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Dorris asked...

Medication concerns when planning for a baby...

Hi I’m 30 years old on levothyroxine 125mcg, bisprolol 5mg, ramipril 10mg, lyrica 200mg and now they want to add add statins. I would also like to start trying for a baby, as you can understand I am hesitant to add another medication to the list.

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The answer

Thank you for contacting health at hand.

According to manufacturer’s data, the following information is provided in relation to taking the mentioned medication whilst trying to conceive or during pregnancy.

  • Statins should be avoided in pregnancy where possible. It is advisable to discontinue 3 months before attempting to conceive as congenital abnormalities have been reported and the lowered cholesterol production may possibly affect foetal development. The manufacturer advises adequate contraception during treatment with statins and for 1 month afterwards. Additionally, treatment with Simvastatin must be suspended for the duration of pregnancy or until it has been determined that the woman is not pregnant.
  • Bisoprolol is not recommended during pregnancy unless necessary. If treatment with bisoprolol is considered necessary, monitoring of the blood flow between the placenta and uterus and foetal growth is recommended.
  • The safety of Levothyroxine treatment during pregnancy is not known, however any possible risk of foetal abnormalities should be weighed against the risk to the foetus of an untreated underactive thyroid gland.
  • There are no clinical data on the effects of Pregabalin on female fertility, therefore it is not possible to conclude on the implications of taking Pregabalin whilst trying to conceive or during pregnancy.
  • The use of ACE inhibitors (e.g. Ramipril) is not recommended during the first trimester of pregnancy unless continued ACE inhibitor therapy is considered essential, patients planning pregnancy should be changed to alternative treatments which have an established safety profile for use in pregnancy. When pregnancy is diagnosed, treatment with ACE inhibitors should be stopped immediately, and, if appropriate, alternative therapy should be started.

Our suggestion would be to clearly communicate to your doctor that you are planning to try for a baby, this will enable them to weigh the benefits versus the risks of continuing these medication and you will gain further guidance as to what would be the next step to take in order to continue treatment yet keep any potential risks to a minimum.

We hope that is of some assistance to you.

Answered by the Health at Hand nurses