What allergy medication is safe during pregnancy

The exact mechanism by which levetiracetam acts to treat epilepsy is unknown. Levetiracetam does not exhibit pharmacologic actions similar to that of classical anticonvulsants. It does not inhibit voltage-dependent Na+ channels, does not affect GABAergic transmission, and does not bind to GABAergic or glutamatergic receptors.[30] However, the drug binds to SV2A,[31] a synaptic vesicleglycoprotein, and inhibits presynapticcalcium channels,[32] reducing neurotransmitter release and acting as a neuromodulator. This is believed to impede impulse conduction across synapses.[33]


Research

Levetiracetam is being looked at in psychiatric and neurologic conditions such as Tourette syndrome,[39] and anxiety disorder.[40] However, its most serious adverse effects are behavioral, and its benefit-risk ratio in these conditions is not well understood.[40]


Society and culture

Levetiracetam is available as regular and extended release oral formulations and as intravenous formulations.[23][34]

The immediate release tablet has been available as a generic in the United States since , and in the UK since [35][8] The patent for the extended release tablet will expire in [36]

The branded version Keppra is manufactured by UCB Pharmaceuticals Inc.[37]

In Aprecia’s 3d-printedorally disintegrating tablet form of the drug was approved by the FDA, under the trade name Spritam.[38]


Medical uses

Other

Levetiracetam has not been found to be useful for treatment of neuropathic pain,[17] nor for treatment of essential tremors.[18] Levetiracetam has not been found to be useful for treating autism,[19][20] but is an effective treatment for partial, myoclonic, or tonic-clonic seizures associated with autism spectrum disorder.[21]

Partial-complex epilepsy

Levetiracetam is effective as add-on treatment for partial (focal) epilepsy.[9]

Prevention of seizures

Based on low-quality evidence, levetiracetam is about as effective as phenytoin for prevention of early seizures after traumatic brain injury.[15] It may be effective for prevention of seizures associated with subarachnoid hemorrhages.[16]

Focal epilepsy

Levetiracetam is effective as single-drug treatment for newly diagnosed focal epilepsy in adults.[7] It reduces focal seizures by 50% or more as an add-on medication.[8]

Generalized epilepsy

Levetiracetam is effective for treatment of generalized tonic-clonic epilepsy.[10] It has been approved in the United States as add-on treatment for myoclonic, and tonic-clonic seizures.[11] Levetiracetam has been approved in the European Union as a monotherapy treatment for epilepsy in the case of partial seizures or as an adjunctive therapy for partial, myoclonic, and tonic-clonic seizures.[12]

Levetiracetam is sometimes used off label to treat status epilepticus[13][14]

Special groups

Levetiracetam is a pregnancy category C drug.

Studies in female pregnant rats own shown minor fetal skeletal abnormalities when given maximum recommended human doses of levetiracetam orally throughout pregnancy and lactation.[14]

Studies were conducted to glance for increased adverse effects in the elderly population as compared to younger patients. One such study published in Epilepsy Research showed no significant increase in incidence of adverse symptoms experienced by young or elderly patients with central nervous system (CNS) disorders.[16]

Levetiracetam may be safely used with caution in children over the age of 4. However, it has not been sure whether it can be safely given to children under the age of 4.[22]


Adverse effects

The most common adverse effects of levetiracetam treatment include CNS effects such as somnolence, decreased energy, headache, dizziness, mood swings and coordination difficulties.

These adverse effects are most pronounced in the first month of therapy. About 4% of patients dropped out of pre-approval clinical trials due to these side effects.[23]

About 13% of people taking levetiracetam experience adverse neuropsychiatric symptoms, which are generally mild. These include agitation, hostility, apathy, anxiety, emotional lability, and depression.

What allergy medication is safe during pregnancy

Serious psychiatric adverse side effects that are reversed by drug discontinuation happen in about 1%. These include hallucinations, suicidal thoughts, or psychosis. These occurred mostly within the first month of therapy, but they could develop at any time during treatment.[24]

Although rare, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which appears as a painful spreading rash with redness and blistering and/or peeling skin, own been reported in patients treated with levetiracetam.[25] The incidence of SJS following exposure to anti-epileptics such as levetiracetam is about 1 in 3,[26]

Levetiracetam should not be used in people who own previously shown hypersensitivity to levetiracetam or any of the inactive ingredients in the tablet or oral solution.

Such hypersensitivity reactions include, but are not limited to, unexplained rash with redness or blistered skin, difficulty breathing, and tightness in the chest or airways.[23]

In a study, the incidence of decreased bone mineral density of patients on levetiracetam was significantly higher than those for other epileptic medications.[27]

Kidney and liver

Kidney impairment decreases the rate of elimination of levetiracetam from the body. Individuals with reduced kidney function may require dose adjustments. Kidney function can be estimated from the rate of creatinine clearance.[23]

Dose adjustment of levetiracetam is not necessary in liver impairment.[23]

Suicide

Levetiracetam, along with other anti-epileptic drugs, can increase the risk of suicidal behavior or thoughts.

People taking levetiracetam should be monitored closely for signs of worsening depression, suicidal thoughts or tendencies, or any altered emotional or behavioral states.[11]

Drug interactions

No significant pharmacokinetic interactions were observed between levetiracetam or its major metabolite and concomitant medications.[28] The pharmacokinetic profile of levetiracetam is not influenced by phenytoin, phenobarbital, primidone, carbamazepine, valproic acid, lamotrigine, gabapentin, digoxin, ethinylestradiol, or warfarin.[29]



Asthma During Pregnancy

Asthma is one of the most common medical problems that occurs during pregnancy.

It can be potentially serious. Some studies own suggested that asthma complicates up to 7% of every pregnancies.About 30% of every womenwith asthma report their asthmaworsened while pregnant. Butwith the correct treatment and care, you and your baby can own a goodoutcome.

Is It Safe to Breastfeed?

Doctors do not believe asthma medicines are harmful to a nursing baby when used in usual amounts.

The transfer of asthma medicines into breast milk has not been fully studied.

When breastfeeding, drinking additional liquids to avoid dehydration is also significant (as it is for every people with asthma). Discuss with your baby’s pediatrician.

What Should I Do to Avoid Asthma Attacks During Pregnancy?

Avoid Your Asthma Triggers

Avoiding asthma triggers is always significant, but is particularly significant during pregnancy. Pregnant women with asthma should increase avoidance measures to acquire greatest comfort with the least medication.

  1. Stay away frompeople who are ill with respiratory infections.
  2. Avoidallergens love dust mites, animal dander, pollen, mold and cockroach.

Stop Smoking Cigarettes/Tobacco

Giving up cigarette smoking isimportant for any pregnant lady.

Smoking may worsenasthma and harmsthe health of the growing fetus as well.

Exercise

Regular exercise is significant to health. Talk to yourobstetrician for the best adviceabout exercising during pregnancy. Swimming isa particularly excellent exercise for people with asthma.

What allergy medication is safe during pregnancy

Using quick-relief medicine10 minutes before exercise may assist you tolerate recommended exercise.

Are Flu Shots Safe to Get During Pregnancy?

People with asthma should get flu shots. Pregnancy does not change that recommendation. In fact, influenza may be particularly severe in pregnant women.

Does Asthma Cause Complications During Pregnancy?

Potential Complications

Pregnant women with asthma may havea bit greater risk of delivering early. Or the baby may own alow birth weight. High blood pressure and a related condition known as pre-eclampsiaare also more common in pregnant women with more severe asthma.

It is not known if uncontrolled asthma causes these problems directly or if other reasonsare to blame.

However, optimal control of asthma during pregnancy is the best way to cutthe risk of these complications.

Will I Pass On Asthma to My Baby?

Genetics plays a role in whether a baby will develop asthma.

In other words, asthma tends to be more likely in a baby if their relatives own it.

What allergy medication is safe during pregnancy

The environment also plays an significant role.

How Does Uncontrolled Asthma Affect the Fetus?

Uncontrolled asthma cuts the oxygen content of the mother's blood. Since the fetus gets its oxygen from the mother's blood, this can lead to decreased oxygen in the fetal blood. The result may impair fetal growth and survival. The fetus requires a constant supply of oxygen for normal growth and development. There is evidence that adequate control of asthma during pregnancy reduces the chances of fetal or newborn death and improves fetal growth inside the uterus.

There are no indications that a mother’s asthma contributes to either spontaneous abortion or congenital malformation of the fetus.

Changes in Asthma Severity

About one-third of pregnant women with asthma will see their asthma symptoms get worse. Another third will stay the same. The lastthird will see their asthma symptoms improve.

Most women with asthmawhose symptoms changed in any way during pregnancy will return to their pre-pregnancy condition within three months after giving birth.

There is a tendency for women whose asthma symptoms increased or decreased during one pregnancy to experience the same thingin laterpregnancies.

It is hard to predict how asthma will change during pregnancy.

Because of this uncertainty,asthma should be followed closely. This way,any change can be promptly matched with an appropriate change in treatment. This calls for goodteamwork between the obstetrician, primary care physician and asthma specialist.

Asthma Attacks During Labor

When asthma is under control, asthma attacks almost never happen during labor and delivery. Also, mostwomen with well-controlled asthma are capable to act out breathing techniques during their labor without difficulty.

Are Allergy Shots Safe During Pregnancy?

Pregnant lady with asthma already receiving allergy shot therapycan generally continueif they are not having reactions.

As an additional precaution, though, the allergist may cut thedosage of the allergy extractto reducethe chance that a severe allergic reactionoccurs or at a minimum hold the dose the same but the dose should not be increased during pregnancy since that increases the chance of a reaction.

Are Asthma Medicines Safe to Use During Pregnancy?

Is It Safe to Use Asthma Inhalers or Corticosteroids While Pregnant

Ensuring asthma is well-controlled is key.

It is recommended that mothers seek regular check-ups to ensure their asthma remains controlled.

What allergy medication is safe during pregnancy

Working with an asthma provider is essential. The asthma regimen that is best suited for the mom is the best approach.

Some asthma medicines are considered "safer" during pregnancy because their risks appear to be less than the risks of uncontrolled asthma. These include:

  1. Anti-leukotriene agents love montelukast (SINGULAIR®)
  2. Short-actinginhaled bronchodilators
  3. Some inhaled corticosteroids, love budesonide

Based on the severity of the mother’s asthma, a doctor may consider switching her treatment to an inhaled corticosteroid alone.

Long-acting beta agonists (like SEREVENT®, Symbicort® and ADVAIR®) and theophylline are not considered first-line treatments for pregnant asthma patients.

But doctors may consider them if the mother’s asthma is not adequately controlled by the above medicines.

If asthma is extremely severe, oral steroids such as prednisone, may be necessary for the health of the mom and baby.

Remember: It is better for mom and baby if the mom maintains asthma control (using any approved asthma drugs).

Can I Do Anything to Prevent Asthma in My Baby?

One major prenatal risk factor for the development of asthma is maternal smoking.

What allergy medication is safe during pregnancy

Giving up cigarette smoking is extremely significant. Other prenatal factors that may influence the development of asthma are:

  1. Antibiotic use
  2. Diet
  3. Vitamin D levels
  4. Maternal stress
  5. Method of delivery

Talk to your doctors about identifying your risk factors and making safe changes in preparation for your new baby.

Medical Review November .

References

Subbarao, P., Mandhane, P.J., Sears, M. R. (). “Asthma: epidemiology, etiology and risk factors.” CMAJ.

+html

Willemsen, G., van Beijsterveldt, T.C.; van Baal, C.G.; et al.

What allergy medication is safe during pregnancy

(). “Heritability of self-reported asthma and allergy: a study in adult Dutch twins, siblings and parents.” Twin Research and Human Genetics.

Holberg, C.J., Elston, R.C., Halonen, M., et al. (). “Segregation analysis of physician-diagnosed asthma in Hispanic and non-Hispanic white families. A recessive component?” American Journal of Respiratory and Critical Care Medicine. ;– [PubMed]

Lawrence, S., Beasley, R., Doull, I., et al. (). “Genetic analysis of atopy and asthma as quantitative traits and ordered polychotomies.” Annals of Human Genetics.

;– [PubMed]

Fraga, M.F., Ballestar, E., Paz, M.F., et al. (). “Epigenetic differences arise during the lifetime of monozygotic twins.” Proceedings of the National Academy of Sciences of the United States of America. [PMC free article]

Qiu, Jane. ().

What allergy medication is safe during pregnancy

“Epigenetics: unfinished symphony.” Nature.

Camargo Jr, C.A., Rifas-Shiman, S.L.,Litonjua, A.A., et al. (). “Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age.” The American Journal of Clinical Nutrition.

Levetiracetam, marketed under the trade name Keppra among others, is a medication used to treat epilepsy.[1] It is used for partial onset, myoclonic, or tonic-clonic seizures.[1] It is taken by mouth as an immediate or extended release formulation or by injection into a vein.[1]

Common side effects include sleepiness, dizziness, feeling tired, and aggression.[1] Severe side effects may include psychosis, suicide, and allergic reactions such as Stevens-Johnson syndrome and anaphylaxis.[1] It is unclear if use is safe during pregnancy but appears to be safe for use when breastfeeding.[2] It is the S-enantiomer of etiracetam.[3] How it works is not clear.[1]

Approved for medical use in the United States in ,[1] levetiracetam is available as a generic medication.[4] A month’s supply in the United Kingdom costs the NHS about £ as of [4] In the United States, the wholesale cost of this quantity is about US$[5] In , it was the 89th most prescribed medication in the United States with more than eight million prescriptions.[6]


Pharmacokinetics

Excretion

In persons with normal kidney function, levetiracetam is eliminated from the body primarily by the kidneys with about 66 percent of the original drug passed unchanged into urine.

The plasma half-life of levetiracetam in adults is about 6 to 8 hours.[23]

Distribution

The volume of distribution of levetiracetam is similar to entire body water. Levetiracetam modestly binds to plasma proteins (less than 10%).[23]

Metabolism

Levetiracetam does not undergo extensive metabolism, and the metabolites formed are not athletic and do not exert pharmacological activity.

Metabolism of levetiracetam is not by liver cytochrome P enzymes, but through other metabolic pathways such as hydrolysis and hydroxylation.[23]

Absorption

The absorption of levetiracetam tablets and oral solution is rapid and essentially finish. The bioavailability of levetiracetam is shut to percent, and the effect of food on absorption is minor.[23]

Analogues

Brivaracetam, a chemical analogue to levetiracetam, is a racetam derivative with similar properties.


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