The WHO initially recommended using acetaminophen instead of ibuprofen to treat coronavirus symptoms, but they have now said otherwise.
Some of the most commonly used pain and fever medications could be harmful to pregnant women and their unborn babies, the U.S. Food and Drug Administration announced Thursday.
The agency is requiring labeling changes for non-steroidal anti-inflammatory drugs (NSAIDs) to explain that if women take these medications at about 20 weeks or later into their pregnancy, they can cause fetal kidney problems.
NSAIDs include both prescription and over-the-counter drugs such as ibuprofen and naproxen, commonly known by the brand names Advil and Aleve. It also includes diclofenac, celecoxib and aspirin above 81 mg.
According to the FDA, these medications work by blocking the production of a certain chemical in the body that causes inflammation.
“It is important that women understand the benefits and risks of the medications they may take over the course of their pregnancy,” said Dr. Patrizia Cavazzoni, acting director of the FDA’s Center for Drug Evaluation and Research.
Fetal kidney problems can lead to other pregnancy-related complications as the kidneys are responsible for producing amniotic fluid, the protective cushion surrounding the baby.
Fetuses produce the most amniotic fluid beginning about 20 weeks after conception, and kidneys damaged by NSIADs could result in low levels of amniotic fluid, reducing a baby’s protection inside the mother’s womb.
Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City, said low levels of amniotic fluid also could cause problems with the baby’s development.
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Doctors can detect a decrease in amniotic fluid levels as soon as two days after taking these medications, the FDA said, but levels usually return to normal after a pregnant women stops taking them.
The agency recommends pregnant women avoid NSAIDs after 20 weeks and opt for other medicine to treat pain and fever during pregnancy, such as acetaminophen.
Wu said taking ibuprofen and other NSIADs in the third trimester also could cause heart problems in the baby.
“When you’re pregnant, your baby is exposed to every medication you’re taking,” Wu said. “So, you need to be careful and check with your health care provider before taking any medications, including over the counter medications.”
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