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Pregnant. Taking Thyronorm. Using anti inflammatrory drugs for Rheumatoid arthritis. Added Wysolone. Safe?

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I am 32 year old woman with 7 weeks of pregnancy. i am taking Thyronorm from last 3 years and also was taking anti inflammatrory drugs for Rheumatoid arthritis. Most of the doctor says that RA reduces with pregnancy in most of the cases but in my case it is increasing hence my doc asked me to do SLE test( My test results not yet come) and given me Wysolone 5 in addition to HCQS(200mg), thyronorm 50mg, Folic Asic, D-CAl 500. are these medicines safe for my pregnancy. this is my first baby and dont want to loose it at any cost
Posted Mon, 23 Sep 2013 in Lupus
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer:
All drugs safe; keep in touch with your doctor

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing in.

I understand your concern and shall address each medication that you are taking separately.

Starting with wysolone, which is a steroid. Steroids are usually avoided during pregnancy, and are only prescribed once the risks versus benefits have been taken into consideration. But, you should know that wysolone in specific with such a low dose (i.e. 5 mg) has not shown to have any side effects in pregnancy or on the baby.

HCQS (hydroxychloroquine) is considered safe to be taken during pregnancy. Women have taken the drug throughout pregnancy with absolutely no side effects to conception, pregnancy or the baby.

Thyronorm is also given to many women who have abnormal thyroid hormone levels, and with the help of thyronorm a successful conception and pregnancy can be attained. Please continue the same as per instructions from your doctor.

Folic acid is required before and after conception as it prevents various neural tube defects in the baby. Please continue the same till your doctor instructs you to discontinue the same. There can be no side effects of this supplement.

D-CAL 500 supplement should only be used during pregnancy when there is a clear necessity for a higher vitamin D level in the body. You might have to discuss the same with your doctor.

I hope you found my response helpful and I hope that I have answered all your queries. Please feel free to write back to me for any further clarifications.

Best wishes.
Above answer was peer-reviewed by
Follow-up: Pregnant. Taking Thyronorm. Using anti inflammatrory drugs for Rheumatoid arthritis. Added Wysolone. Safe? 44 hours later
Thanks for your reply,
As i have mentioned that i have done my SLE test which is showing positive result, i have Lupus anticoagulant presence and antinuclear antibodies positive. Is this a curable disease?
Kindly suggest me what precautions and medicines i should take now to carry forward my pregnancy as i know this will be a high risk pregnancy but I want to have this child. My pains flares up sometimes so much that it becomes unbearable
I will be attaching my reports also for your refrence
Answered by Dr. Shoaib Khan 4 hours later
Brief Answer:
Treatment options listed; avoid meds till 12 weeks

Detailed Answer:
Hello once again XXXXX.

I am sorry to hear about your most recent medical developments. I have gone through your attached medical reports, and this is indeed a high risk pregnancy. I shall try to cover all the points required, and if there are still any doubts you can always write back to me.

-Pregnancy in a woman with SLE puts her at a high risk for spontaneous abortion, intra-uterine death of child, pre-eclampsia, intra-uterine growth retardation, and pre-term birth
-Your renal function needs to be monitored constantly and at very regular intervals as lupus nephritis gets worse during pregnancy
-Now coming to medication. Let me inform you that all medications that are used to treat SLE are not safe to be used during pregnancy, which is why your doctors will have to weigh risks versus benefits and chose only those medications which are really required and avoid all others at least till you deliver
-You will be requiring a team of doctors containing a rhematologist, an obstretician and a nephrologist
-Avoid all medication for the first trimester completely (i.e. week 1 till week 12 of your pregnancy)
-Pain management can be done ONLY with the help of short-actings NSAIDs (non-steroidal anti-inflammatory drugs), and not long-acting NSAIDs
-Prednisone is advised in patients with SLE. Low-dose prednisone can be used (less than 15-20 mg per day)
-Your coagulation and bleeding profile will have to be constantly monitored and if require low-dose aspirin and/or low-dose heparin can be used
-After delivery, breast feeding can be conducted only if the mother was not on the following medications: azathioprine, methotrexate, cyclophosphamide, mycophenolate, or hydroxychloroquine
-Diet will have to have a low-salt content; calcium and vitamin D supplements might also be required
-Mild exercise will also help in preventing/controling pain and avoiding depression

Please discuss all these options with your doctor. And consult all three specialist mentioned above, only after this initiate any treatment with medication. I hope and pray your pregnancy is most uneventful, resulting in the birth of a beautiful and healthy child.Please write back to me for any further clarifications.

God bless.
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