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Family Forum / Pregnancy / Pregnancy / November 2008Prednisone in 2nd trimester
I am 19 1/2 weeks with #3. I have been having a terrible sinus infection for the past 2 weeks. It is keeping me from sleeping, giving me constant headaches, and generally making me feel awful. I went to see my family practice physician, and she prescribed me an antibiotic (Augmentin) and Prednisone. I was concerned about prednisone and specifically asked if it was safe to take, and she assured me it was. She said it was necessary in my situation because the antibiotic might clear up the sinus infection right now, but I will likely get sick right away again once I'm off the antibiotics. (This is consistent with my last pregnancy -- I had a sinus infection for 5 months -- I'd go on antibiotics and be well for a day, and then it would come right back). She also encouraged me to take a steroid nasal spray like Afrin to keep inflammation down. I see prednisone is Category C but my internet research gave me inconsistent information about whether it's generally thought of as okay. Same with Afrin - some info seems to say it's a good idea, some says it's an absolute no-no. Any thoughts, info, or anecdotal information? Thank you. -Carlye DD 9-2004 DS 6-2006 #3 due 4-2-2008 I don't have time right now to look up exact research details for prednisone, but if it's cat C, the mantra is only take if the benefits to you clearly outweigh the risks to the baby - which right now, I personally wouldn't feel it was, you don't know you will definitely get sick again once you stop the antibiotics and there isn't any harm, only suffering in getting sick again, it may well be a reasonable thing to do once you've got sick again, but as a first line of defence for something you can't guarantee would happen, it does seem a but over the top. With nasal sprays, even if there isn't good studies on this particular one, it does seem to be a reliable general finding that anything that is applied locally gets into the blood in very small quantities. I occasionally use a steroid nasal spray as I'd be struggling badly with seasonal allergies and there is still the odd thing that flares them up and by taking occasional doses of the spray I drastically reduce the desire/need to take antihistamines or decongestants. I don't know how well they work on sinuses though, my congestion never seemed to be quite that far up. I think if I were you I'd be doing the antibiotics and the spray and crossing my fingers. I might also look into which foods are antinflamatory and which encourage inflamation, I know there are some major ones, but I've never really bothered with it so I don't know which foods, but I definitely want to try something like that to avoid the prednisone. Cheers Anne You may also want to try more gentle solutions like a neti pot http://www.youtube.com/watch?v=j8sDIbRAXlg which just gives you a gentle salt water cleanse of your sinuses, and can keep them from getting so backed up and infected. Perhaps antibiotics in conjunction with a neti pot may be enough to keep you from repeat infections.  SignatureJamie Clark www.ClarkDigitalArts.com >I don't have time right now to look up exact research details for >prednisone, but if it's cat C, the mantra is only take if the benefits to [quoted text clipped - 23 lines] > Cheers > Anne Thanks, Jamie and Anne. I went to the pharmacy before the thread had any responses, and I actually decided consistent with your suggestions. I didn't fill the prednisone prescription. I bought the Afrin but haven't decided if I'll use it, and I picked up some Breathe Right strips to help keep everything opened up at night without chemicals at all. I didn't think about the NetiPot, as you suggest, Jamie. I'll think about that. I am fearful that if I used such a thing, I'd end up inhaling some water and having that unpleasant water-up-my-nose-in- the-swimming-pool sensation that reminds me of my childhood. But that's probably just me being stupid. I do hope the antibiotics kick in soon. I took a 3-hour nap this afternoon with DS and am still feeling completely run down. I can't remember the last time I felt this awful for this long. -Carlye DD 9-2004 DS 6-2006 #3 due 4-2-2009 > all. I didn't think about the NetiPot, as you suggest, Jamie. I'll > think about that. I am fearful that if I used such a thing, I'd end > up inhaling some water and having that unpleasant water-up-my-nose-in- > the-swimming-pool sensation that reminds me of my childhood. But > that's probably just me being stupid. I have a terrible aversion to water in my nose, to the point where when I'm standing in the shower I can feel like I'm drowning(of course I cope with that but when I'm swimming, well, it's not so easy to cope with!) The NetiPot was so easy to use and I felt like such a baby afterwards for how whiny I was about using it. And it *really* feels so much better after I used it, it was unbelievable! Something to start out with- mix some salt and very warm water in a bowl, and stick your finger in the bowl to get a drop on it. Lean your head as far as possible to the side and drop the saltwater into your nostril from your fingertip. Then sniff it up. I had to start out with very small drops to prove to myself I wouldn't drown :oP After I felt ok about it, I used larger amounts. Marie > I didn't fill the prednisone prescription. I bought the Afrin but > haven't decided if I'll use it, Great minds think alike! LOL If you've never used a nasal spray before you might be impressed, I was really struggling with allergies this summer and nasal spray hadn't crossed my mind. I was taking multiple antihistamines at max dose and full strength sudafed to the max dose and still not clearing it. Within a couple of days of nasal spray I was down to just one zyrtec per day and fairly quickly was able to drop the nasal spray down to a maintenance dose. I'd no idea things had got so inflamed. Now we are in to cold season it's hard to tell sometimes whether something is allergies or a cold, but I'm comfortable with occasional doses of zyrtec and nasal spray. I think you generally feel some effect from antibiotics within 24 hours, but when you're run it takes longer to perk back up. Antibiotics usually have a slight aninflamatory effect as well, so they are helping in that respect too. Cheers Anne > > I didn't fill the prednisone prescription. I bought the Afrin but > > haven't decided if I'll use it, > > Great minds think alike! LOL > > If you've never used a nasal spray before you might be impressed, I used just one spray (dose is 2-3) last night before bed and was impressed. I have been a fan of plain saline spray for a long time, especially while pregnant, but I couldn't believe that between the Afrin, Breathe Right strips, and possibly the antibiotics starting to kick in, I could actually breathe last night! It made me feel foolish for being "tough" for so many days. > I think you generally feel some effect from antibiotics within 24 hours, > but when you're run it takes longer to perk back up. Yeah, they are starting to kick in, but I still feel like I need a ton of rest. Early to bed tonight again, and hopefully I'll be doing a lot better by tomorrow. Thanks again to everyone. I am hoping once this infection is gone, I can keep using the Breathe Right, NetiPot (maybe - jury is still out), and occasionally Afrin to keep from getting sick again. -Carlye DD 9-2004 DS 6-2006 #3 due 4-2-2009 <snip> > Thanks again to everyone. I am hoping once this infection is gone, I > can keep using the Breathe Right, NetiPot (maybe - jury is still out), > and occasionally Afrin to keep from getting sick again. You might want to check out homeopathic remedies. I have a nasal spray here that's called Euphorbium comp. (by Heel), it's a mixture that's available at german pharmacies, I don't know if you'd be able to find it in the US. I've been using it for Sara who's 14 month old and I got it way back when she was just a few months old because she had a really congested nose that made nursing really hard, and right now she has a yucky cold (her first) with a runny nose. I can't believe how awesome this stuff is. I used it twice the first and second day, once the next two and not at all today and while she was totally hating it it dried that running nose right up! It's composed of: Euphorbium dil. D4, Pulsatilla Dil. D2, Luffa opercolata Dil.D2, Mercurius bijodatus Dil. D8, Heparsulfuris Dil D10, Argentum nitricum Dil D10. If you take that list to a pharmacy that knows their way around homeopathic remedies they'll probably be able to find something for you. I'm really impressed with it anyway. Take care nicole > > I didn't fill the prednisone prescription. I bought the Afrin but > > haven't decided if I'll use it, [quoted text clipped - 19 lines] > Cheers > Anne Just remember that with the nasal sprays (afrin or generic) that you should only use them for 3 days straight, no longer. I second the neti pot (although I just use a bulb syringe--they didn't have neti pots available when I had chronic sinusitis--did "nasal irrigation" 3 times a day for 4 years before having a roto-rooter job, and have had 3 sinus infections since). Also, hot shower with lots of steam, or a bathwith the baby vapo-bubble bath stuff in it. :-) Sharalyn > Just remember that with the nasal sprays (afrin or generic) that you > should only use them for 3 days straight, no longer. I don't know about afrin, but a lot of meds you can buy in the pharmacy have warnings like don't use for x days without consulting a doctor - which means just that not that under orders of a doctor there are no cases where you should use it continuously, so I'd check with your doctor on this one. Cheers Anne > > Just remember that with the nasal sprays (afrin or generic) that you > > should only use them for 3 days straight, no longer. [quoted text clipped - 7 lines] > Cheers > Anne Actually, that is very specific to Afrin (and generic forms), and MDs will tell you not to use for more than 3 days also. Afrin is very caustic to the mucus membranes, and can actually wear a hole in the septum. Sharalyn > Actually, that is very specific to Afrin (and generic forms), and MDs > will tell you not to use for more than 3 days also. Afrin is very > caustic to the mucus membranes, and can actually wear a hole in the > septum. Good to know, sounds like that doctor was handing out poor advice. The reasons I mentioned it was because so many things, such as Tylenol do say not to use for more than a certain amount of time without consulting you doctor, but it's more to avoid covering up a pain that needs to be investigated than anything bad about taking tylenol long term, because although it's very toxic to the liver in high doses, taken at the correct dose it's cleared from the body very fast. Carlye, I'd ask you doctor about alternatives, depending on how your recovery goes, because if keeping down inflamation is part of the key to not reinfecting yourself, then you may need other alternatives. If I'm understanding it correctly Afrin is a decongestant, the doctor was suggesting also taking oral steroids - so the middle line option is a steroid nasal spray. I tried two this summer and as they were samples from the doctor, they had the massive extended paper work and both of them were ok for maintenance use. Cheers Anne |
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