The only reason he isn't my OB is because I don't want to deliver at the small local hospital. I would get a second opinion and have they done anything like a 24 hour holter monitor to know more accurately what it is during sleep/resting/activty/etc.? As a nurse I would honestly want this information before taking anything for my heart whether it be for pregnancy or not.

No he hasn't done anything like a holter monitor, but I will mention that to him at my appointment Monday. I'd like to get solid details and facts about the condition rather than just assuming the medication is the best way to go.

rileymiller · February 2014

I would def get a second opinion. I would be worried with how concerned the pharmacist is for a class C medication. Typically class C meds are still on the list to take if the meds out weigh other things that can happen. I am on Keppra for past history of seizures), which is a class C med. It is much safer for me and baby to be on the med, rather than not taking meds at all. However, I am considered high risk because of it. Our AS at 20 weeks went great and little man looked perfect (no noticeable side effects that the med causes), but we have to go back at 28 weeks to check progress and make sure all is well still. If it is, I will no longer be high risk. Maybe this is something you can talk to your doctor about, having another in depth AS to make sure all is well with baby if you do decide to take the meds.

TunieBee · February 2014

beta blockers are generally considered an acceptable medication after the first trimester

b48kate · February 2014

Thanks for the info…just wanted to make sure you were super stable before I gave any advice to disregard MD orders! If your vitals were crazy or you were in atrial fibrillation, this would be an entirely different opinion from me...

Low dose propanolol in the second trimester would not, for me personally, cause major red flags, but definitely give the doc a call if your are very concerned. As mentioned previously, doctors and pharmacists have very different outlooks when it comes to treatment plans. You may find a third opinion that agrees with neither of them!

Actually sounds to me like the system is working for you…the doctor prescribes, pharmacist throws a red flag, they collaborate and come to a compromise (in this case lower dosing). Glad to hear you have such an engaged health care team.

BabyCurtiss2014 · February 2014

A pharmacist @ Target would not sell me ZertecD for allergies even though my doc said it was ok. He said its a C and not to use it. So is my inhaler but I do use that bc if I can't breathe what can you do?? My doc prescribed some pills to replace the rescue inhaler but they are daily so I decided not to use them. I figured I don't want to start a new medicine while preggo. I'd get a 2nd opinion and see if there is an alternative.

BabyCurtiss2014 · February 2014

Also pharmacists might know more about the drugs than the doctors...

Jennylou0604 · February 2014

Internationalkate said:
Thanks for the info…just wanted to make sure you were super stable before I gave any advice to disregard MD orders! If your vitals were crazy or you were in atrial fibrillation, this would be an entirely different opinion from me...

Low dose propanolol in the second trimester would not, for me personally, cause major red flags, but definitely give the doc a call if your are very concerned. As mentioned previously, doctors and pharmacists have very different outlooks when it comes to treatment plans. You may find a third opinion that agrees with neither of them!

Actually sounds to me like the system is working for you…the doctor prescribes, pharmacist throws a red flag, they collaborate and come to a compromise (in this case lower dosing). Glad to hear you have such an engaged health care team.

The dosage they came to agreement to was 10mg twice a day. Thanks for your input and for all of you ladies input. Y'all are awesome!

BabyCurtiss2014 · February 2014

krptcmschfmkr128 said:

BabyCurtiss2014 said:
Also pharmacists might know more about the drugs than the doctors...
Not always. Some pharmacists are just quacks, just like some doctors. I know, I've worked with some... it's always best to get other opinions and not take for gold the word of one person, even if they are in the medical field, especially when you have discrepancies between two professionals.

Yeah I do agree with you! I have a cousin that's a pharmacist and she is very knowledgable. There was also the MORON at Walgreens that gave me the regular flu shot instead Thimerosal free in my first trimester! So yeah you are right some are quacks for sure!!

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Class C Drug

Re: Class C Drug

Married DH 7/30/11

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