Tapering off Medications

[Momof2or3]

I'm planning to become pregnant soon. I have successfully gotten off the Escatolopram and am down to .5 of the Klonopin a day. I have gotten down to 25mg of the Metoprolol a day. Is this a safe amount to stop after a week of it?

[Carrie Fu, PharmD]

Dear Momof2or3:

It is wonderful you are planning to get pregnant again. However, due to your blood pressure and heart conditions, it is very important for you to work closely with your physicians, primary care and OBGYN. Please do not stop taking any medication without consulting your healthcare providers first.

From your med list:
1. Clonazepam (Klonopin) - for anxiety?

It is good you are able to taper down from 1 mg two times daily to 0.5 mg once daily. It is important to taper clonazepam down slowly and not to stop taking it suddenly. If you stop suddenly, you may experience withdrawal symptoms such as sweating, uncontrollable shaking, anxiety, changes in behaviors, and possible seizures, etc.

2. Metoprolol ER 50mg - for high blood pressure

It is important to manage your blood pressure, especially during pregnancy. If you stop taking your blood pressure medications while being hypertensive, you are at risk for strokes. Please do not stop taking metoprolol without consulting your physician.

Metoprolol is in pregnancy category C, which means its safety use during pregnancy in human is not conclusive. Animals studies have shown adverse effects, but there are no adequate and well-controlled studies in humans. It is important to assess the risks vs the benefits with metoprolol during pregnancy.

There are blood pressure medications which are safe to take during pregnancy as alternatives. Please consult your OBGYN. You may have high risk pregnancy due to your heart conditions, high blood pressure and heart murmurs.

3. Escitalopram (Lexapro) - for depression and/or anxiety disorder?

Depression may be common during and after pregnancy. Please do not stop taking any medication without consulting your providers, especially heart medications and anti-depressants.

For more information, please go to:
1. Clonazepam - Medline Plus
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682279.html

2. Metoprolol - Medline Plus
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682864.html

3. Escitalopram - Medline Plus
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603005.html#why

4. Depression During and After Pregnancy Fact Sheet - Womens Health.org
http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.cfm

5. Pregnancy - Womens Health.org
http://womenshealth.gov/pregnancy/you-are-pregnant/prenatal-care-tests.html#d

[poorlawyer]

Hello, Im not a doctor Im a law student. but typically when you try to wein off medications you lower the dosage gradually, and you eventually, when aty lowest dose, take the medicine only every other day then stop completely. Hope this helps.