# AUGH! Anyone taking nifedipine (ADALAT) during 3d trimester?



## tammyswanson (Feb 19, 2007)

I just got out of the hospital late yesterday because they said I was in preterm labor (i'm about 27 weeks along). They have me on this nifedipine drug, I read that it can cause birth defects!!!! HOLY $!#@! Has anyone taken this during pregnancy?? I'm so worried that if I do take it, my baby will be screwed up...I did have them decrease the dosage to 10 mg because they were giving me 20 and I was feeling really bad from the side effects. They also diagnosed me with high blood pressure (I've had it before I got pregnant, but I'm physically fit and normal weight).

Now I'm worried about taking it at all, I dont' want to ask the doctor because most of them just work for the drug companies, plus my next appt isn't until the 11th. PLEASE HELP, normally things don't freak me out, but this is. I don't want my kid to be messed up.









Thanks for any info!


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## ksera05 (Apr 14, 2006)

I would try asking this over in the NICU and preemie parenting board.


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## Crisstiana (Jan 18, 2007)

Quote:


Originally Posted by *tammyswanson* 







I just got out of the hospital late yesterday because they said I was in preterm labor (i'm about 27 weeks along). They have me on this nifedipine drug, I read that it can cause birth defects!!!! HOLY $!#@! Has anyone taken this during pregnancy?? I'm so worried that if I do take it, my baby will be screwed up...I did have them decrease the dosage to 10 mg because they were giving me 20 and I was feeling really bad from the side effects. They also diagnosed me with high blood pressure (I've had it before I got pregnant, but I'm physically fit and normal weight).

Now I'm worried about taking it at all, I dont' want to ask the doctor because most of them just work for the drug companies, plus my next appt isn't until the 11th. PLEASE HELP, normally things don't freak me out, but this is. I don't want my kid to be messed up.









Thanks for any info!

Nifidepine is used both for PTL and hypertension. It is pregnancy risk category C, with adverse affects shown in animals at higher doses than are prescribed in humans. There seems to be continued debate about its safety to fetuses.

You need to talk to your doctors about your concerns. You are mistaken about doctors' relationship with drug companies. They do not get money from drug companies for writing prescriptions to individual patients. They should have no financial reason for prescribing you one drug versus another. And your doctors will know your specific medical history and course of your pregnancy, details that people here or on another internet site will not be familiar with. It's obviously important to prevent PTL and decrease high blood pressure. Even without an appointment, I'm sure your doctor would prefer you call to talk about nifidepine and any risks rather than not take it. I hope you can get some reassuring info from your docs soon.

FWIW, here are some links and quotes:

From the RISK newsletter: Calcium channel blockers and pregnancy

...Nifidepin is also considered to be of minimal risk to the fetus. It is generally used in the second half of pregnancy for hypertension, cardiovascular disease and pre-term labor. A retrospective study of 102 women who received nifedipine for inhibition of pre-term labor found the drug to be a safe means of therapy (Waisman et al., 1989). In addition, no increase in the frequency of congenital anomalies was observed in 57 infants exposed to nifedipine in-utero in the first trimester (Magee et al., 1994). Clinical trials involving from 20 to 99 infants of women treated with nifedipine in the second and third trimesters also failed to show any treatment-related adverse effects (Read and Wellby, 1986; Ferguson et al., 1990; Meyer et al., 1990; Bracero et al., 1991; Fenakel et al., 1991; Murray et al., 1992; Sibai et al., 1992; Glock and Morales, 1993; Roy and Pan, 1993; Smith and Woodland, 1993; Childress and Katz, 1994)....

...

From the Annals of Pharmacotherapy (1994): Use of nifedipine in the hypertensive diseases of pregnancy

...Current data indicate that nifedipine is an appropriate second-line antihypertensive medication in pregnancy, but more clinical trials are needed before it can be considered an appropriate choice for initial therapy. As do other antihypertensive agents, nifedipine provides maternal benefit by lowering blood pressure and reducing the risk of cerebral hemorrhage and end-organ damage. However, perinatal benefit of nifedipine remains to be established....

...
From Review of efficacy and safety of nifidepine as tocolyte in late pregnancy

...High quality clinical evidence has accumulated to form a convincing argument to list nifedipine as an antioxytocic (tocolytic) for inhibiting preterm labour, tablets, capsules, 10 milligrams; 20 milligrams on the WHO Model List of Essential Medicines....

...

From OBLink.Com: Nifedipine trials: effectiveness and safety aspects

...Currently, over 40 studies have been published on nifedipine's tocolytic effectiveness, including five meta-analyses. The quality of the studies suffered particularly from performance bias since the majority of the trials failed to ensure blinding to treatment, both for providers and patients. Concerns about other methodological flaws include measurement, outcome assessment and attrition bias. In particular, the safety aspects of nifedipine for tocolysis have been under-assessed. The conclusion from the meta-analyses, favouring the use of nifedipine as a tocolytic agent, is not supported by solid data.

One should realise that the tocolytic effectiveness and safety of nifedipine has been primarily assessed in normal pregnancies. Based on its pharmacological properties, one should be cautious when administering nifedipine when the maternal cardiovascular condition is potentially compromised....


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## tammyswanson (Feb 19, 2007)

Hi! Actually they said that it's a dual effect drug, the nifedipine actually keeps the uterus 'quieted' and keeps it from contracting. The fact that I have high bp is just incidental. They had given me other drugs to try and stop the contractions, (not sure what they were), but they didn't work. They said that my urine was fine and let me out of the hospital, so that's good at least.


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## tammyswanson (Feb 19, 2007)

Thank you so much for the links, Crisstiania! That was really nice of you.







I'm still uneasy, but it did make me feel better. Thanks a bunch! I'm still taking the nifed, I wouldn't just stop doing that of course.


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## JessicaTX (Jul 9, 2006)

I was on procardia for preterm labor. I think that's the same thing. that was 7 years ago though, and it was an offlabel use. It worked, I went to term. I never had high blood pressure or gd or anything, just an irritable uterus. I started dilating and effacing 4 months early. One of the things I wasn't warned about was reactions with grapefruit. that was one of the things I craved during pregnancy, and I accidentally came across that information when I was researching the meds. I delivered a healthy 9lb 8oz boy at 38 weeks =)


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## ksera05 (Apr 14, 2006)

Ahh! I feel dumb. I didn't realize that was also known as procardia.







: Now that I know that...makes much more sense. Sorry!









Glad you posted over on the NICU board - I think a good 50% of those women have taken it!


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## tammyswanson (Feb 19, 2007)

Thanks JessicaTX for your story! I do feel better now, I was just so freaked out when I saw the stuff about animal studies and birth defects....(shudder). I hope he's okay.


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## tammyswanson (Feb 19, 2007)

Ksera, don't feel dumb, heck I didn't know the brand names either...I'm on the generic one (nifedipine). So many names....


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## witch's mom (Dec 8, 2003)

I took it 10 years ago as an off-label use for pre-term labor symptoms. I went on it at 27 weeks and took it for 9 weeks, on bedrest. It seemed to slow the number of contractions I had, but it made me feel awful--racing heart, blood rushes to my arms and legs, short of breath. My pulse was crazy-fast the day my doctor said, "This is enough." With my contraction profile, she expected I'd deliver within a few days of going off the nifedipine.

I went to term.

So when the same symptoms hit with my second daughter, at exactly the same point, I did some research. My OB was eager to put me on bedrest and nifedipine again--in her opinion, that treatment had worked. I got a second and third opinion, though, including a major ultrasound to measure my cervix, and the prevailing opinion (other than my OB's) was that nifedipine and bedrest hadn't been my savior before, that I simply had what they call "an irritable uterus" and that the contractions, although frequent and strong, were not causing any cervical changes and were not truly preterm labor. So with my second DD, I did not accept any treatment, other than to do a salivary estriol test every two weeks, which gave my OB some idea of what my risk of true preterm labor might be. (These tests were always negative.) My OB disagreed with me for refusing bedrest and nifedipene, and tried to convince me I was taking too much of a risk, but I felt really confident that I'd carry to term, just like I had with my first DD.

I went past term with second DD.

In my case, I didn't have preterm labor. True preterm labor, I was told at the time, is virtually unstoppable. You can stave it off for one week, two at the most, with bedrest and medication. The problem is, doctors can't predict whether such symptoms are true preterm labor or just SYMPTOMS of preterm labor, and they at the time didn't know whether the contractions of an irritable uterus could suddenly BECOME true preterm labor. (I asked so many times, "Are these contractions really a threat to my pregnancy?" "We don't know," they said, telling me to go on bedrest and take the medication if it would ease my mind, even though they pretty much convinced me that those measures wouldn't stop TRUE preterm labor for long.) I hope that now, 8 years later, they can better predict. Because a treatment regimen of long-term bedrest and medication is very costly to the patient, and a nice liability cushion for the doctor--even if the worst occurs and you deliver way too early, the doctors can at least say they did everything they could, even if they suspect the treatment available isn't all that effective.

Maybe they know more now. I sure hope so. It was a very frustrating time for me, and nifedipine definitely did not agree with me!


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