Zacoldine Pregnancy

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Consists of Acetaminophen, chlorpheniramine maleate, K sulphoguaiacolate, phenylephrine

Pregnancy of Acetaminophen (Zacoldine) 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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Acetaminophen (Zacoldine) crosses the placenta (Naga Rani 1989).

Based on epidemiological data, an increased risk of major congenital malformations has not been observed following maternal use of Acetaminophen (Zacoldine) during pregnancy. Although not considered a major birth defect, an association between maternal Acetaminophen (Zacoldine) use and cryptorchidism (undescended testis) has been observed (Fisher 2016; Jensen 2010; Kristensen 2011; Snijder 2012). The use of Acetaminophen (Zacoldine) in normal doses during pregnancy is not associated with an increased risk of miscarriage or still birth; however, an increase in fetal death or spontaneous abortion may be seen following maternal overdose if treatment is delayed (Li 2003; Rebordosa 2009; Riggs 1989). Prenatal constriction of the ductus arteriosus has been noted in case reports following maternal use during the third trimester (Allegaert 2019); although this association was not confirmed in a large observational study (Dathe 2019), Acetaminophen (Zacoldine) has been evaluated for the treatment of a persistent patent ductus arteriosus in preterm neonates (Terrin 2016). Additional adverse events such as wheezing and asthma in early childhood and adverse neurodevelopmental effects such as ADHD following in utero Acetaminophen (Zacoldine) exposure have been evaluated in multiple studies; outcome information is inconclusive, and a causal association has not been established (Cheelo 2014; Fan 2017; Lourido-Cebreiro 2017; Scialli 2010; SMFM 2017). It should be noted that maternal fever is also associated with adverse fetal outcomes, including neural tube defects, oral clefts, and congenital heart defects. Treatment of maternal fever with an antipyretic may reduce these risks (Drier 2014).

Due to pregnancy-induced physiologic changes, some pharmacokinetic properties of Acetaminophen (Zacoldine) may be altered. Dose adjustments are not recommended (Kulo 2014). Acetaminophen (Zacoldine) is considered appropriate for the treatment of pain and fever in pregnancy (SMFM 2017). Acetaminophen (Zacoldine) may be used as part of a multimodal approach to pain relief following cesarean delivery (ACOG 209 2019), for the treatment of acute migraine in pregnant patients (Burch 2019; Hamilton 2019a; Marmura 2015) and is recommended for the treatment of fever in pregnant women diagnosed with influenza (ACOG 753 2018). Acetaminophen (Zacoldine) is recommended to be used at the lowest effective dose for the shortest duration of time to effectively treat the mother and protect the health of the fetus (Kilcoyne 2017).

Acetaminophen (Zacoldine) 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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One small study has reported that following a 1000 mg dose of Acetaminophen (Zacoldine) to nursing mothers, nursing infants receive less than 1.85% of the weight-adjusted maternal oral dose.

Aspirin 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 aspirin 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 aspirin as a drug that has been "associated with significant effects on some nursing infants and should be given to nursing mothers with caution." Acetaminophen (Zacoldine) is excreted into human milk in small concentrations. One case of a rash has been reported in a nursing infant. Acetaminophen (Zacoldine) is considered compatible with breast-feeding by the American Academy of Pediatrics. Caffeine is excreted into human milk in small amounts. Adverse effects in the nursing infant are unlikely. However, irritability and poor sleep patterns have been reported in nursing infants. The amount of caffeine generally found in caffeinated beverages is considered to usually be compatible with breast-feeding by the American Academy of Pediatrics. Because caffeine is excreted into human milk and because caffeine is metabolized slowly by nursing infants, consumption of more than moderate levels of caffeine by nursing mothers is not recommended.

Pregnancy of Chlorpheniramine maleate (Zacoldine) 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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Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Chlorpheniramine maleate (Zacoldine) 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!

There are no data on the excretion of Chlorpheniramine maleate (Zacoldine) into human milk. However, because other antihistamines are excreted into human milk in low concentrations, the manufacturer recommends that caution be used when administering Chlorpheniramine maleate (Zacoldine) to nursing women.

See references

References for pregnancy information

  1. "Product Information. Chlortrimeton (Chlorpheniramine maleate (Zacoldine))." Schering-Plough, Liberty Corner, NJ.
  2. Black RA, Hill DA "Over-the-counter medications in pregnancy." Am Fam Physician 67 (2003): 2517-24
  3. Heinonen O, Slone D, Shapiro S; Kaufman DW ed. "Birth Defects and Drugs in Pregnancy." Littleton, MA: Publishing Sciences Group, Inc. (1977): 297
  4. Nelson MA, Forfar JO "Associations between drugs administered during pregnancy and congenital abnormalities of the fetus." Br Med J 1 (1971): 523-7

References for breastfeeding information

  1. "Product Information. Chlortrimeton (Chlorpheniramine maleate (Zacoldine))." Schering-Plough, Liberty Corner, NJ.

Pregnancy of Phenylephrine (Zacoldine) 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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Phenylephrine (Zacoldine) crosses the placenta at term.

Maternal use of Phenylephrine (Zacoldine) during the first trimester of pregnancy is not strongly associated with an increased risk of fetal malformations; maternal dose and duration of therapy were not reported in available publications. Phenylephrine (Zacoldine) is available over-the-counter for the symptomatic relief of nasal congestion. Decongestants are not the preferred agents for the treatment of rhinitis during pregnancy.

Oral Phenylephrine (Zacoldine) should be avoided during the first trimester of pregnancy; short-term use (<3 days) of intranasal Phenylephrine (Zacoldine) may be beneficial to some patients although its safety during pregnancy has not been studied. Phenylephrine (Zacoldine) injection is used at delivery for the prevention and/or treatment of maternal hypotension associated with spinal anesthesia in women undergoing cesarean section. Phenylephrine (Zacoldine) may be associated with a more favorable fetal acid base status than ephedrine; however, overall fetal outcomes appear to be similar. Nausea or vomiting may be less with Phenylephrine (Zacoldine) than ephedrine but is also dependent upon blood pressure control. Phenylephrine (Zacoldine) may be preferred in the absence of maternal bradycardia.

Phenylephrine (Zacoldine) 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!

Small amounts of Phenylephrine (Zacoldine) are secreted in breast milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

See references

References for pregnancy information

  1. "Product Information. Lusonal (Phenylephrine (Zacoldine))." Wraser Pharmaceuticals, Ridgeland, MS.

References for breastfeeding information

  1. "Product Information. Lusonal (Phenylephrine (Zacoldine))." Wraser Pharmaceuticals, Ridgeland, MS.

References

  1. DailyMed. "CHLORPHENIRAMINE POLISTIREX; HYDROCODONE POLISTIREX: 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. DailyMed. "ACETAMINOPHEN; ASPIRIN; CAFFEINE: 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).
  3. PubMed Health. "Chlorpheniramine (By mouth): This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).

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