[Analgesic drugs during pregnancy].
Some important limitations must be taken into consideration for analgesic therapy during pregnancy. Paracetamol is the agent of choice for mild to moderate pain in any stage of pregnancy. Ibuprofen is the non-steroidal anti-inflammatory drug (NSAID) of choice; however, these substances are contraindicated after 28 weeks of gestation due to the increasing risk of premature closure of the ductus arteriosus and impairment of fetal kidney function. Even opioids can be used for severe pain but peripartum administration can lead to neonatal respiratory depression and adaptation disorders and long-term therapy up to the end of pregnancy can lead to neonatal withdrawal symptoms. Migraine can also be treated with sumatriptan. Antiepileptic drugs should not be taken during pregnancy as a teratogenic risk mostly cannot be excluded; however, well studied antidepressants, such as amitriptyline can be used for chronic pain with the appropriate indications.
Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie, Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13553, Berlin, Deutschland. stefanie.hultzsch@charite.de.
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Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie, Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13553, Berlin, Deutschland.
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Schaefer
D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use; D059787:Acute Pain / Q000188:drug therapy*; D000700:Analgesics / Q000009:adverse effects* / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use; D007231:Infant, Newborn; D008134:Long-Term Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012307:Risk Factors; D018170:Sumatriptan / Q000009:adverse effects / Q000627:therapeutic use
D000700:Analgesics; D000701:Analgesics, Opioid; D000927:Anticonvulsants; D000082:Acetaminophen; D018170:Sumatriptan; D007052:Ibuprofen
Acute pain; Analgesics, opioid; Anti-inflammatory agents, non-steroidal; Chronic pain; Migraine