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Discussion Starter #1
Those of you who have been pregnant and on Plaquenil, did your doctor take you off or let you stay on it for the duration of your pregnancy? My doc just took me off and now I'm terrified of having a flare. Also I read that if my Lupus Nephritis goes active during my pregnancy, I have a 75% chance of miscarrying.

Any info is great....

Thanks!

~Leah
 

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Most doctors these days recommend patients stay on Plaquenil during their pregnancy as the risk of a lupus flare is far greater than the risk of the drug to the fetus. I stayed on it during my pregnancy, but was taken off it for breastfeeding which was a big mistake. I have since located evidence that it is medically unnecessary to take a person off Plaquenil for breastfeeding too.

I stayed on only 200mg a day during my pregnancy though, instead of the 400 my doctor wanted me to stay on. However, that's because I knew 400 was actually too much for me based on weight... My baby turned out just fine as have most every other baby I've heard about being delivered after a mom stayed on Plaquenil. Good luck with everything.

If at all possible, get a second opinion. Quickly. And ask your high risk OBgyn about it too...

Oh and a hearty CONGRATULATIONS! :)
 

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cinderashes
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Hi Leah, congratulations on your pregnancy!

i have a healthy 3 month old baby girl and was recommended to stay on 200mg plaquenil during my pg. i was told the drug does pass the placenta and into breastmilk but at 200mg dose the level is not considered to be unsafe and any risk is more than outweighed by the risk of the mother flaring while prgnant.

once the baby was born i was told i could up the dose to 400mg but as yet havent done this as i am still breastfeeding and can cope with the pain etc.

hope this helps. let us know how you get on
Ash x
 

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Hi Leah,

Congraulations on getting this far. How many weeks are you now?

What meds are you on in total? Was the plaquenil your only DMARD?

It is pretty safe to take plaquenil, prednisolone and azathioprine in pregnancy. Most of the other DMARD are not reccomended, and methorexate and cyclophosphamide are definately dangerous.

These days most doctors will recommend staying on the plaquenil, so I'd definately ask your obstetrician's advice and if he/she is for it, restart. The other option is prednisolone. Especially if you have a history of lupus nephritis, it is really important to keep your lupus inactive, and the potential risk of meds to your baby is much less than the risk of nephritis. Given that these risks are so different, in my opinion it is clear - you should be on some kind of DMARD. I'd talk to your doctor again and also the Ob/Gyn. If you have further concerns, you may like to seek a second opinion.

All the best,

X C X
 

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I just found out few weeks ago that I was pregnant. I preplanned it and just about had to get off all my meds before hand except my stomach med and Plaqunil. I go to ob/gyno Thursday and will no more about my pregnacy then and he may want to reduce Plaqunil to 200 mg instead of 400 mg. Most docs do want to keep you on Plaqunil because of the harmful flares when getting off of it during pregnancy. I would talk to your ob/gyno about it though every doc is different. Congrats , I am wondering to how many weeks you are so we can compare lol.


Jen
 

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I called the OB today and he said to stay on the medication as there is more risk involved with a flare. So I restarted today on 200 mg. I took prednisone for most of my last pregnancy because I flared at about 13 weeks until a few weeks after I delivered. At that point I hadn't been diagnosed with lupus so I didn't know what was going on, it just happened that an ER doctor decided to give prednison a try after many other meds didn't work. Good thing for me, and Alexander. After reading all the info on the subject I realize that my son could have easily died while I was carrying him, so I definitely am trying my best to be informed this time around.

Thanks so much for the info. Oh, btw, somebody asked how far along I am. It's very early in my pregnancy. I'm only about 5 weeks now, though I haven't been to the OB yet to have a dating scan. We have one scheduled for about three weeks from now.

cath - I was taking lisinopril for BP, but went off of that as soon as I got a positive test. But, plaquenil is the only DMARD I'm on. I have prednisone as a back up, just in case I do flare. I am on a couple more meds, but for different problems. Synthroid for hypothyroidism and Glucophage for insulin resistance.

Another question... Those of you who have borderline BP issues, did your BP issues get worse during your pregnancy? I'm a bit worried about it since having to go off the lisinopril.

~Leah
 

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you need to visit your rheumie asap to see how they think you need to handle your pg (perhaps also your nephrologist ?). It is really important that all the various doctors work together during your pg to keep you and the baby as healthy as possible.

Prednisone is definitely an option, and be taken in place of plaquenil but then it seems most just stay on plaq.

Your rheumie likely knows an awful lot more about plaquenil than your OB, so you rheumie may well be able to have a word to your OB about this.

My pregnancy was 20 years ago so I make it a total rule never to discuss what I was advised to do as things just change so much over time.

congrats on your pregnancy and best of luck with it all

raglet
 

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Unless you get pre-eclampsia, your blood pressure will likely drop a little bit through your second trimester due the the blood volume changes associated with pregnancy. Most pregnant women experience a drop in blood pressure - I'm not sure about someone with existing blood pressure problems though. This of course is a good question to ask your doctor!

Glad to hear you are back on the Plaquenil and your OB is well informed! :)
 

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Hi,

I'm glad you are doing OK at the moment. Lots of good wishes oing your way from me:blush:.

Having pre existing hypertension does mean you have a higher risk of getting high blood pressure in pregnancy, and also of getting pre-eclampsia. Your obstetrician will keep a close eye on you and your blood pressure. There are BP meds that are safe to use in pregnancy, so if you need them I'm sure he/she will prescribe them. Remember to let the doctor know if you are having symptoms - headaches, flashing lights before your eyes, blurred vision, tingling in the fingers etc.

All the best,

X C X
 
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