Cholesterol Drugs... and pregnancy

[oceanv]

Hello,
I wanted to know if anyone on the forum had / has been on cholesterol drugs (statins, mine was crestor) while pregnant or before pregnancy was confirmed with tests. If there were any complications with the pregnancy because of the statins etc....

Currently I'm ttc, so stopped the cholesterol drugs and switched the bp drugs to safer class.

Eventually if this ttc'ing goes on for more than a few more months I might try to not think about ttc every moment and just go with it, I'll still be on  the safer bp meds but should/would have to go back on the statins for cholesterol.  I'm sure there are quite a few people who have been on these drugs before confirming pregnancy but I'd like to hear that the pregnancies weren't affected by the drugs....

Thanks
Joanne

[oceanv]

Basically I'm s**********

Medications for Chronic Conditions
Women with chronic conditions should speak with their providers before becoming pregnant so they can agree on appropriate medications. They should never discontinue their medication discussing it first. "In cases such as diabetes, hypertension, or asthma, patients can become very sick without their medication," says Dr. Lund.

"Some drugs for high cholesterol, such as the statins Lovastatin and Atorvastatin (Lipitor), are Category X drugs," warns Dr. Lund. "People who need cholesterol-lowering drugs and are pregnant, considering becoming pregnant, or breastfeeding, should not take these drugs, and instead try to treat their cholesterol without drugs."

Angiotensin-converting enzyme inhibitors, commonly known as ACE Inhibitors, which are taken for high blood pressure, are also not recommended during pregnancy. "In the case of someone who wants to get pregnant but is taking ACE inhibitors, we'd switch her to a drug in a safer category before she becomes pregnant," Dr. Lund says.

This is the rest of the article
Pregnancy and Medications: What's Safe?
Pregnancy is often a time of discovery and excitement, but it can be confusing or even dangerous for women who need to take medications while they carry another life.

Michael Lund, MD, Medical College of Wisconsin Assistant Professor of Obstetrics and Gynecology, practices at the Froedtert & Medical College of Wisconsin Obstetrics and Gynecology Clinic. He says there are many factors to consider when deciding if a medication is safe to take during pregnancy, but the most important consideration is "Does it cross the placenta?"

In the placenta, nutrients, wastes, and gases are exchanged between the blood of the mother and the blood of the fetus, so any drugs or other chemicals that cross the placenta could have an effect on the growing fetus.

There are also drugs that have a direct effect on the fetus, disrupting growth or development. These are called teratogens. Not all teratogenic drugs have the same effect on the fetus, says Dr. Lund. "Each drug that has the potential to cause a problem has a different way of causing it," he explains. "Drugs taken for epilepsy are associated with certain birth defects, but those effects are different than those caused by the acne drug Accutane."

"Many medications don't cross the placenta," Dr. Lund continues. "In that case, you don't have to worry about them unless they cause some effect on the mother that indirectly affects the fetus." For instance, if a mother takes a drug that dramatically decreases her blood pressure, it might also decrease the blood flow to the fetus.

Drug Categories
The Food and Drug Administration has classified every drug that's available into five pregnancy safety categories: A, B, C, D, and X. Category A is the safest, while drugs in Category X are unsafe for women who are pregnant or could become pregnant.

There are not many Category A drugs, says Dr. Lund. "Prenatal vitamins are not even Category A, because if you overdose on them, they cause problems." But there are Category A drugs available for conditions such as nausea and vomiting, thyroid disorders, and gestational diabetes. "Women who develop diabetes during pregnancy are typically treated with insulin because we know that insulin is safe," says Dr. Lund.

"Most drugs are Category C," says Dr. Lund, "which just means that we don't have a lot of information on them. If a drug has been around for a longer time and we have more safety information available on it, it will often move up to a Category B."

Dr. Lund mentions thalidomide and diethylstilbestrol (a synthetic form of estrogen usually called DES) as examples of Category X drugs: "Thalidomide, which was used for nausea in pregnancy in the late 1950s and early 1960s, had an effect on the limbs of fetuses; and DES, which was taken off the market in the early 1970s after it was prescribed for more than 20 years to prevent miscarriages, had an effect not only on the fetus but on the fetus' daughters" - the pregnant woman's granddaughters.

Because of the dangers of Category X drugs, patients today who are taking teratogenic drugs such as Accutane must verify to their provider that they are using not one form of birth control, but two.

Everyday Choices Can Affect Outcomes
Lifestyle choices also affect the fetus, Dr. Lund emphasizes. "Alcohol is Category X because of the possibility of Fetal Alcohol Syndrome. We are often asked, 'How much alcohol is safe for me during pregnancy?' And of course, the answer is 'we don't know.'" The safest route is not to consume any alcohol during pregnancy. Street drugs should never be used by pregnant women, Dr. Lund notes, and he strongly advises against smoking during pregnancy.

Pregnant women should consult their provider before taking any medication - even non-prescription drugs (also called over-the-counter or OTC drugs).

"We tell people what we consider safe - what the general consensus says is safe - but not all are Category A or B. Category C doesn't mean that it's bad," says Dr. Lund, "it just means we don't have clear-cut proof that this drug is always safe."

Sudafed, for instance, is a Category C drug, but is generally thought to be safe for pregnant women who have nasal congestion. Tums, Mylanta, and Maalox are Category A, says Dr. Lund. "Most OTC stomach medicines don't even get into the blood, much less the placenta." Ibuprofen, however, is not recommended during pregnancy, nor is aspirin. "We recommend acetaminophen (Tylenol) for pain. It crosses the placenta, but doesn't cause problems for the fetus. In therapeutic doses, it's safe for short-term use."

While vitamins and minerals are important to a pregnant woman and her developing fetus, Dr. Lund questions the use of commercial dietary supplements, herbal remedies, or high doses of vitamins and minerals. "The simple answer is that we don't know if these are perfectly safe or not, because they are not regulated. It's very difficult for me to tell you with any certainty that they're safe. For instance, mega-doses of vitamin A have been associated with birth defects." His advice is to stop taking any supplements except provider-approved prenatal vitamins.  

[oceanv]

Well, I did some reasearch and Crestor is category X so don't think thats an option for just going with it - ttc - for the next year or so (and maintaining artery health).  I'll have to see if all cholesterol drugs are cat x or not.......