Paracetamol in pregnancy

Paracetamol during pregnancy has the widest application among other anti-inflammatory drugs. But the question of the safety of this drug and the question of its possible harm to the fetus is also widely debated. As to the harm of the drug or its benefits during pregnancy, the approach to this issue is strictly individual, but in order to understand the general questions of the prescription of the drug in this case, it is necessary to know some features of its pharmaceutical effect and the metabolism of the drug.

[1], [2], [3], [4], [5], [6]

Indications for use of paracetamol in pregnancy

Paracetamol, due to its pronounced effect on the center of thermoregulation, is widely used as an antipyretic. At pregnancy the indications for decrease in body temperature are indicators not less than 38,5 degrees. Also indications for the use of the drug is a headache of medium intensity, muscle pain, pain in the spine with osteochondrosis or other neurological pathology, inflammatory diseases of the respiratory system, infectious diseases with a pronounced intoxication syndrome. Paracetamol from a headache during pregnancy can be taken if the headache is associated with an inflammatory disease or intoxication syndrome, otherwise it is better to give preference to antispasmodics. Children's paracetamol during pregnancy can be taken at the same indications and in the same dosage as regular paracetamol, only the form of release and the concentration of the drug in the volume of the syrup or suspension differ.

Pharmacodynamic features of the preparation

The form of the preparation is tablets, rectal suppositories, syrup, suspension. All these drugs increase the availability of paracetamol for various purposes.

Paracetamol is a drug from a group of non-steroidal anti-inflammatory drugs that has many therapeutic effects. The most pronounced property of paracetamol is its antipyretic effect, and it also has an analgesic effect, an anti-inflammatory, a mild antispasmodic effect. The mechanism of action of the drug is its central effect: paracetamol penetrates the blood-brain barrier and irritates the center of thermoregulation in the hypothalamus, reducing its excitability and reaction to an increase in body temperature. Thanks to this, the thermoregulation center becomes less sensitive and the body temperature decreases. Its analgesic effect is due to a decrease in the activity of synthesis of inflammatory mediators and prostaglandins, which reduces the irritating property of these substances on tissues, vessels. So the spasmolytic effect of the drug is realized. Dosage of the drug during pregnancy should not exceed the average therapeutic dose, it is better to take no more than 1500 milligrams of paracetamol per day.

Pharmacokinetic features of the drug

As a result of taking the drug inside, there is a rapid absorption of the active substance in the duodenum, and the maximum concentration of the drug in the blood is determined after half an hour of intake. The effect occurs in a half to two hours, which is necessary to overcome the blood-brain barrier. After entering the blood, paracetamol enters the liver, where its metabolism passes. The active substances that make up the paracetamol, after metabolism, are able to induce the synthesis of methemoglobin, which is a toxic substance and due to this effect the toxic effect of the drug is realized. When paracetamol enters the blood, it binds to a quarter of the blood plasma proteins, which contributes to a short half-life of the drug. There is no direct teratogenic effect of paracetamol, but it is able to penetrate the fetoplacental barrier, which explains its potential threat to the fetus.

Basic principles of paracetamol application during pregnancy

Pregnancy is the period when another woman's life develops in the female body and at this time one should take a very careful attitude to the nutrition and reception of any pharmacological preparations. The process of organogenesis begins in the first trimester, and then the growth and differentiation of tissues continues, which also requires increased attention to taking any medications. Fetus is an agent alien to the body of a woman, in fact 50% of the information it contains from the pope. The immune system of a woman perceives it as an antibody to some extent, therefore, until the formation of its placenta with an individual barrier and blood flow, a state of relative immunosuppression develops. Such a state of a pregnant woman helps to change all the reactions of the female body, which before could be normal. That is, pharmacological transformation reactions of drugs also occur in a different way, which in this way can significantly affect the child. This especially applies to the first trimester of pregnancy, when there is still no placenta, as an individual protective mechanism. With this, and the specific features of the use of paracetamol for different periods of pregnancy.

Is paracetamol available during pregnancy and is it harmful to the baby? This question is asked by many women when there is a need for treatment of pathology. In the instructions to paracetamol, you can see a paragraph that says that during pregnancy, paracetamol should be taken with caution. This is due to some features that you need to know before you start taking the drug.

The state of relative immunosuppression of the pregnant woman's organism promotes a more rapid development of diseases, especially the pathology of the upper respiratory tract, usually a viral etiology. In this case, there is a pronounced intoxication syndrome in the form of a rise in body temperature, headache, muscle pain, and general malaise. In this case, these symptoms most effectively removes drugs from the group of non-steroidal anti-inflammatory drugs. As for the drug, paracetamol here has the most pronounced effect. The use of paracetamol in pregnancy in this case has the most mild effect of all drugs in this group, therefore, if necessary, the use of these drugs, preference is given to paracetamol.

There are some features of the use of paracetamol for different terms of gestation. This is due precisely to the development of the fetus in the mother's body. Paracetamol in early pregnancy, particularly in the first trimester, should not be taken. During this period, the process of formation of the basic vital organs of the child, as well as the formation of the placenta, which is a barrier to harmful factors, occurs. Therefore, taking any medications, including paracetamol, in the first trimester of pregnancy is strongly discouraged. Although it does not have a pronounced teratogenic effect, it is possible that the damage is high. With regard to the use of paracetamol in pregnancy in the second trimester, there is also growth of the fetal tissues, but there is a formed placenta that protects the child in some way. Therefore, if there is evidence, paracetamol may be taken in the second trimester. But it is necessary to approach this question differently, because the temperature increase to the low-grade figures does not require the use of paracetamol, alternative means can be used. If it is a significant intoxication syndrome with an increase in body temperature above 38, 5, then it is necessary to take an antipyretic. Paracetamol during pregnancy in the third trimester has the least harm, as all the organs of the child are formed, and it is already a matter of the fact that toxic products have a stronger effect on the fetus than paracetamol. Therefore, the use of paracetamol in the third trimester is the most favorable option.

In any case, when talking about the harm or benefit of the drug during pregnancy, it is necessary to know that any medication is a potential threat to the child and there must be some indication for its use. Therefore, the question of using paracetamol in pregnancy in any case should be decided by the doctor individually.

[7], [8], [9], [10], [11]

Contraindications to paracetamol during pregnancy and side effects

Paracetamol in pregnancy is contraindicated in case of acute disorders or serious pathologies on the part of the liver and kidneys, as well as in the presence of allergic reactions in the anamnesis or in case of allergies to additional compound components of the drug. Local forms of paracetamol in the form of rectal suppositories can not be used if there are erosions or other inflammatory damage in the rectum. Side effects of paracetamol are possible in the form of oppression hemopoiesis with a decrease in the level of leukocytes, erythrocytes, platelets, as well as impaired renal function with renal colic and asymptomatic pyuria. Other side effects may manifest in the form of allergic manifestations with skin rash, nausea and vomiting, stool, abdominal pain, drowsiness and dizziness.

Side effects of paracetamol in pregnancy in case of its use in the first trimester are possible violations of differentiation of the fetal tissues and violation of placentation. Overdose of paracetamol can cause its toxic effect on the liver.

Paracetamol storage conditions are as follows: shelf life of two years. Store at a relative temperature below 25 degrees, avoiding direct action of high and low temperatures, and also to exclude high humidity.

Reviews of paracetamol during pregnancy talk about its effective antipyretic properties, but also its pronounced analgesic effect. Prove that the use of infant paracetamol in a lower dosage of 200 milligrams is not so harmful to the child, so they prefer this form. If the pain is strong, the use of paracetamol, according to reviews, very effectively reduces it.

Paracetamol in pregnancy can be used in the presence of clear indications for use, when pain or intoxication syndrome is expressed significantly and affects the maternal organism. Having studied the basic pharmacological features of paracetamol, it can be precisely said that the drug has no pronounced proven effect on the future child's organism. In this case, the drug is contraindicated in the first trimester, because in the process of laying the fetal organs any influence, even with local treatment, can be teratogenic. Therefore, paracetamol can be used during pregnancy, because it has a pronounced antipyretic and analgesic effect, but should be used only in the second and third trimester and according to the doctor's prescription.

[12], [13], [14], [15], [16]