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June 2016 Moms
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Asthma

alylove11alylove11 member
in June 2016 Moms
I didn't refill my Advair because insurance sucks until January 1st. It's over $300 now, but will be $40 soon. I called the GP to see if he had any samples or anything else to give me until the new year, and he gave me Symbicort. I have not called the OB yet to see if it is compatible with pregnancy. Anyone use it? I'm finding mixed reviews on Dr Goggle.

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Re: Asthma

  • goldie987goldie987 member
    As far as I can tell it's class C which means it isn't proven safe during pregnancy and it has been shown in animals to cause problems (remember that while we are similar to rats, we aren't the same).  I would give your OB a call and see what they say, if the benefits outweigh the risks, they may recommend you take it anyways but that's totally a decision a medical professional has to make.  
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  • TunieBeeTunieBee member
    Both meds are category C. Advair is fluticasone/salmeterol. Symbicort is budesonide/fomoterol. Budesonide is the inhaled steroid of choice in pregnancy and Salmeterol is the inhaled long acting beta agonist of choice in pregnancy. So it's sort of 6 of one, half dozen of the other. Since you know you tolerate Advair well and if it controls your symptoms, probably best to stick with it long-term, but Symbicort is likely fine for the time-being. I would recommend going to an asthma specialist, they may be able to step you down on your meds if things are well-controlled. 




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  • TunieBeeTunieBee member
    Sgoldberg247 said:
    As far as I can tell it's class C which means it isn't proven safe during pregnancy and it has been shown in animals to cause problems (remember that while we are similar to rats, we aren't the same).  I would give your OB a call and see what they say, if the benefits outweigh the risks, they may recommend you take it anyways but that's totally a decision a medical professional has to make.  
    Pregnancy categories are actually a bit more confusing and nuanced than this. What Category C actually means is that 
    1) animal studies have shown risk to the fetus
    OR
    2) there are no controlled studies in women
    OR
    3) studies in women and animals are not available.

    Many times options 2 and 3 are the cause for the rating because meds aren't often studied in pregnant women, so that data isn't available.

    Here is the deal with the meds the pt is considering:

    Because there are more published gestational human data for budesonide (the steroid in Symbicort), it is the preferred inhaled glucocorticoid for use during pregnancy. However, other inhaled glucocorticoids could be continued if the patient was well-controlled on one of these medications prior to pregnancy. Salmeterol (the LABA in Advair) is recommended as the inhaled long-acting beta agonist of choice in the United States due to the longer duration of clinical experience with this agent compared with formoterol. 

    Basically meaning the "recommended" meds have just been better studied and/or have been around longer although the other meds haven't been deemed "dangerous". 





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  • goldie987goldie987 member
    edited December 2015
    TunieBee said:


    Sgoldberg247 said:

    As far as I can tell it's class C which means it isn't proven safe during pregnancy and it has been shown in animals to cause problems (remember that while we are similar to rats, we aren't the same).  I would give your OB a call and see what they say, if the benefits outweigh the risks, they may recommend you take it anyways but that's totally a decision a medical professional has to make.  

    Pregnancy categories are actually a bit more confusing and nuanced than this. What Category C actually means is that 
    1) animal studies have shown risk to the fetus
    OR
    2) there are no controlled studies in women
    OR
    3) studies in women and animals are not available.

    Many times options 2 and 3 are the cause for the rating because meds aren't often studied in pregnant women, so that data isn't available.

    Here is the deal with the meds the pt is considering:

    Because there are more published gestational human data for budesonide (the steroid in Symbicort), it is the preferred inhaled glucocorticoid for use during pregnancy. However, other inhaled glucocorticoids could be continued if the patient was well-controlled on one of these medications prior to pregnancy. Salmeterol (the LABA in Advair) is recommended as the inhaled long-acting beta agonist of choice in the United States due to the longer duration of clinical experience with this agent compared with formoterol. 

    Basically meaning the "recommended" meds have just been better studied and/or have been around longer although the other meds haven't been deemed "dangerous". 

    -------qbf----------
    Well then. You learn something new every day! Thanks for the info (honestly), I love learning new things from people who know what they're talking about (I believe you're a nurse of some form based on the profession thread, right?)
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  • mamabuddmamabudd member
    I take Symbicort when necessary. Third pregnancy and every time my midwives have said it's fine to use when I need to. I figure I need to breathe to keep this baby alive, soooo.....
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  • TunieBeeTunieBee member
    @Sgoldberg247 It's ridiculous that the categories are so confusing. The FDA has actually proposed making changes to the classification system. I hope they do. I guess the answer to always check with your OB is the right one. It's too confusing and nervewracking to make the decisions yourself. 




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  • TunieBeeTunieBee member
    TunieBee said:
    Sgoldberg247 said:
    As far as I can tell it's class C which means it isn't proven safe during pregnancy and it has been shown in animals to cause problems (remember that while we are similar to rats, we aren't the same).  I would give your OB a call and see what they say, if the benefits outweigh the risks, they may recommend you take it anyways but that's totally a decision a medical professional has to make.  
    Pregnancy categories are actually a bit more confusing and nuanced than this. What Category C actually means is that 
    1) animal studies have shown risk to the fetus
    OR
    2) there are no controlled studies in women
    OR
    3) studies in women and animals are not available.

    and I actually wrote this incorrectly... It's 1) AND 2) OR 3). Geez, pregnancy brain...but the premise that perhaps they are just not well-studied and are may be suitable stands...




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  • fishwife799fishwife799 member
    edited December 2015
    I have taken Symbicort during all of my pregnancies. For me the benefits outweigh the risks. However we do drop my dosage to 2 puffs once daily rather than the prescribed twice daily. Both of my kids are healthy and hopefully this one will be as well. I would definitely ask your ob about it before taking it, but in my case it has been the inhaler of choice.


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  • alylove11alylove11 member
    Thanks for all the info, I appreciate it!

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