Paging our friendly neighborhood pharmacist!

TheThornBird · April 2016

I remember we have a pharmacist here in May 2016 who started an "Ask A Pharmacist" thread (which I couldn't find, because TB's search function sucks).

If you are still around, I'd *love* to hear about allergy meds! The pollen here is ridiculously awful and I can't breathe. My midwife didn't have much information for me (and was very "suck it up, buttercup!") and Dr. Google isn't much help. I'm dying and would love to know what is and isn't safe!

Jenly17 · April 2016

@ayeshaohara is who you're looking for

proudparent2b · April 2016

My doctor approved over the counter nasal sprays, like Nasacort or Flonase (sp). You have to steer clear of the pill options though, because they affect LO (go through blood stream).

finnybooboo · April 2016

Suck it up buttercup!!!!!

Just kidding, I hope you get some relief!! Have you tried a nettipot? Not sure if that might help a little bit?

swflJD · April 2016

@TheThornBird This is c&p'd from the guidelines on my OB's website:

In regards to MEDICATIONS in pregnancy, we ask that you try to limit your exposure to medications (including over-the-counter medications and herbal products). If, however, you find you need treatment for any of the following conditions, the medications listed below may be used.

For severe symptoms of cold/sinus/allergies, you may use an over-the-counter decongestant or antihistamine such as Claritin, Claritin-D, Sudafed, Benadryl, Tylenol Cold/Sinus/Flu, Contac, Theraflu or Triaminic products for a short period of 3 to 5 days. Commercial cough syrups or cough drops on a short 3 to 5 days basis is acceptable (Robitussin DM, Vicks 44E). We discourage the use of nose sprays during pregnancy. Nose bleeds are common in pregnancy. If you have great chest congestion or discomfort, fever or yellow, green or bloody sputum, call the office. For a sore throat, salt water gargles or over-the-counter sprays and lozenges are acceptable. If your throat should remain severely sore for more than 3 to 7 days, call the office for a possible throat culture.

My allergies have been so much worse this season, so I have used Tylenol sinus on a few occasions. If you have risk factors or are otherwise concerned, though, you should probably call your midwife and ask her directly whether a particular medication would be safe for you.

rlworzalla · April 2016

I was told that a generic allergy medication (I use a 4 hour tablet of Chlorpheniramine) is safe, because I used it, and still do sometimes, when I can't sleep at night, as it's a Class B. Now I'm a little concerned...

obryana6219 · April 2016

@swflJD I'm suprised that your OB's office says that pseudoephedrine products are okay. They can cause increased blood pressure and generally they don't recommend them to everyone because of the risk of pregnancy induced hypertension or pre-eclampsia.

swflJD · April 2016

obryana6219 said:

@swflJD I'm suprised that your OB's office says that pseudoephedrine products are okay. They can cause increased blood pressure and generally they don't recommend them to everyone because of the risk of pregnancy induced hypertension or pre-eclampsia.

Like I said, the above is just c&p'd from their website. I'm not a medical doctor, so you can take it for what it's worth. But, everyone should probably talk to their own doctor/midwife/medical provider to determine whether a medication is safe for their particular situation.

ayeshaohara · April 2016

I laughed when I saw the title. Hey!! I'm here and just catching up.

Ok so heres the low down on what you can use

nasacort nasal spray - use every day to take down swelling and inflammation caused by the allergies

drowsy antihistamines like Benadryl

claritin WITHOUT the decongestant (the non drowsy ones aren't considered as safe as the drowsy ones but Claritin is fine)

don't overlook a good saline rinse too!!

Hope that helps. Ask more if you need to!

JessRX88 · April 2016

Hey there! Pharmacist here lurking from the June 2016 group.

Generally, most of the non-decongestant containing allergy meds would be safe to use in pregnancy. Opt for a single ingredient product rather than a combination product, so you can be sure of what you are taking. The following are generally considered safe when taken as directed at normal doses:

Claritin (generic name loratadine)- day time
Zyrtec (generic name cetirizine)- day time
Steroid nasal sprays like Flonase, Rhinocort or Nasocort- but you have to use them continuously for the entire allergy season for them to work
Benadryl (generic name diphenhydramine)- night time, this one will knock you out

Allegra does not have much data in pregnant women, it is likely safe, but there is better safety data in the aforementioned. I would avoid any behind the counter product that contains psuedoephedrine, or "the D's" as I like to call them (Allegra-D, Zyrtec-D, sudafed, etc). These can all raise blood pressure, increase heart rate, and will keep you awake at night. The same goes for in front of the counter decongestant phenylephrine or "the PE's" (Sudafed PE and such) for the same reasons. Saline nasal sprays or netti pots are always safe... but I haven't found them terribly useful.

Hope that helps! If you have any other drug questions, feel free to ask! It is literally my job

TheThornBird · April 2016

Thanks pharmacists!

What do you think about Afrin? I couldn't get a straight answer if it's bad for the baby, just that you can become dependent on it.

ayeshaohara · April 2016

Good to see that June pharmacist and your trusty neighborhood May pharmacist both recommended exactly the same stuff. She just wrote it out so much nicer than me because I have literally written the same post at least 5 times, so I got lazy. Thank you June pharmacist for showing me up

and hi!!!

JessRX88 · April 2016

I love Afrin! It works within minutes and typically doesn't have the systemic effects of oral decongestants. It is safe to use during pregnancy. However, you can only use it for 3-5 days in a row (pregnant or not). The reason being long term use causes rebound congestion... as in your congestion will be worse than it was in the first place.

ayeshaohara · April 2016

What she said ^^^

jessRX I'm losing my job here with you answering all the questions for me. I was feeling useful before!

JessRX88 · April 2016

Ha! Sorry girl, I'll go on break... ***Puts up 'pharmacist not on duty' sign**

ayeshaohara · April 2016

JessRX88 said:

Ha! Sorry girl, I'll go on break... ***Puts up 'pharmacist not on duty' sign**

You take breaks? Wow I live in the wrong country

gorgeousariel · April 2016

I don't want to hijack the thread but have a question for @ayeshaohara. What should I have in LO's medicine cabinet? What is considered safe at such a young age?

ayeshaohara · April 2016

Hey! Well i have baby Tylenol and Advil ready to go. That's basically it. There's not a lot you would need to be using when they're infants and a lot of meds don't start being safe until they're over 6 months or over 2 years. The best advice I can give here is that if you think you need to give baby something, check with the pharmacist first, but infant Tylenol and Advil are totally fine - just remember to always dose according to baby's weight not their age because as we're already starting to see baby weights are highly variable at certain age points.

Just remember that when they get all stuffy from a cold there's nothing you can use except saline drops and a snot sucker. None of the OTC cold medicines are safe in infants (in Canada they're not allowed for children under 6-I don't know the regulations in the states though)

Hope that helps

JessicaB0627 · April 2016

@ayeshaohara I think most cold medicines are 6 years and up here too. DD's pediatrician said not to use Advil before 6 months. Is that right?

ayeshaohara · April 2016

JessicaB0627 said:

@ayeshaohara I think most cold medicines are 6 years and up here too. DD's pediatrician said not to use Advil before 6 months. Is that right?

From what I can see, yes. I wasn't aware of this to be honest but there's no dosing guidelines less than 6 months that I can find. However I don't know why it is because it IS used in neonates and infants for specific purposes. Stick to Tylenol just to be safe!! I'll see if I can find some more info

ETA: I found this piece of info:

In pediatrics: Exposure to NSAIDs increases risk of acute kidney injury, even with normal doses. Ensure proper hydration status of children when on NSAID therapy.

I interpret that to mean, only use if a doctor tells you so.

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