Ibuprofen in pregnancy in 1, 2, 3 trimesters

Procreation is an honorable and very responsible mission that has been entrusted to a woman since the appearance of life on Earth. How much happiness and joyful troubles a small creature brings to the house, having absorbed the features of its parents. But before this happiness enters the house in the arms of one of its parents, for 9 months it will be firmly connected with the mother, in whose womb the conception occurred on one of the happiest days in the family. For the expectant mother, this is a very important period, because pregnancy does not protect her from sorrows and illnesses. But many drugs, even those that we are used to taking almost daily for the slightest reason (for example, Ibuprofen, Aspirin, Paracetamol, Analgin and some others), can be harmful to the baby or provoke a miscarriage. Therefore, expectant mothers often wonder if it is dangerous to take Ibuprofen, so sincerely loved by doctors, during pregnancy? How can its use affect the health of the fetus?

Can I take Ibuprofen during pregnancy?

The news of pregnancy, especially if it is long-awaited, begged for, asked from God, literally lifts a woman to heaven. But over time, the feeling of euphoria subsides somewhat, and not always joyful everyday life comes to replace it. The restructuring of the female body, the change in hormonal levels makes a woman even more vulnerable to various diseases. It is not for nothing that doctors strongly recommend taking care of yourself during pregnancy, resting more, avoiding hypothermia and overwork, which reduce the already shaken immunity.

But few women, being a good housewife and keeper of the hearth, on whose shoulders lies the care of her husband and family, can afford to do nothing. And even if the expectant mother is single, she has no less worries, because she is forced to be both the mistress of the house and the breadwinner. Women just can’t find peace and quiet. Trips to the store, to the market, to work, chores around the house and worries about the life and health of loved ones do not pass without a trace and at some point the pregnant woman begins to feel unwell: headaches appear, the temperature rises, terrible fatigue and body aches fall upon her. Such symptoms can be a sign of severe fatigue and overwork, or they can indicate an infection that has entered the woman’s body.

Complaints about toothache during pregnancy are also not uncommon. Even women who did not have any particular problems with their teeth before conceiving a baby may experience them during pregnancy. There may be several reasons for toothache in pregnant women. These include natural changes in hormonal levels during this period, changes in metabolism (disturbances in phosphorus-calcium metabolism), and the subsequent deficiency of vitamins and minerals, some of which the fetus takes for itself, and an exacerbation of existing diseases of the teeth and gums.

Pain and fever are the field of action of non-steroidal anti-inflammatory drugs (NSAIDs), which many of us have long replaced old analgesics with. And at first glance, there is no particular difference in the drugs, because both groups have an analgesic, antipyretic and anti-inflammatory effect expressed to varying degrees. And if there is no difference, then a person is guided by the price and safety of the drug.

Today, the most affordable and safe of the drugs that help with pain and fever is "Ibuprofen", and according to doctors, this drug is also distinguished by the rarest development of side effects. In theory, if a drug has few side effects and they appear rarely, the drug is unlikely to cause significant harm to the body. It is not for nothing that it has acquired such wide application.

But we have already said that the drugs that we successfully and without consequences use in everyday life may not be so safe during pregnancy. In relation to "Ibuprofen", the manufacturers of the drug do not see any particular danger for the expectant mother and the child in her womb, so they do not exclude its use during pregnancy. But at the same time, they limit themselves to the reservation that the drug can only be used as prescribed or with the permission of the attending physician.

Such reservations, understandably, alarm pregnant women who previously sought relief from pain and fever in this particular drug, and they begin to actively inquire whether Ibuprofen is harmful for pregnant women or whether the reservation is simply a way to play it safe and not bear responsibility for the consequences of taking NSAIDs by expectant mothers?

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

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Indications Ibuprofen in pregnancy

"Ibuprofen", like any non-steroidal anti-inflammatory drug, is considered the most gentle medicine for inflammation, pain, and fever. Compared to hormonal drugs, NSAIDs are considered safer and have virtually no severe side effects that would have to be dealt with over a long period of time. It is not surprising that such drugs have found wide application in all cases where pain relief and tissue inflammation are required.

The indications for the use of Ibuprofen, as a code of NSAIDs, include the following pathologies:

• Rheumatoid arthritis (a systemic disease that affects small joints and is accompanied by pain, inflammation of cartilage and muscle tissue, and degenerative processes in them).
• Osteoarthritis (a vascular disease with gradual destruction of cartilage and bone tissue, which is accompanied by tissue swelling and sharp pain in the affected area with any movement).
• Bechterew's disease (a chronic systemic pathology, the symptoms of which include pain that increases over time and an inflammatory process in the lumbar spine),
• Gout (a characteristic feature of the disease is regular attacks of arthritis, the symptoms of which are inflammation and swelling of tissues in the joint area, tissue hyperemia, pain).
• Radiculitis (an inflammatory process that affects the nerve roots located in the spine and entering its openings; it is characterized by severe piercing pain).
• Bursitis (an inflammatory process in the mucous bags of the joints, accompanied by pain).
• Neuralgia (damage to peripheral nerves, accompanied by inflammation and pain in the affected area, although the appearance of reflected pain is also possible),
• Myalgia (muscle pain that occurs due to hypertonicity and often develops into an inflammatory process).

As we can see, "Ibuprofen" is considered one of the effective drugs for degenerative-inflammatory diseases of the musculoskeletal system and neuromuscular system. Its ability to relieve inflammation and pain is also used in the treatment of injuries (for example, tissue inflammation due to a blow, damage to the skin, muscles and bones in wounds and fractures as part of complex therapy). Moreover, gynecologists quite often prescribe the drug for painful periods (as part of monotherapy for the condition or in a complex treatment regimen for algomenorrhea).

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

Pregnancy is a period when the load on a woman's body increases significantly. On the one hand, changes in hormonal levels and metabolism, causing a decrease in immunity. On the other hand, an increase in the load on many vital organs, and in particular on the digestive organs. It is not surprising that during pregnancy the risk of developing inflammatory processes of various localizations increases.

It is not necessary to dwell once again on the fact that a pregnant woman's existing chronic diseases are exacerbated. In addition, new pathologies may 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 can be provoked by more dangerous infections, usually transmitted sexually. 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 be that as it may, this disease poses a threat to the mother and the baby in her womb, since it significantly increases the risk of miscarriage, spreading to other organs of the reproductive system.

To combat the infection that caused the disease, doctors prescribe antibiotic therapy. And symptoms such as severe squeezing pain and inflammation remain the task of antispasmodics and NSAIDs, among which the most popular and frequently prescribed is Ibuprofen.

Another disease that expectant mothers often suffer from is proctitis. Intestinal inflammation is usually provoked by constipation, which is considered the scourge of pregnant women. The baby growing in the womb gradually begins to squeeze the digestive organs, the normal functioning of which is disrupted as a result. The expectant mother begins to suffer from heaviness in the stomach and constipation.

Inflammatory diseases of the stomach, liver and pancreas, intestinal dysbacteriosis can also contribute to digestive disorders. Stagnant processes in the rectum, in turn, provoke inflammation of its mucous membrane.

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

So far we have talked about serious and dangerous diseases that a woman may encounter during pregnancy, but women do not encounter them as often as the ubiquitous respiratory infections. And again, for fever and body aches during pregnancy, doctors often suggest "Ibuprofen".

It is clear that treating infectious pathologies with NSAIDs alone is not effective, especially when it comes to fungal and bacterial pathologies. Here, the drug will only help relieve the main symptoms, for example, a dangerous increase in temperature. But with viral pathologies, Ibuprofen not only helps reduce fever (and the temperature can rise even above 39 degrees, which is dangerous for both the mother and the fetus) and relieve headaches, but also allows the body to gather the strength it needs to fight viruses. But we know that the best medicine for viruses is a well-functioning immune system.

Well, headaches in pregnant women can be caused not only by colds and viruses. Constant worries about their family, the course of pregnancy, various dangers that await a woman during this period cause nervous tension and, as a result, migraines. Ibuprofen can also help with headaches during pregnancy.

It is clear that this is not the only drug that helps in this situation. But the low risk of side effects again pushes it to the top of the list of preferences during the period when any disturbances in the body of the expectant mother necessarily affect the health and condition of the fetus in her womb.

For the same reason, dentists may also recommend Ibuprofen during pregnancy for toothache (nervous, caused by caries and inflammation of the tooth roots, after treatment or tooth extraction), gum inflammation and other pathologies that may occur in pregnant women. This drug is considered more preferable than Nimesil, Aspirin, Tempalgin, Ketanov and other potent drugs.

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Release form

There are probably not many home medicine cabinets where among the first aid medications there would not be tablets called "Ibuprofen". A pack of 50 tablets, the cost of which barely exceeds the twenty hryvnia threshold, is quite a bargain. And considering that the medicine helps with many pathologies and health problems, it is truly a lifesaver for many.

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

But Ibuprofen tablets are not the only form of this universal NSAID. The drug in tablet form has a hard shell, which prevents it from dissolving prematurely and causing harm to the gastric mucosa. It is not intended for crushing.

The dosage of one tablet is calculated for a patient weighing 20 kilograms or more. It is clear that this form of release of a relatively safe medicine is inconvenient for treating small children. For young patients up to 6 years old, a different form of the drug is provided. Children's "Ibuprofen" is presented in the form of a suspension for internal use, which is released in bottles of different volumes: from 90 to 125 ml (5 options in total).

Sometimes this form of the drug is called syrup. It is used to treat children starting from the age of six months (and sometimes earlier, if the baby's temperature rises after vaccination) and up to 12 years. In principle, children's "Ibuprofen" can be taken during pregnancy if this form seems more convenient for the expectant mother, but the effective dosage should be discussed with the doctor, taking into account that 5 ml of the drug contains 0.1 g of ibuprofen.

The suspension can be used not only internally, but also rectally (into the rectum in the form of microclysters for proctitis and adnexitis) or externally (for diseases of muscles and joints). Sometimes in the pharmacy you can also find such a form of medicine as suppositories, which are also intended for insertion into the rectum. The dosage of suppositories is designed for the treatment of children under 2 years of age and is used in babies starting from 3 months.

In case of muscle or nerve pain and inflammatory-degenerative diseases of joints, internal use of NSAIDs may not give the desired effect. In this case, local treatment is more relevant, which is carried out using the drug "Ibuprofen" in a 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 allowed only in the 1st and 2nd trimesters of pregnancy, and then with the permission of the doctor observing the woman during this period. In the third trimester, the use of external forms of "Ibuprofen" is considered extremely undesirable.

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Pharmacodynamics

We mentioned that Ibuprofen is one of the most popular NSAIDs. Nonsteroidal anti-inflammatory drugs are a class of drugs that have analgesic (pain-relieving) and antipyretic (antipyretic) effects in small doses, but when the dose is increased, they begin to exhibit a pronounced anti-inflammatory effect. The effect of taking NSAIDs is slightly lower than that of corticosteroids, but these drugs do not have the side effects typical of hormonal drugs.

The pharmacodynamics of Ibuprofen correspond to the mechanism of action of most NSAIDs. The active substance of the drug is considered an inhibitor of cyclooxygenase isoenzymes 1 and 2, which take an active part in the synthesis of prostaglandins. Prostaglandins, in addition to other functions, are characterized by the role of a 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 involving them, which leads to a decrease in the production of prostaglandins and the relief of the inflammatory process. Inhibition of prostaglandin E2, which affects the cells of the hypothalamus and disrupts the thermoregulation process, provides the drug with an antipyretic effect. Inhibition of COX and prostaglandins is a reversible process, so after the drug's effect ends, all reactions in the body are restored. Over time, prostaglandin synthesis decreases naturally.

The use of ibuprofen preparations for gout is due to its ability to inhibit the phagocytosis of uric acid salt crystals, which accumulate in the joints during the disease.

The drug has anti-inflammatory and antipyretic effects due to COX inhibition. Moreover, its antipyretic effect is more effective than that of the equally popular paracetamol and drugs based on it. The analgesic effect of the drug follows from its other properties, and as an NSAID, ibuprofen is especially relevant for pain caused by inflammatory processes.

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Pharmacokinetics

When ibuprofen enters the stomach orally, it does not stay there for long and is quickly absorbed into the blood in the intestinal lumen. The drug begins to act even faster when administered into the rectum, thereby avoiding the irritating effect of NSAIDs on the walls of the stomach and duodenum. When applied locally, the drug easily penetrates the skin and soft tissues, accumulating in the affected tissues and penetrating into the blood.

When absorbed in the intestine, the maximum content of the 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 lasts for 8 hours. The analgesic effect for non-inflammatory pain usually lasts 2-3 hours.

The drug is metabolized in the liver, but is excreted from the body through the kidneys. During pregnancy, some women begin to have serious kidney problems, especially in the last trimester of pregnancy, so "Ibuprofen" can cause some harm to such patients, creating an additional burden on the diseased organ. However, this aspect is taken into account in the "contraindications for use" section of the instructions for the drug, and expectant mothers should definitely pay attention to this information.

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Dosing and administration

If the dosage and duration of administration are so important for the drug "Ibuprofen", since they affect its safety for the expectant mother, then it is worth considering this issue in more detail. Since pregnant women most often turn to such a form of drug release as tablets in the treatment of headaches or toothaches, as well as high body temperature, then let's talk about them first.

It should be noted that the instructions for the drug do not specify strict time limits for taking the medicine. As for the intervals between taking the drug and eating, there are no special instructions on this account. Doctors recommend taking the tablets outside of meals, although this has little effect on the pharmacokinetics of the drug. If a woman has inflammatory or ulcerative diseases of the gastrointestinal tract, it is better to take the tablets during meals.

It is not recommended to chew or crush the tablets, 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 glass).

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

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

During pregnancy, you should take Ibuprofen in the minimum effective dosage. Usually, for headaches, taking 1 tablet 2 or 3 times a day is enough. To combat high fever, 3-4 doses may be required, and to reduce the dose of medication, you need to wipe the body with a damp cloth soaked in cool water.

Doctors advise taking the medicine for pain relief for no more than 5 days in a row, and for colds - from 1 to 3 days.

If a woman prefers a suspension, it is better to take it after meals. Considering that 5 ml of suspension contains 100 mg of ibuprofen, 10-20 ml of the drug should be taken at one time. The interval between doses is the same as for tablets.

To treat muscle, neurological and joint pain, you can use external agents with ibuprofen, although in the 3rd trimester of pregnancy you will have to give up such drugs. A strip of gel (ointment, cream) 5 to 10 cm long is squeezed out of the tube onto the affected area and rubbed thoroughly into the skin. Up to 4 procedures can be carried out per day, but during pregnancy it is better to stick to the minimum dosage and use the drug no more than 3 times a day. The course of treatment is usually 2-3 weeks, but a woman expecting a child should discuss the duration of treatment with her doctor.

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Use Ibuprofen in pregnancy during pregnancy

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

When talking about the safety of Ibuprofen during pregnancy, they mostly mean the 2nd trimester, when the risk of miscarriage or premature birth is relatively low. This is the safest period, when the main vital systems of the fetus are already formed, so taking medications less often causes developmental disorders in the child.

It should be said that no toxic or teratogenic effect on the fetus has been observed for Ibuprofen. Research shows 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 rule out that the drug, when used regularly, can provoke minor disorders, such as abnormalities in the structure of the heart or abdominal wall in a child.

There is no consensus among experts regarding the possibility of using Ibuprofen during early pregnancy. In small quantities, it is considered harmless to the fetus and any developmental disorders in the child can only be expected with prolonged use, so doctors do not prohibit taking the drug at this time, but only ask to limit its use as much as possible. For example, take 1 tablet of NSAIDs only for high temperatures and pain that cannot be relieved by safe folk remedies.

But the restriction of Ibuprofen use 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 spontaneous miscarriage. However, the statistics of such cases are based mainly on miscarriages that occurred almost immediately after conception during the first couple of weeks. Therefore, doctors treat it with doubt, suspecting that such failures could be provoked by the drug taken before conception on the eve of ovulation. The changes it produced in the uterine endometrium could cause the rejection of the fertilized egg by the organ. They could also cause a disruption in the formation of the tissues of the amniotic sac (placenta), as a result of which they were unable to hold the embryo.

Be that as it may, there is a danger in the first trimester of pregnancy, and it cannot be ignored. Less dangerous during this period is considered to be "Paracetamol", which can be taken for headaches and toothaches, as well as to reduce fever. However, it is unlikely to cope with severe pain in the teeth and gums. It is not for nothing that doctors strongly advise treating teeth even before pregnancy, and not only because carious cavities are a source of infection for the mother and her unborn baby, but also due to the fact that the possibilities of treating moderate and severe pain syndrome during pregnancy are limited.

Ibuprofen is also dangerous in the last 3 months of pregnancy. Although it is not an antispasmodic, it can slow down the process of contraction of the uterine walls, which significantly complicates the birth process. When the time comes for childbirth, the production of estrogens increases in the woman's body, increasing the sensitivity of receptors in the uterus to acetylcholine. It is acetylcholine that causes contraction of the uterine walls during childbirth, which allows the fetus to move through the birth canal. It is believed that ibuprofen can block the hormones necessary to stimulate labor, so it is not recommended to use it after the 30th week of pregnancy.

Another unpleasant feature of the drug was also noticed. In the intrauterine period, the pulmonary artery of the fetus is connected to the aortic arch by means of the arterial duct, ending with an opening in the atrial septum. Thus, venous blood in the fetus can mix with arterial blood, which is necessary during the child's stay in the mother's womb, where it cannot breathe with the help of the lungs and thus receive the oxygen necessary for the body. Thanks to it, the blood goes around the lungs.

After the birth of the child, when the baby begins to breathe independently, the need for the duct, which was named Botallov after its discoverer, disappears. Usually, the opening through which the venous and arterial vessels communicate overgrows within a few hours or days of the baby's life. Taking "Ibuprofen" by the mother during pregnancy in the 3rd trimester can cause premature closure of the duct. After all, it is the prostaglandins that ibuprofen blocks that slow down the closure of the duct. If the duct closes prematurely due to a lack of prostaglandins, the fetus may develop pulmonary hypertension, which often results in right ventricular failure and early death.

Women taking Ibuprofen may develop oligohydramnios. For the child, this threatens kidney function disorders, which may develop into renal failure. There is also a risk of severe and prolonged bleeding during childbirth caused by the anticoagulant effect inherent in NSAIDs. Moreover, a decrease in blood viscosity can be observed even when taking low doses.

It is clear that such passions during pregnancy are unlikely to be caused by a single tablet of Ibuprofen taken for a headache or toothache. It is another matter if the expectant mother in the later stages will solve many of her problems with this drug. In the third trimester of pregnancy, even forms for local use are dangerous, although in this case the absorption of the drug into the blood is less than with oral administration.

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

You should not relax and take Ibuprofen during pregnancy in the 2nd trimester. It is one thing if the expectant mother uses ibuprofen to relieve a severe headache or toothache, but another thing if she uses the drug to treat any ailment. During pregnancy, it is generally advisable to use pills less. For example, tea with raspberry jam or a decoction of currant twigs helps well with colds and fever. And you can cope with a headache and the same cold with linden or mint tea. A salt solution helps with toothache, and muscle and joint pain subsides if you apply a cabbage or plantain leaf to the affected area.

A course of treatment with Ibuprofen can be prescribed by a gynecologist if a woman is at risk of spontaneous termination of pregnancy due to contraction of the uterine walls caused by hormonal imbalances. It is indicated during the period when the fetus is not yet viable. This is a necessary measure to maintain pregnancy, which can be prescribed in the 2nd trimester.

But let's get back to the contraindications for the use of Ibuprofen. Despite the fact that starting from the 14th week of pregnancy and up to the 30th week, Ibuprofen is considered a relatively safe drug, not every woman can afford it. Exacerbation of gastrointestinal diseases, blood diseases, liver and kidney disorders will most likely become an obstacle to such treatment. And ignoring contraindications will lead to a deterioration in the condition of the expectant mother, which is very undesirable during pregnancy, when the load on the body is already great. A weakened body may simply not cope with the mission assigned to it, various vital organs will begin to malfunction, and doctors may decide to purposefully terminate the pregnancy, threatening the life and health of the woman.

Contraindications

This section of the instructions for any medication should not be ignored not only by pregnant women, but also by any other person. After all, it deals with pathologies and conditions in which even a medicine that is safe under normal conditions can cause serious harm to human health.

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

• in case of exacerbation of erosive and ulcerative pathologies of the gastrointestinal tract of any localization (erosive gastritis, gastric ulcer and duodenal ulcer, ulcerative colitis, etc.),
• in cases of severe gastrointestinal bleeding, which is usually diagnosed by bloody vomiting and diarrhea,
• if a woman has a history of a symptom complex called the aspirin triad while taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs: attacks of bronchial asthma, rashes in the form of urticaria, runny nose (rhinitis),
• the form in the form of rectal suppositories is not used in cases of inflammatory bowel pathologies occurring in an acute form,
• if the patient has been diagnosed with hypokalemia or potassium deficiency in the body,
• in case of blood clotting disorders, when the risk of bleeding increases, including hereditary pathologies,
• in case of serious liver and kidney diseases, when their functionality is greatly weakened, which can lead to disruption of ibuprofen metabolism and its retention in the body, and this is a risk factor for the development of side effects and intoxication of the body,
• in case of hypersensitivity to the active substance and other components of the dosage form,
• if intolerance reactions have occurred in the past while taking other NSAIDs.

A suspension containing sorbitol is not recommended for patients with hereditary fructose intolerance.

In some diseases, taking the drug is not prohibited if the medicine is taken in low dosages and irregularly. We are talking about inflammatory and erosive-ulcerative pathologies of the gastrointestinal tract in the remission stage, about liver and kidney diseases with sufficient functionality of the organs (and a frequent companion of pregnant women is kidney inflammation - pyelonephritis), about such blood diseases as leukopenia and anemia. In this case, caution should be exercised so as not to exacerbate existing diseases and worsen the condition. Some side effects of the drug may be dangerous for people with hearing or vision impairments.

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Side effects Ibuprofen in pregnancy

We have already clarified the question of why you 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 experience while taking the drug. Most often, the symptoms described below occur against the background of oral administration of the drug.

Taking oral forms of the drug may be accompanied by reactions from the digestive system. Nausea (less often vomiting), abdominal pain and discomfort, increased gas formation, bowel disorders (usually diarrhea) may occur. If a woman has already been diagnosed with inflammatory diseases of the gastrointestinal tract, if there is a risk of their exacerbation, the appearance of erosions and ulcers on the mucous membrane of the organs, 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. Inflammation of the tissues of the pancreas and liver caused by taking NSAIDs is possible.

The respiratory system may react to taking NSAIDs by developing shortness of breath, and 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 aggravate heart failure.

Taking the drug may also be accompanied by headaches and dizziness, the appearance of incomprehensible anxiety and irritability, sleep disorders (insomnia or, conversely, increased sleepiness). Some patients may experience hallucinations, confusion, aseptic meningitis may develop, but this usually occurs against the background of existing diseases of the nervous system or autoimmune pathologies.

Taking NSAIDs can also have a negative impact on the urinary system. Cystitis, polyuria, and edema syndrome caused by kidney dysfunction are possible. In women with kidney pathologies, frequent use of Ibuprofen can cause acute organ failure.

Doctors do not exclude the possibility of developing blood pathologies while taking NSAIDs: anemia, thrombocytopenia, leukopenia, etc. Patients may also complain of tinnitus and hearing loss, blurred vision, dry mucous membranes of the eyes, swelling of the face and eyelids, and increased sweating.

When using ointment or gel locally, one can expect mainly allergic reactions. If a woman is found to have increased sensitivity to NSAIDs, then even bronchospasm may develop, but usually everything is limited to redness and swelling of the skin, the appearance of a rash on it, sensations such as tingling or burning at the site of application of the drug.

We have listed the side effects that are typical for most NSAIDs, but Ibuprofen is considered the safest of this class of drugs during pregnancy because the symptoms listed above occur much less frequently (in less than 1% of patients) than when using other nonsteroidal anti-inflammatory drugs and analgesics. It should be said that side effects of Ibuprofen usually develop either against the background of existing diseases in the patient, or with regular and long-term use of high doses, or as a result of individual characteristics of the body, which simply rejects the drug.

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Overdose

Probably, few people can be surprised by the statement that taking high doses of drugs 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 still not an exception in this case.

True, during pregnancy, when any medications should be used with special caution and in minimal doses, the risk of overdose with Ibuprofen is minimal, but a woman should still have an idea of what she might encounter if she accidentally takes an excessive dose of the drug.

According to research, the risk of overdose occurs if a person takes a dose of more than 80 mg of ibuprofen per kilogram of weight, i.e. for a woman whose weight is within 60 kg, a dose of 2400 mg (12 tablets) would be excessive. But even with such a dose, overdose symptoms do not always occur.

If symptoms do appear within 4 hours after taking the medicine, it will most likely be limited to nausea, vomiting, epigastric pain, diarrhea (a rather rare symptom). Less often, patients complain of tinnitus, headaches, and signs of gastrointestinal bleeding.

More serious and dangerous symptoms occur in severe poisoning (15 tablets or more). The victim experiences dizziness, loss of spatial orientation, visual impairment, decreased blood pressure and body temperature, confusion, drowsiness, ataxia, respiratory failure, acute renal failure. In rare cases, patients fall into a lethargic sleep or coma.

Treatment of mild overdose is limited to gastric lavage and activated charcoal if a short time has passed since taking the drug. If absorption into the blood has already occurred, alkaline solutions are used to promote rapid excretion of acidic metabolites of ibuprofen in the urine. Severe cases of overdose are treated in a hospital setting using forced diuresis, hemodialysis, and other effective procedures.

It is clear that during pregnancy a woman is unlikely to take the drug in doses that can cause severe intoxication of the body, dangerous for both the mother and the fetus. But the consequences of even a mild overdose can be disastrous, because the listed quickly passing symptoms in the mother do not compare with the danger that high doses of the drug pose to the unborn baby.

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Interactions with other drugs

Now let's look at the information that will help make treatment with Ibuprofen effective and safe not only during pregnancy, but also after childbirth, as well as in the subsequent period. There is such a point in the instructions for drugs, which usually few people pay special attention to, not understanding its importance. We are talking about drug interactions, i.e. the possibility of using the drug together with other drugs, because some types of interactions can be far from useful.

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

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

Let us now consider the interaction of Ibuprofen with other drugs and the undesirable effects that may occur with such a combination of drugs:

• The simultaneous use 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. The simultaneous use of angiotensin II antagonists or angiotensin-converting enzyme inhibitors with NSAIDs can negatively affect the condition of the kidneys, especially if the woman has already had problems with this organ.
• Diuretics can increase the toxic effects of NSAIDs on the kidneys, which can lead to organ failure.
• The simultaneous use of NSAIDs with anticoagulants that reduce blood viscosity enhances this specific effect. This means that the combined use of Ibprofen and Warfarin or any other anticoagulant is a risk factor for severe, difficult-to-stop bleeding.
• Use with antiplatelet agents and SSRIs increases the risk of gastrointestinal bleeding.
• In patients taking cardiac glycosides, Ibuprofen, like other NSAIDs, can potentiate cardiac dysfunction by affecting glomerular filtration of the kidneys and increasing the concentration of glycosides in the blood, which leads to an overdose of the latter and increased toxicity.
• Taking lithium with drugs can lead to an increase in the concentration of the latter in the blood plasma, which will subsequently lead to the appearance of neurological and psychopathic symptoms.
• "Ibuprofen" can increase the concentration of the cytostatic methotrexate in the blood, an overdose of which has a toxic effect on the kidneys, causing the development of renal failure, inhibits hematopoiesis, causes inflammatory reactions in the liver, irritation of the mucous membranes, nausea and vomiting, and the appearance of dangerous neurological symptoms.
• When taken together, Ibuprofen increases the nephrotoxicity of the immunosuppressant cyclosporine.
• If a woman does not want to have children in the future and resorts to oral contraception, she needs to know that any NSAIDs reduce the effectiveness of the antigestagen "Mifepristone", used for emergency termination of pregnancy. The interval between taking the drugs should be at least 8-12 days.
• Taking Ibuprofen may increase the nephrotoxicity of the immunosuppressant tacrolimus.
• "Ibuprofen" can cause intoxication of the body when taken simultaneously with an antiviral drug called zidovudine, which may cause hematomas on the body and accumulation of blood in the joint bags, but these symptoms are more common in patients with hemophilia.
• The use of Ibuprofen and quinolone antibiotics increases the risk of developing seizures.

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Storage conditions

But it is also important to realize that the medicine will have the effects stated in the instructions throughout the entire shelf life 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, they should also not be given access to the medicine.

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Shelf life

When taking medications for headaches or toothaches, we rarely pay attention to their expiration dates. There is only a desire to quickly get rid of the painful symptom, which outweighs the fear of getting poisoned by a medicine whose expiration date has already expired.

During pregnancy, such behavior can be called extremely unwise. After all, a woman should think not only about herself, but also about that little creature that is tightly attached to her by the umbilical cord and is not yet able to protect itself from trouble. It is important to understand that only a drug that has not expired can be considered relatively safe.

So the shelf life of Ibuprofen tablets and ointment is 3 years, gel and suspension - 2 years. But if the bottle with the suspension was opened, it must be used within six months.

Analogues of Ibuprofen

It should be said that tablets called "Ibuprofen" are the most budget-friendly variety of NSAIDs with this active ingredient, which is considered the safest during pregnancy along with paracetamol. Previously, it was very popular to prescribe "Aspirin" for fever and pain, but recent studies have shown the teratogenic effect of this drug on the fetus, and doctors have refused to prescribe it to pregnant women.

As for other drugs whose active ingredient 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" children's 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
• Suspension "Ibunorm baby" 100 mg/5 ml
• Ibuprex capsules and tablets 200 mg
• Ibuprom Sprint capsules 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 "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 "Caffetin Lady" 200 mg
• Suspension "Nurofen" and "Nurofen Forte" 100 and 200 mg of ibuprofen in 5 ml
• Tablets and capsules "Nurofen" or "Nurofen Express" 200 g
• Orafen suspension 100 mg ibuprofen per 5 ml

This is a list of drugs with safe dosage during pregnancy. All of them contain the active ingredient ibuprofen and differ only in prices and auxiliary components.

But for the treatment of headaches and fever, a drug with a gentle effect, such as paracetamol, is quite suitable. This is an antipyretic with a mild analgesic and mild anti-inflammatory effect. In addition to the tablets of the same name, containing 200 or 325 mg of paracetamol, capsules of 325 mg, syrup and suspension containing 120 mg of paracetamol in 5 ml are produced under the same name.

All these forms of the drug can be taken during pregnancy, but again without abuse, because both paracetamol and ibuprofen cannot be taken in large doses and for a long time during pregnancy. If you have drugs such as Panadol, Tylenol, Rapidol, Milistan in your home, the active ingredient of which is paracetamol, they can also be used during pregnancy for pain and fever, but a safe dosage in any case should be discussed with a doctor. But you need to understand that with severe muscle and joint pain, paracetamol drugs can do little to help, or their dosage will have to be significantly increased, which is undesirable during pregnancy, and in this case you should immediately turn to ibuprofen.

In the pharmacy, the expectant mother may also be offered combination drugs containing 2 active ingredients: ibuprofen and paracetamol. One of these drugs is "Ibuclin". On the one hand, the drug has a rather attractive composition, because it combines the effective antipyretic effect of paracetamol and the pronounced anti-inflammatory effect of ibuprofen, plus it copes well with pain of various localizations and intensities.

But on the other hand, if you take "Ibuclin" 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 safe only in the 2nd trimester of pregnancy, if taken once.

Caring mothers during pregnancy are better off using ibuprofen or paracetamol separately in low doses, and you can take children's "Ibuclin", because one tablet of this form contains only 100 mg of ibuprofen and 125 mg of paracetamol, which is considered a completely acceptable dose, even if you take 2 tablets at a time in case of emergency.

In the 3rd 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 dosage indicated by him. This period is the most important, because this is actually preparation for the birth of the baby, and the health of the baby largely depends on how smoothly the birth goes.

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Reviews of the drug

Reviews of doctors and expectant mothers about the drug "Ibuprofen" and its safety during pregnancy are mostly positive. Many gynecologists are generally skeptical about the assertion that in the early stages the drug can provoke a miscarriage, believing that pregnancy problems in subjects most likely began at the time of ovulation and conception, so taking ibuprofen is more dangerous during this period.

Quite often doctors advise treating headaches and toothaches with Ibuprofen even in the early stages of pregnancy. In their opinion, pain should not be tolerated, especially by the expectant mother, and ibuprofen in this case is the lesser of two evils. However, doctors emphasize that a pregnant woman should take NSAIDs only as a last resort, when other non-drug methods do not give results. After all, there are many different ways to calm pain of any localization and reduce a temperature that has risen by more than 38 degrees. At the same time, knowledge of folk methods of treating pain and fever will still be useful to a woman who will later use this knowledge to treat her child who has finally seen the light of day.

In case of severe pain, doctors often recommend Ibuprofen as a medicine with a minimal risk of side effects. But in order to keep the expectant mother from unjustified passion for the drug, they can scare her by saying that with regular use of the drug, the child will suffer from oxygen starvation. We will not judge how true this statement is (after all, with weak labor there is indeed a risk of hypoxia), but in this case it would not be superfluous to play it safe. Fear for the future of the child will keep the woman from abusing drugs, and she will take them only as a last resort, looking for other ways to combat pain and fever. So let's not judge caring doctors harshly.

As for the expectant mothers themselves and their attitude to the drug "Ibuprofen", few of them can complain about the occurrence of side effects while taking the drug. And yet women prefer to treat the drug with caution, taking no more than 2-3 tablets per day. Some even break the tablet to reduce the dosage.

There are good reviews about pain treatment with children's forms of "Ibuprofen". Women consider the children's dosage, which is 2 or more times less than the adult dosage. Safer. And often it turns out to be quite sufficient for a woman to feel better.

As we can see, Ibuprofen during pregnancy is a completely accessible and quite safe method of combating ailments, if you treat it as an emergency aid, and do not reach for it when necessary and not necessary. This is well understood by both gynecologists and expectant mothers for whom the life and health of the baby are above all else. And the fact that during pregnancy, taking any medications should be carried out only with the permission of a doctor should be a rule for all women dreaming of healthy offspring. Therefore, it is worth taking the phone number of the doctor at the antenatal clinic in advance and not being embarrassed to bother him with such questions.