Ibuprofen during pregnancy in the 1st, 2nd, 3rd trimesters

Continuation of the family is an honorable and very responsible mission, which is entrusted to a woman from the moment of the appearance of life on Earth. How much happiness and joyous hassle brings to the house a small creature that has absorbed the features of its parents. But before this happiness enters the house in the hands of one of its parents, it will be closely connected with the mother for 9 months, in the bosom of which the conception took place on one of the happiest days in the family. For a future mother this is a very critical period, because pregnancy does not protect her from sorrows and illnesses. But after all, many drugs, even those that we used to take almost every day for the slightest reason (for example, Ibuprofen, Aspirin, Paracetamol, Analgin, and some others) may be harmful to the baby or provoke disruption of pregnancy. Therefore, future mothers are often interested, is it not dangerous to take so sincerely loved by doctors "Ibuprofen" during pregnancy? How can his reception affect the health of the fetus?

Can I take Ibuprofen during pregnancy?

The news of pregnancy, especially if it is long-awaited, begged, begged from God, raises a woman literally to heaven. But over time, the feeling of euphoria subsides somewhat, and it's not always the happy days that come to replace it. Reorganization of the female body, a change in the hormonal background makes the woman even more vulnerable to various diseases. It is not for nothing that doctors recommend that during pregnancy, take care of yourself, rest more, avoid hypothermia and overwork, reducing the already shaken immunity.

But few women, being a good housewife and guardian of the home, on whose shoulders care for her husband and family, can afford nothing. And even if the future mother is lonely, her concerns are no less, because she is forced to be both the mistress of the house, and the breadwinner. Well, it does not work for women to care in the warmth and peace. Going to the store, to the market, to work, caring for the home and worrying about the life and health of loved ones do not pass without a trace and at some point a pregnant woman begins to feel unwell: headaches, fever, heavy tiredness and body aches . Such symptoms may be a sign of severe fatigue and fatigue, or may indicate an infection that has been implanted in a woman's body.

Complaints are frequent during pregnancy and on toothache. Even those women who before conception of the baby had no special problems with the teeth, they can arise during pregnancy. The causes of toothache in pregnant women can be several. This is also a natural change in the hormonal background during this period, changes in metabolism (disruption of phosphorus-calcium metabolism), and the subsequent deficiency of vitamins and minerals, some of which the fetus takes away, and exacerbation of existing diseases of teeth and gums.

Pain and fever is the field of activity of non-steroidal anti-inflammatory drugs (NSAIDs), which many of us have long replaced the old analgesics. And there is no difference in the preparations at first glance, because both groups have analgesic, antipyretic and expressed in different ways anti-inflammatory effect. And if there is no difference, then the person is guided by the price and safety of the medicine.

To date, the most budgetary and safe of drugs that help with pain and heat, is Ibuprofen, and according to doctors this drug is also distinguished by the most rare development of side effects. In theory, if side effects of the drug is small and they appear rarely, the drug is unlikely to cause significant harm to the body. No wonder he got so widespread use.

But we have already said that those drugs that we successfully and without consequences use in everyday life, during pregnancy may not be so safe. With regard to "Ibuprofen," drug manufacturers do not see a particular danger for the future mother and baby in her womb, so use during pregnancy does not exclude. But at the same time they limit themselves to the reservation that the drug can be used only for the intended purpose or with the permission of the attending physician.

Such reservations, of course, are worrisome to pregnant women who previously sought rescue from the pain and heat in this drug and they are beginning to actively inquire whether ibuprofen is harmful to pregnant women or a reservation is just a way to be reinsured and not be responsible for the consequences of taking NSAIDs future mothers?

To understand these issues, you need to understand what is "Ibuprofen", in what cases is its administration recommended and what are the features of its use in pregnancy. Let's also try to understand what the risks may be with regular medication.

[1], [2], [3]

Indications Ibuprofen during pregnancy

"Ibuprofen", like any anti-inflammatory non-steroid drug, is considered the most sparing medicine for inflammation, pain, and fever. In comparison with hormonal agents, NSAIDs are considered safer and have almost no serious side effects, which would have to be combated for a long time. It is not surprising that such medicines are widely used in all cases where pain and inflammation of the tissues are required.

In the indications for the use of Ibuprofen, kaknogo from NSAIDs, you can find the following pathologies:

• Rheumatoid arthritis (a systemic disease that affects small joints and is accompanied by pain, inflammation of the cartilaginous and muscular tissues, degenerative processes in them).
• Osteoarthrosis (vascular disease with gradual destruction of cartilage and bone tissue, which is accompanied by swelling of the tissues and sharp pain in the affected area in any movement).
• Bechterew's disease (chronic systemic pathology, among the symptoms of which is pain and inflammation that increases with time and inflammation in the lumbar spine)
• Gout (a feature of the disease are regular attacks of arthritis, the symptoms of which are inflammation of the swelling of the tissues in the joint area, tissue hyperemia, pain).
• Radiculitis (inflammatory process, exciting nerve roots located in the spine and entering its openings, it is characterized by strong piercing pains).
• Bursitis (inflammatory process in mucous bags of joints, accompanied by painful sensations).
• Neuralgia (defeat of peripheral nerves, accompanied by inflammation and pain in the affected area, although the appearance of reflected pain is not excluded),
• Myalgia (muscle pain that appears due to hypertonicity, and often turning into an inflammatory process).

As we see, "Ibuprofen" is considered one of the effective drugs for degenerative-inflammatory diseases of the musculoskeletal system and the neuromuscular system. Its ability to relieve inflammation and pain finds its application in the treatment of injuries (for example, inflammation of the tissues due to impact, damage to the skin, muscles and bones in injuries and fractures in the composition of complex therapy). Moreover, gynecologists quite often prescribe the drug for painful periods (as part of a monotherapy state or in a complex treatment regimen for algodismenorrhea).

In pregnancy, some of the diseases described above may occur, but the reception of Ibuprofen in this case will be justified if the drug is prescribed by the attending physician, taking into account the position of the woman. But there are some other diseases that can bother the expectant mother, complicating the course of pregnancy and concealing the risk of its early interruption.

Pregnancy is the period when the load on the body of a woman is noticeably increasing. On the one hand, changes in the hormonal background and metabolism, provoking a decrease in immunity. On the other hand, increasing the burden on many vital organs, and in particular on the digestive system. It is not surprising that during pregnancy the risk of development of inflammatory processes of different localization increases.

It will not be necessary to dwell once again on the fact that a pregnant woman exacerbates existing chronic diseases. So, plus, new pathologies can appear, such as adnexitis (inflammation of the appendages) or proctitis (inflammation of the rectal mucosa).

Adnexitis can develop against the background of activation of opportunistic microflora, which is part of the internal environment of the body, or life triggered by more dangerous infections, usually transmitted by sex. The disease can occur during pregnancy or worsen during this period (if the diagnosis was made earlier) against the background of a general decrease in immunity. But anyway, this disease is a threat to the mother and baby in her womb, since it significantly increases the risk of miscarriage, spreading to other organs of the reproductive system.

To combat infection, which became the causative agent of the disease, doctors prescribe antibiotic therapy. And such symptoms as severe constrictive pains and inflammation remain the task of antispasmodics and NSAIDs, among which the most popular and often prescribed is Ibuprofen.

Another disease, which often suffers future mothers, is proctitis. Inflammation of the intestines in them usually provoke constipation, which is considered a scourge of pregnant women. Growing in the womb, the baby gradually begins to squeeze the digestive organs, the normal functioning of which is therefore broken. The future mummy begins to be tormented by heaviness in the abdomen and constipation.

Inflammatory diseases of the stomach, liver and pancreas, dysbacteriosis of the intestine can also contribute to their mite in violation of digestion. Stagnant processes in the rectum in turn provoke inflammation of its mucosa.

With this pathology, a pregnant woman begins to feel pain in the rectum, which can irradiate in the lower back or perineum, it can have fever, weakness, etc. "Ibuprofen" during pregnancy will help a woman cope with these symptoms, but it is not considered the main medicine for the treatment of the disease.

So far, we have talked about serious and dangerous diseases that a woman may encounter during pregnancy, but women do not experience them as often as with omnipresent respiratory infections. Again, from the temperature and body aches during pregnancy, doctors often offer "Ibuprofen".

It is clear that the treatment of infectious pathologies by NPVS alone is not effective, especially if it is a question of fungal and bacterial pathologies. Here, the drug will only help to remove the main symptoms, for example, a dangerous temperature increase. But with viral pathologies, "Ibuprofen" not only helps to reduce fever (and the temperature can rise even above 39 degrees, which is dangerous for both the mother and the fetus) and to ease the headache, but also enables the body to gather with the forces necessary for it to fight with viruses. But we know that the best medicine for viruses is the good work of the immune system.

Well, the headache in pregnant women can be not only because of the common cold and viruses. Constant experiences about his family, the course of pregnancy, the various dangers facing the woman during this period cause nervous overstrain and as a consequence of migraine. Again, headache during pregnancy can again help Ibuprofen.

It is clear that this is not the only drug that helps in this situation. But the low risk of side effects again moves him to the top of the list of preferences at a time when any disturbances in the future mother's body necessarily affect the health and condition of the fetus in her womb.

For the same reason, "Ibuprofen" during pregnancy can also recommend dentists from toothache (nervous, caused by tooth decay and inflammation of the roots of the tooth, after treatment or removal of the tooth), inflammation of the gums and other pathologies that can occur in a woman in position. This drug is considered more preferable than Nimesil, Aspirin, Tempalgin, Ketanov and other potent drugs.

[4], [5], [6]

Release form

Probably, there are not many home medicine kits, where among the first aid medicines there would not be any tablets called "Ibuprofen". Packing of 50 tablets, the cost of which barely exceeds the twenty-hryvnia limit, is a fairly profitable acquisition. And given that the medicine helps with many pathologies and health problems, it is truly a wand-a lot for many.

In pharmacies, you can find more modest packaging with tablets of various manufacturers. The package may contain 1, 2 or 5 blisters containing 10 tablets each. But the dosage of tablets is constant. Each of them contains 0.2 g of active ingredient.

But the tablets "Ibuprofen" are not the only form of release of this universal NSAID. The drug in the form of tablets has a hard shell, which does not allow it to dissolve prematurely and cause damage to the gastric mucosa. It is not intended for grinding.

The dosage of one pill is calculated on the weight of the patient 20 and more kilograms. It is clear that for the treatment of young children this form of release of a relatively safe drug is inconvenient. For patients of early age to 6 years, another form of the drug is provided. Children's Ibuprofen is presented as a suspension for internal reception, which is available in vials of different volumes: from 90 to 125 ml (5 variants in total).

Sometimes this form of the drug is called syrup. They use it to treat children from the age of six months (and sometimes even earlier, if the temperature rises after the vaccination) and up to 12 years. In principle, children's "Ibuprofen" can be taken during pregnancy, if this form seems more convenient for a future mother, but the effective dosage will need to be discussed with the doctor, taking into account the fact that 5 ml of the drug contain 0.1 g of ibuprofen.

Suspension can be used not only inward, but also rectally (in the rectum in the form of microclysters with proctitis and adnexitis) or externally (with diseases of the muscles and joints). Sometimes in the pharmacy you can find a form of medicine like a candle, which is also intended for insertion into the rectum. The dosage of suppositories is calculated for the treatment of children under 2 years of age and is used in infants, starting from 3 months.

With muscular or nervous pains and inflammatory-degenerative joint diseases, the internal administration of NSAIDs may not produce the desired effect. In this case, topical local treatment is performed, which is carried out with the preparation "Ibuprofen" in the form intended for external use in the area of pain and inflammation: ointment, cream or gel.

Despite the fact that these are forms for external use, their use is permissible only in the first and second trimesters of pregnancy, and then with the permission of a doctor who watches a woman during this period. In the third trimester, the use of external forms of "Ibuprofen" is considered extremely undesirable.

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

Pharmacodynamics

We mentioned that "Ibuprofen" is one of the most popular drugs from the category of NSAIDs. Nonsteroidal anti-inflammatory drugs are a class of drugs in small dosages that have analgesic (analgesic) and antipyretic (antipyretic) effect, but with an increase in the dose they begin to show a pronounced anti-inflammatory effect. The effect of taking NSAIDs is slightly lower than that of corticosteroids, but these drugs do not have side effects peculiar to hormonal drugs.

Farmakodinamika "Ibuprofen" corresponds to the mechanism of action of most NSAIDs. The active substance of the drug is considered an inhibitor of isoenzymes of cyclooxygenase 1 and 2, which are actively involved in the synthesis of prostaglandins. Prostaglandins, in addition to other functions, are characterized by the role of mediator in inflammatory processes, i.e. They contribute to the maintenance and spread of inflammation.

Ibuprofen inhibits the production of COX isoenzymes and slows down reactions with their participation, which leads to a decrease in the production of prostaglandins and the cessation of the inflammatory process. Inhibition of prostaglandin E2, which affects the cells of the hypothalamus and disrupts the process of thermoregulation, provides the drug with antipyretic effect. Inhibition of COX and prostaglandins is a reversible process, therefore at the end of the action of the drug all reactions in the body are restored. Over time, the synthesis of prostaglandins decreases in a natural way.

The use of ibuprofen with gout is due to its ability to inhibit the phagocytosis of uric acid salts crystals, which accumulate in the joints when the disease occurs.

The preparation has an anti-inflammatory and antipyretic effect due to inhibition of COX. Moreover, the antipyretic effect of it is more effective than that of no less popular paracetamol and preparations based on it. The analgesic effect of the drug stems from the rest of its properties, and as an NSAID ibuprofen is especially relevant for pain caused by inflammatory processes

[11], [12]

Pharmacokinetics

Getting into the stomach during oral administration, ibuprofen does not stay there for a long time and is quickly absorbed into the blood in the lumen of the intestine. Even more quickly, the drug begins to act when injected into the rectum, while avoiding the irritating effect of NSAIDs on the walls of the stomach and duodenum. With topical application, the drug easily penetrates through the skin and soft tissues, accumulating in the affected tissues and penetrating into the blood.

When absorbed in the intestine, the maximum content of active substance in the blood is noted after 1-1.5 hours, and in the joint fluid - after 2.5-3 hours. The half-life of the drug is 2 hours. The anti-inflammatory effect of the drug persists for 8 hours. Anesthetic effect with non-inflammatory pain usually lasts 2-3 hours.

The metabolism of the drug occurs in the liver, but is excreted from the body by means of the kidneys. In pregnancy, some women begin serious problems with the kidneys, especially in the last trimester of pregnancy, so "Ibuprofen" to such patients can cause some harm, creating an additional burden on the patient's facet. However, this aspect is considered in the section "contraindications to the use" of the instructions to the drug, and future moms should always pay attention to this information.

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

Dosing and administration

If the dosage and duration of administration is so important for the drug Ibuprofen, since it affects its safety for a future mother, then it is worth considering this issue in more detail. Since in the treatment of headache or toothache, as well as fever, pregnant women often turn to such form of the drug as tablets, then we will talk, first of all, about them.

I must say that the instructions to the drug do not have rigid time frames for taking the medicine. As for the intervals between taking the drug and eating, there is no special indication for this. Doctors recommend taking tablets outside food, although on the pharmacokinetics of the drug this is little reflected. If a woman has inflammatory or ulcerative gastrointestinal diseases, it is better to drink tablets during meals.

To chew or grind tablets is not recommended, as this will only increase their irritating effect on the gastric mucosa. The tablet should be swallowed whole and washed down with a sufficient amount of water (at least ½ cup).

According to the instructions, adult patients with various diseases can be prescribed taking the drug in a single dose of 2 to 4 tablets (400-800 mg). The frequency of administration of the drug is 2-4 times a day. The maximum daily dose is 4 tablets.

But as practice shows to reduce the temperature and treat pain of moderate strength, 1-2 tablets are enough. The interval between doses should not be less than 4 hours.

When pregnancy should take "Ibuprofen" in the minimum effective dosage. Usually, with a headache, you can take 1 tablet 2 or 3 times a day. To combat high fever, it may take 3-4 doses, and to reduce the dose of medications, you need to wipe the body with a damp cloth moistened in cool water.

Doctors advise for pain relief to take the medicine for no more than 5 consecutive days, and for colds - from 1 to 3 days.

If a woman chooses a suspension, then it is better to take it after eating. Taking into account the fact that 5 ml of the suspension contain 100 mg of ibuprofen, 10-20 ml of the drug should be taken in one session. The interval between doses is the same as for tablets.

For the treatment of muscular, neurological and joint pain, it is possible to use external agents with ibuprofen, although in the third trimester of pregnancy these drugs will have to be abandoned. On the site of the lesion from the tuba squeeze out a strip of gel (ointment, cream) length of 5 to 10 cm and carefully rubbed into the skin. In a day you can spend up to 4 procedures, but in pregnancy it is better to adhere to the minimum dosage and apply the drug no more than 3 times a day. The course of treatment is usually 2-3 weeks, but the woman waiting for the appearance of the child, the duration of treatment should be discussed with your doctor.

[22]

Use Ibuprofen during pregnancy during pregnancy

The time during which a small man grows and develops in the womb of a woman is a period when a woman also needs to be extra careful when taking various medications. After all, even those drugs that are considered relatively safe in pregnancy (for example, the same "Ibuprofen"), in some situations can cause irreparable harm.

When they talk about the safety of Ibuprofen during pregnancy, they basically mean the 2nd trimester, when the risk of miscarriage or premature birth is relatively small. This is the safest period when the basic vital systems of the fetus are formed, so taking medications less often causes disruptions in the development of the child.

It should be noted that there was no toxic or teratogenic effect on the fetus for Ibuprofen. Studies say that taking the drug is not capable of causing fetal death in the womb or causing mutations that will subsequently cause disability. But scientists do not exclude that the drug, with regular use, can provoke non-severe disorders, such as anomalies in the structure of the heart or abdominal wall in a child.

Experts do not have a common opinion about the possibility of using "Ibuprofen" during early pregnancy. In small amounts, it is considered harmless to the fetus and any developmental disorders of the child can be expected only after prolonged use, so doctors do not prohibit taking the drug at this time, but only ask to limit its reception as much as possible. For example, take 1 tablet of NSAIDs only at high temperatures and pains that can not be managed by safe alternative means.

But limiting the use of "Ibuprofen" during pregnancy in the first trimester is not only related to this. There is a suspicion that taking the drug may become a risk factor for involuntary miscarriage. True, the statistics of such cases are based primarily on miscarriages that occurred almost immediately after conception during the first couple of weeks. Therefore, doctors treat her with doubt, suspecting that such failures could provoke a drug taken before conception on the eve of ovulation. The changes he made in the endometrium of the uterus could cause rejection of the organ of a fertilized egg. They also could cause a violation of the formation of the tissues of the amniotic egg (placenta), as a result of which they were unable to retain the fetus.

However, there is a danger in the 1st trimester of pregnancy, and it can not be ignored. Less dangerous during this period is "Paracetamol", which can be taken with headache and toothache, as well as to reduce the temperature. True, with severe pain in the teeth and gums, it is unlikely to cope. It's not for nothing that doctors strongly advise you to treat your teeth before the pregnancy, and not only because the carious cavities are the source of infection for mom and her unborn baby, but also because the possibilities for treating moderate and severe pain in pregnancy are limited.

Danger "Ibuprofen" represents and in the last 3 months of pregnancy. He, although not an antispasmodic, is able to inhibit the process of contracting the walls of the uterus, which significantly complicates the birth process. When the time of childbirth arrives in the woman's body, the production of estrogens increases, which increase the sensitivity of the receptors in the uterus to acetylcholine. It is acetylcholine that causes the reduction of the walls of the uterus during childbirth, which allows the fetus to move in a generic way. It is believed that ibuprofen is able to block hormones necessary for the stimulation of labor, therefore it is not recommended to use it after 30 weeks of pregnancy.

Another unpleasant feature was noticed behind the drug. In the prenatal period, the pulmonary artery of the fetus is connected to the arch of the aorta by means of the arterial duct, which ends with an orifice in the atrial septum. Thus, the venous blood of the fetus can mix with the arterial blood, which is a necessity during the time of finding the baby in the womb, where it can not breathe with the help of the lungs and thus get the body's oxygen. Blood thanks to him goes around the lungs.

After the birth of the child, when the baby begins to breathe on his own, the need for a duct, which, after the name of his discoverer, was named Botallov, disappears. Usually, the hole through which the venous and arterial vessels are communicated is overgrown for several hours or days of the baby's life. Admission of the mother during pregnancy "Ibuprofen" in the 3rd trimester may cause premature closure of the duct. After all, prostaglandins, which block ibuprofen, inhibit the closure of the duct. If the duct is closed prematurely due to a lack of prostaglandins, the fetus may develop pulmonary hypertension, which often results in a failure of the right ventricle of the heart and early death.

At women on a background of reception "Ibuprofena" can develop a water shortage. For a child, this threatens with impaired renal function, which can develop into kidney failure. There is also a risk of severe and prolonged bleeding during childbirth caused by the anticoagulant effect of NSAIDs. And a decrease in the viscosity of the blood can be observed even against the background of low doses.

It is clear that such passions during pregnancy are unlikely to be caused by a single tablet of Ibuprofen taken from headache or toothache. Another thing is if the future mother at a later date will solve many of her problems with this drug. In the third semester of pregnancy, even forms for topical administration are dangerous, although in this case the absorption of the drug into the blood is less than in oral administration.

And yet, before asking for help with ibuprofen without special need, it is worth a hundred times to think about the possible consequences for themselves and the child. Doctors of "Ibuprofen" during pregnancy during this period prescribe only in serious situations that threaten the life and health of women, if there is no possibility to treat with even safer drugs. In this case, the course of treatment should be minimal to avoid the consequences of long-term use of the medication.

Do not relax and take "Ibuprofen" during pregnancy in the 2nd trimester. It's one thing if a future mother removes strong headache or toothache with ibuprofen, another thing is if she is treating any malaise with the drug. At pregnancy in general it is desirable to address to tablets less. For example, with cold and fever, tea with raspberry jam or a broth of currant twigs well helps. And you can cope with the headache and the same cold with lime or mint tea. From the pain in the teeth helps a solution of salt, and the muscular and joint pains subside, if a place of defeat to attach a leaf cabbage or plantain.

Course treatment "Ibuprofenom" can appoint a gynecologist if a woman has a threat of involuntary interruption of pregnancy due to the reduction of the walls of the uterus, caused by malfunctions in the hormonal background. It is shown in a period when the fetus is still unviable. This is a necessary measure for maintaining a pregnancy, which can be prescribed in the 2nd trimester.

But let's return to contra-indications for the use of Ibuprofen. Despite the fact that from the 14th week of pregnancy and up to 30 weeks of "Ibuprofen" is considered a relatively safe drug, not every woman can afford it. Exacerbation of gastrointestinal diseases, blood diseases, liver and kidney disorders, most likely, will become an obstacle to such treatment. And ignoring contraindications will lead to deterioration of the state of the future mother, which is very undesirable in pregnancy, when the load on the body is so great. A weakened organism can simply not cope with the mission entrusted to it, various vital organs will start to malfunction, and doctors can decide to deliberately terminate a pregnancy that threatens the life and health of a woman.

Contraindications

This section of the instructions to any medication can not be ignored, not only for pregnant women, but for any other person. After all, it deals with pathologies and conditions in which even a drug that is safe under normal conditions can seriously harm a person's health.

Before taking the first and subsequent tablet of Ibuprofen during pregnancy (this applies to other forms of release), you need to know that doctors advise you to refuse taking the drug in the following cases:

• with exacerbation of erosive and ulcerative pathologies of the digestive tract of any localization (erosive gastritis, stomach ulcer and duodenal ulcer, ulcerative colitis, etc.),
• with severe gastrointestinal bleeding, which is usually diagnosed by bloody vomiting and diarrhea,
• if in a woman's history on the background of taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, there was a symptom complex called an aspirin triad: seizures of bronchial asthma, rashes in the form of urticaria, rhinitis,
• the form in the form of rectal suppositories is not used in the case of inflammatory bowel pathologies occurring in an acute form,
• if the patient was diagnosed with "hypokalemia" or a lack of potassium in the body,
• if there is a clotting disorder, when the risk of bleeding increases, including hereditary pathologies,
• with serious liver and kidney disease, when their functionality is greatly weakened, which can lead to a disruption of metabolism of ibuprofen and its retention in the body, and this is a risk factor for the development of side effects and intoxication of the body,
• when hypersensitivity to the active substance and other components of the dosage form,
• if in the past there were reactions of intolerance during intake of other NSAIDs.

Suspension containing sorbitol is not recommended for patients with hereditary intolerance to fructose.

In some diseases, the drug is not prohibited if the medicine is taken in a low dosage and irregularly. These are inflammatory and erosive-ulcerative gastrointestinal pathologies in the remission stage, liver and kidney diseases with sufficient functionality of the organs (a frequent companion of pregnant women is inflammation of the kidneys - pyelonephritis), of blood diseases such as leukopenia and anemia. In this case, care should be taken not to aggravate existing diseases and worsen the condition. Some of the side effects of the drug may be dangerous for people with hearing or visual impairment.

[17], [18], [19]

Side effects Ibuprofen during pregnancy

We have already clarified the question of why we should not ignore contraindications to the use of Ibuprofen and other drugs during pregnancy. It's time to get acquainted with the side effects that a woman may have when taking the medicine. Most often, the symptoms described below appear against the background of oral administration of the drug.

Reception of oral forms of the drug may be accompanied by reactions from the digestive system. Perhaps the emergence of nausea (less often vomiting), pain and discomfort in the abdomen, increased gas formation, stool (often diarrhea). If a woman has already been diagnosed with inflammatory diseases of the digestive tract, if the risk of their exacerbations, the appearance of erosions and ulcers on the mucous membrane, perforation of the walls of the stomach and intestines, bleeding from the gastrointestinal tract. There have been cases of complaints of severe dryness and soreness of the oral mucosa, the appearance of small wounds on the gums, the development of stomatitis. Possible inflammation of the tissues of the pancreas and liver, caused by the intake of NSAIDs.

Respiratory system on the intake of NSAIDs may respond with the appearance of dyspnea, with increased sensitivity to the drug, bronchospasm is possible. The cardiovascular system may suffer from increased blood pressure and heart rate. In women with a weak heart, taking the drug may cause the development or aggravation of heart failure.

Reception of the drug can also be accompanied by headaches and dizziness, the appearance of confusing anxiety and irritability, sleep disorders (insomnia or vice versa, increased drowsiness). Some patients may experience hallucinations, confusion may occur, aseptic meningitis may develop, but this usually happens against the background of already existing diseases of the nervous system or autoimmune pathologies.

Admission of NSAIDs may also adversely affect the urinary system. Possible development of cystitis, polyuria, edematous syndrome caused by impaired renal function. In women with kidney pathology, the frequent administration of Ibuprofen may cause the development of acute organ failure.

Doctors do not exclude the possibility of development of blood pathologies on the background of NSAIDs: anemia, thrombocytopenia, leukopenia, etc. Patients can also complain about the appearance of noise in the ears and hearing impairment, impaired vision, dry eye mucosa, edema of the face and eyelids, increased sweating.

With topical use of ointments or gel, you can expect mainly allergic reactions. If a woman shows increased sensitivity to NSAIDs, then even the development of bronchospasm is possible, but usually everything is limited to reddening and swelling of the skin, the appearance of rashes on her, such sensations as tingling or burning in the place of application of the drug.

We listed the side effects that characterize most NSAIDs, but "ibuprofen" in pregnancy is therefore considered to be the safest of this class of drugs, that the symptoms listed above appear more rarely (less than 1% of patients) than with other non-steroidal anti-inflammatory drugs and analgesics. It must be said that the side effects of Ibuprofen usually develop either against the background of already existing diseases of the patient, or with the regular and long-term use of high doses, or as a result of individual characteristics of the organism, which simply rejects the medicine.

[20], [21]

Overdose

Probably, few people can be surprised by the statement that taking high doses of medications can cause such a phenomenon as an overdose, characterized by the appearance of unpleasant symptoms from various organs and systems. Ibuprofen, although considered a more or less safe drug, is not an exception in this case.

However, in pregnancy, when any medications should be used with extreme caution and in minimal doses, the risk of overdosing with the drug "Ibuprofen" is minimal, a woman still needs to have a concept with what she can face if she accidentally takes an overestimated dose of the medicine.

According to studies, the risk of overdose arises if a person takes a dose of over 80 mg of ibuprofen per kilogram of body weight, i.e. For a woman whose weight is within 60 kg, the dose will be excessive from 2,400 mg (12 tablets). But even with this dose, the symptoms of an overdose do not always occur.

If the symptoms still appear within 4 hours after taking the medication, then most likely it will be limited to nausea, vomiting, epigastric pains, diarrhea (a fairly rare symptom). Less often, patients complain of tinnitus, headaches and the appearance of signs of gastrointestinal bleeding.

More serious and dangerous symptoms occur with severe poisoning (from 15 tablets or more). The victim has dizziness, loss of spatial orientation, visual impairment, decreased pressure and body temperature, confusion, drowsiness, ataxia, breathing disorders, acute renal failure. In rare cases, patients fall into a lethargic sleep or to whom.

Treatment of a light overdose is reduced to washing the stomach and taking activated charcoal, if it's been a while since taking the medication. If absorption into the blood has already occurred, alkaline solutions are used that promote the rapid elimination of acid metabolites of ibuprofen in the urine. Severe cases of overdose are treated in a hospital with forced diuresis, hemodialysis and other effective procedures.

It is clear that during pregnancy, a woman is unlikely to take the drug in such doses that can cause severe intoxication of the body, dangerous for the mother and the fetus. But the consequences of even an easy overdose can be deplorable, because the listed rapidly passing symptoms in the mother do not go in comparison with the danger that high doses of medication for the unborn baby represent.

[23], [24], [25], [26]

Interactions with other drugs

And now let us dwell on the information that will help to make the treatment "Ibuprofen" effective and safe not only during pregnancy, but also after childbirth, and also in the subsequent period. There is such a point in the instructions to the drugs, which are usually very few people pay special attention, not understanding its importance. It's about drug interactions, i.e. About the possibility of using the drug with other drugs, because some types of interactions may not be useful.

"Ibuprofen" belongs to the category of non-steroidal anti-inflammatory drugs, for which there are certain limitations:

• They can not be taken in combination with acetylsalicylic acid, which is a known anticoagulant. "Ibuprofen" and other NSAIDs may reduce the specific effect of low doses of this drug, but with increasing doses, the risk of developing side effects of both drugs is significantly increased.
• NSAIDs are not prescribed with drugs of the same class. Including drugs with a similar mechanism of action. This also increases the chance of side effects.

Consider now the interaction of "Ibuprofen" with other drugs and those undesirable effects that may occur with such a combination of drugs:

• Simultaneous reception of non-hormonal "Ibuprofen" and anti-inflammatory steroid drugs increases the risk of bleeding.
• Ibuprofen, like other NSAIDs, can reduce the effectiveness of drugs used to treat hypertension. Simultaneous use of angiotensin II antagonists or angiotensin-converting enzyme inhibitors with NSAIDs can adversely affect the kidneys, especially if the woman already had problems with this organ.
• Diuretics can increase the toxic effects of NSAIDs on the kidneys, which can lead to malfunctioning of the organ.
• Simultaneous reception of NSAIDs with anticoagulants, reducing the viscosity of blood, enhances this specific effect. So the joint application of "Ibprofen" and "Warfarin" or any other anticoagulant is a risk factor for the appearance of strong, difficult to stop bleeding.
• Use with antiplatelet agents and SSRIs increases the risk of bleeding from the gastrointestinal tract.
• In patients taking cardiac glycosides, Ibuprofen, like other NSAIDs, can potentiate cardiac arrhythmias, affecting glomerular filtration of the kidneys and increasing the concentration of glycosides in the blood, leading to an overdose of the latter and an increase in their toxicity.
• Admission with lithium drugs can lead to an increase in the concentration of the latter in blood plasma, which will subsequently lead to the appearance of neurological and psychopathic symptoms.
• "Ibuprofen" is able to increase the concentration in the blood of the cytotoxic methotrexate, an overdose of which has a toxic effect on the kidneys, provoking the development of renal insufficiency, depresses hematopoiesis, causes inflammatory reactions in the liver, irritation of the mucous membranes, nausea and vomiting, and the appearance of dangerous neurological symptoms.
• "Ibuprofen" with a joint admission increases the nephrotoxicity of the immunosuppressant cyclosporine.
• If in the future the woman does not want to have children and resorts to the help of oral contraception, she needs to know that any NSAIDs reduce the effectiveness of the anti-gestagen "Mifepristone", which is used for the urgent termination of pregnancy. The interval between the medications should be at least 8-12 days.
• The intake of "Ibuprofen" may increase the nephrotoxicity of tacrolimus immunosuppressant.
• "Ibuprofen" can provoke an intoxication of the body with simultaneous administration with an antiviral agent called zidovudine, with the appearance of bruising on the body and blood clots in the joint bags, but these symptoms are more common in patients with hemophilia.
• The use of "Ibuprofen" and antibiotics of the quinolone group increases the risk of a convulsive syndrome.

[27], [28]

Storage conditions

But it is also important to realize that the effects stated in the instructions will be inherent to the medicine during the entire storage period only if the storage conditions are observed. The drug "Ibuprofen", which is allowed even during pregnancy, does not require any special conditions. It is perfectly stored at room temperature, but it is recommended to protect it from direct sunlight and moisture. If there are children in the house, then they should not be given access to the medicinal product.

[29], [30], [31], [32], [33], [34]

Shelf life

Taking medications for headache or toothache, we rarely pay attention to the period of their validity. There is only a desire to quickly get rid of a painful symptom, which outweighs the fear of getting poisoned by a medicine whose shelf life has already been completed.

In pregnancy, such behavior can be called extremely unreasonable. After all, a woman should think not only about herself, but also about that little creature that is tightly attached to her umbilical cord and not yet able to protect herself from trouble. It should be understood that only the drug that has not expired is safe.

So the shelf life of tablets and ointments "Ibuprofen" is 3 years, the gel and suspension - 2 years. But if the vial of the suspension was opened, it should be used within six months.

Analogues of Ibuprofen

It should be noted that the tablets named "Ibuprofen" are the most budgetary variety of NSAIDs with this active substance, which is considered the safest in pregnancy along with paracetamol. Earlier, the appointment with temperature and pain "Aspirin" was very popular, but recent studies have shown the teratogenic effect of this drug on the fetus, and doctors refused to assign it to pregnant women.

As for other drugs, the active ingredient of which is ibuprofen, there are quite a few of them. Here are the names of some of them that can replace the popular "Ibuprofen" during pregnancy:

• "Arviprox" in tablets 200 mg
• "Arofen" infant suspension 100 mg / 5 ml
• "Bolinet" in the form of effervescent tablets 200 mg
• Suspension "Bofen" 100 mg / 5 ml
• Suspension "Brufen" and "Brufen forte" 100 and 200 mg ibuprofen in 5 ml
• Capsules "Gofen", "Eurofast", "Ibunorm" 200 mg
• "Ibunorm baby" suspension 100 mg / 5 ml
• Capsules and tablets "Ibuprex" 200 mg
• Capsules "Ibuprom sprint" and children's suspension "Ibuprom For Children" and "Ibuprom For Children Forte" 100 and 200 mg of ibuprofen in 5 ml
• "Ibutex" tablets 200 mg
• Suspensions of "Ibufen" and "Ibufen forte" 100 and 200 mg / 5 ml
• Capsules "Ibufen Junior" 200 mg.
• Tablets "Ivalgin" 200 mg
• Children's suspension "Imet" 100 mg / 5 ml
• Tablets "Irfen" and "Kaffetin Lady" 200 mg
• "Nurofen" and "Nurofen Forte" suspension 100 and 200 mg of ibuprofen in 5 ml
• Tablets and capsules "Nurofen" or "Nurofen Express" 200 g
• Suspension «Orafen» 100 mg ibuprofen per 5 ml

This is a list of drugs with safe dosage at pregnancy. They all contain the active substance ibuprofen and differ only in prices and auxiliary components.

But for the treatment of headache and fever, this drug with a sparing effect, like paracetamol, is quite suitable. It is an antipyretic with a mild analgesic and non-expressed anti-inflammatory effect. In addition to the same tablets containing 200 or 325 mg of paracetamol, under the same name, capsules 325 mg, a syrup and a suspension containing 120 mg of paracetamol in 5 ml are manufactured.

All these forms of the drug can be taken during pregnancy, but again without abuse, because paracetamol and ibuprofen in pregnancy can not be taken in large doses and for a long time. If in the house there are such drugs as Panadol, Tylenol, Rapidol, Milistan, the active substance of which is paracetamol, during pregnancy they can also be used for pain and temperature, but a safe dose in any case will need to be discussed with a doctor. But you need to understand that with strong muscle and joint pain, paracetamol preparations can not help much, or their dosage will have to be significantly increased, which is undesirable in pregnancy, and in this case one should immediately turn to ibuprofen.

In the pharmacy, the future mother can also offer combined preparations containing 2 active substances: ibuprofen and paracetamol. One such drug is Ibuklin. On the one hand, the preparation has a rather attractive composition, because it combines the effective antipyretic effect of paracetamol and the pronounced anti-inflammatory effect of ibuprofen, plus it also copes well with pains of different localization and intensity.

But on the other hand, if you take Ibuklin in tablets intended for the treatment of adults, you need to know that each tablet contains 400 mg of ibuprofen and 325 mg of paracetamol, i.e. In fact, a woman takes 3 tablets at once: 2 ibuprofen and 1 paracetamol. Such a dosage of the drug can be considered harmless unless in the 2nd trimester of pregnancy, if it is taken once.

Caring mothers in pregnancy is better to use separately ibuprofen or paracetamol in low dosages, and Ibuklin can be taken with a baby, because one tablet of this form contains only 100 mg of ibuprofen and 125 mg of paracetamol, which is considered a perfectly acceptable dose, even if taken at 2 times pills in case of emergency.

In the third trimester of pregnancy, any analgesics and NSAIDs can be taken only as a last resort, and then with the permission of the doctor and in the indicated dosage. This period is the most responsible, because this is actually a preparation for the birth of a baby, and on how smoothly the childbirth will pass, the health of the baby largely depends.

[35], [36], [37], [38], [39], [40]

Reviews about the drug

Comments of doctors and expectant mothers about the drug "Ibuprofen" and its safety during pregnancy are more positive. Many gynecologists in general are doubtful about the statement that in the early stages the drug is capable of provoking a miscarriage, believing that the pregnancy problems in the subjects most likely began at the time of ovulation and conception, so taking ibuprofen is more dangerous in this period.

Quite often doctors advise to treat headache and toothache "Ibuprofen" even in the early stages of pregnancy. In their opinion, it is impossible to tolerate pain, and even more so to the future mother, and ibuprofen in this case is the lesser of evils. However, doctors emphasize the fact that a pregnant woman should take NSAIDs only as a last resort, when other non-medicinal methods do not work. After all, there are many different ways to calm the pain of any localization and reduce the temperature that has increased by more than 38 degrees. At the same time, the knowledge of alternative methods of treating pain and heat will be useful to a woman who will later apply this knowledge to the treatment of her child who has finally seen the light.

With severe pain, doctors often advise exactly "Ibuprofen", as a medicine with a minimal risk of side effects. But in order to keep the future mother from unjustified addiction to the drug, they can scare her, saying that with regular intake of the medicine the child will suffer from oxygen starvation. We are not going to judge how just this statement is valid (after all, if there is a weak labor activity, there really is a risk of hypoxia), but it will be superfluous to be reinsured in this case. Fear for the future of the child will deter a woman from abuse of medicines, and she will take them only as a last resort, seeking other ways to combat pain and heat. So we will not strictly judge the caring doctors.

As for the future mothers themselves and their relationship to the drug Ibuprofen, few of them can complain of the occurrence of side effects while taking the medication. And yet women prefer to treat the drug with caution, taking no more than 2-3 tablets a day. Some even break the pill to reduce dosage.

Good reviews about the treatment of pain with children's forms of Ibuprofen. Women consider a child's dosage, which is 2 or more times less than the adult. More secure. And often it is quite sufficient to make a woman feel better.

As you can see, "Ibuprofen" during pregnancy is quite affordable and quite safe method of dealing with discomforts, if it is treated as a means of an ambulance, rather than reaching for it when it is necessary and not necessary. This is well understood by both gynecologists and future mothers for whom the life and health of the baby is above all. And the fact that during pregnancy, taking any medication should only be done with the permission of a doctor, should be the rule for all women who dream of a healthy offspring. Therefore, it is worthwhile in advance to take a telephone consultation from a doctor and feel free to disturb him with such questions.