Citramon Pregnancy

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Consists of Acetylsalicylic Acid, Caffeine, Paracetamol

Pregnancy of Acetylsalicylic Acid (Citramon) in details

Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Acetylsalicylic Acid (Citramon) has not been formally assigned to pregnancy category by the FDA. However, Acetylsalicylic Acid (Citramon) is considered to be in pregnancy category D by the FDA if full dose Acetylsalicylic Acid (Citramon) is taken in the third trimester. Use of nonsteroidal anti-inflammatory drugs during the third trimester of pregnancy should be avoided due to effects on the fetal cardiovascular system (closure of the ductus arteriosus). Acetylsalicylic Acid (Citramon) use in pregnancy has been associated with alterations in both maternal and fetal hemostasis. In addition, high doses have been associated with increased perinatal mortality, intrauterine growth retardation, and teratogenic effects. During the first two trimesters of pregnancy, Acetylsalicylic Acid (Citramon) should only be given during pregnancy when clearly needed and when benefit outweighs risk. In 1990, the FDA issued a warning that it is especially important not to use Acetylsalicylic Acid (Citramon) during the last trimester of pregnancy unless specifically directed to do so by a physician because it may cause problems in the unborn child or complications during delivery.

Increased maternal bleeding can occur during delivery when Acetylsalicylic Acid (Citramon) is used 1 week prior to and/or during labor and delivery. Prolonged gestation and labor have been reported due to Acetylsalicylic Acid (Citramon)'s inhibition of prostaglandin. A study of the use of low-dose Acetylsalicylic Acid (Citramon) (60 mg per day) to prevent and treat preeclampsia in 9364 pregnant women (the Collaborative Low-dose Acetylsalicylic Acid (Citramon) Study in Pregnancy--CLASP) did "not support routine prophylactic or therapeutic administration of antiplatelet therapy in pregnancy to all women at increased risk of preeclampsia or IUGR." In that study, no excess of intraventricular hemorrhage, neonatal bleeds, or mortality attributable to bleeding were observed. The investigators did identify a possible role for low-dose Acetylsalicylic Acid (Citramon) in the treatment of early-onset preeclampsia severe enough to need very preterm delivery. Another study of low-dose Acetylsalicylic Acid (Citramon) (follow-up from the Italian Study of Acetylsalicylic Acid (Citramon) in Pregnancy) has suggested that "low dose Acetylsalicylic Acid (Citramon) in pregnancy is safe with respect to the risks of malformation and of major impairment in development at 18 months of age." High-dose Acetylsalicylic Acid (Citramon) (2 g per day) has been associated with stillbirths, cerebral hemorrhage, oculoauriculovertebral dysplasia, neonatal salicylate toxicity, constricted ductus arteriosus, cyclopia, and neonatal acidosis. Some cases of congenital heart defects have been reported. However, a case control study of Acetylsalicylic Acid (Citramon) use in the first trimester concluded that Acetylsalicylic Acid (Citramon) "does not increase the risk of congenital heart defects in relation to that of other structural malformations."

See references

Acetylsalicylic Acid (Citramon) breastfeeding

When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!
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Acetylsalicylic Acid (Citramon) is excreted into human milk in small amounts. Peak milk salicylate levels have been reported at nine hours after maternal dosing (and measured at 1.1 mg/dL). Use of large doses of Acetylsalicylic Acid (Citramon) can result in rashes, platelet abnormalities, and bleeding in nursing infants. Because of a single case report of metabolic acidosis, the American Academy of Pediatrics characterizes Acetylsalicylic Acid (Citramon) as a drug that has been "associated with significant effects on some nursing infants and should be given to nursing mothers with caution."

See references

References for pregnancy information

  1. Karlowicz MG, White LE "Severe intracranial hemorrhage in a term neonate associated with maternal acetylsalicylic acid ingestion." Clin Pediatr (Phila) 32 (1993): 740-3
  2. Subtil D, Deruelle P, Trillot N, Jude B "Preclinical phase of polycythemia vera in pregnancy." Obstet Gynecol 98(5 Pt 2) (2001): 945-7
  3. Leonhardt A, Bernert S, Watzer B, Schmitz-Ziegler G, Seyberth HW "Low-dose Acetylsalicylic Acid (Citramon) in pregnancy: maternal and neonatal Acetylsalicylic Acid (Citramon) concentrations and neonatal prostanoid formation." Pediatrics 111 (2003): e77-81
  4. Kozer E, Nikfar S, Costei A, Boskovic R, Nulman I, Koren G "Acetylsalicylic Acid (Citramon) consumption during the first trimester of pregnancy and congenital anomalies: A meta-analysis." Am J Obstet Gynecol 187 (2002): 1623-30
  5. Li DK, Liu L, Odouli R "Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study." BMJ 327 (2003): 368
  6. Parazzini F, Bortolus R, Chatenoud L, Restelli S, Benedetto C "Follow-up of children in the italian study of Acetylsalicylic Acid (Citramon) in pregnancy." Lancet 343 (1994): 1235
  7. "Product Information. Bayer Acetylsalicylic Acid (Citramon) (Acetylsalicylic Acid (Citramon))." Bayer, West Haven, CT.
  8. Schoenfeld A, Bar Y, Merlob P, Ovadia Y "NSAIDs: maternal and fetal considerations." Am J Reprod Immunol 28 (1992): 141-7
  9. "Clasp: a randomised trial lf low-dose Acetylsalicylic Acid (Citramon) for the prevention and treatment of pre-eclampsia among 9364 pregnant women." Lancet 343 (1994): 619-29

References for breastfeeding information

  1. Committee on Drugs, 1992 to 1993 "The transfer of drugs and other chemicals into human milk." Pediatrics 93 (1994): 137-50
  2. "Product Information. Bayer Acetylsalicylic Acid (Citramon) (Acetylsalicylic Acid (Citramon))." Bayer, West Haven, CT.
  3. Erickson SH, Oppenheim GL "Acetylsalicylic Acid (Citramon) in breast milk." J Fam Pract 8 (1979): 189-90

Pregnancy of Caffeine (Citramon) in details

Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Caffeine (Citramon) crosses the placenta; serum concentrations in the fetus are similar to those in the mother (Grosso 2005).

Based on current studies, usual dietary exposure to Caffeine (Citramon) is unlikely to cause congenital malformations (Brent 2011). However, available data show conflicting results related to maternal Caffeine (Citramon) use and the risk of other adverse events, such as spontaneous abortion or growth retardation (Brent 2011; Jahanfar 2013; Nehlig 1994). Chronic maternal consumption of high amounts of Caffeine (Citramon) during pregnancy may lead to neonatal withdrawal at delivery (eg, apnea, irritability, jitteriness, vomiting) (Martin 2007).

The half-life of Caffeine (Citramon) is prolonged during the second and third trimesters of pregnancy and maternal and fetal exposure is also influenced by maternal tobacco or alcohol consumption (Brent 2011; Koren 2000). Current guidelines recommend limiting Caffeine (Citramon) intake from all sources to ≤200 mg/day during pregnancy (ACOG 2010).

Caffeine (Citramon) breastfeeding

When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!

Caffeine (Citramon) citrate is not indicated for use in adult patients. Excreted into human milk: Yes Comments: -Caffeine (Citramon) readily crosses the placenta into the fetal circulation. -Breastfeeding mothers of infants receiving Caffeine (Citramon) citrate should not ingest Caffeine (Citramon)-containing foods, beverages, and medicinal products.

See references

References for pregnancy information

  1. "Product Information. Cafcit (Caffeine (Citramon))" Roxane Laboratories Inc, Columbus, OH.

References for breastfeeding information

  1. "Product Information. Cafcit (Caffeine (Citramon))" Roxane Laboratories Inc, Columbus, OH.

Pregnancy of Paracetamol (Citramon) in details

Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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During pregnancy patients should avoid prolonged use of Paracetamol (Citramon) Zodley Pharmaceuticals because the risk of addiction in the fetus and the occurrence of withdrawal in the neonatal period.

If necessary using in lactation (breastfeeding) should be aware that tramadol in small amounts excreted in breast milk. In the case of long-term treatment can not been excluded the possibility of drug dependence.

Paracetamol (Citramon) Zodley Pharmaceuticals is not recommended for treatment of withdrawal syndrome drugs.

Patients need to avoid combination with MAO inhibitors.

During the period of treatment with Paracetamol (Citramon) Zodley Pharmaceuticals you should avoid to take alcohol.

Tramadol in the form of long-acting formulations should not be used in children under the age of 14 years.

During the period of tramadol using is not recommended to engage in activities that require special attention, speed of psychomotor reactions.

References

  1. DailyMed. "CAFFEINE; ERGOTAMINE TARTRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubMed Health. "Vivarin: This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).
  3. Human Metabolome Database (HMDB). "Caffeine: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". http://www.hmdb.ca/metabolites/HMDB0... (accessed September 17, 2018).

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