Should I stop Thyroxine sodium tablets before planning for a baby?
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Hello Doctor, I am 26 years of age. I have migraine headache and have been taking "Amitriptyline Hydrocloride" 0.5 mg, "Thyroxine Sodium Tablets" 37.5 mcg and Flunarizine (Sibelium) (5 mg) since 2 years ago. I have stopped taking the first medicine (A.H.) since a week ago and the third medicine sibelium since over a month. Now, I am planning for a baby. So seeking for your advice if I can plan for it now or I need to wait for sometime. Right now, I have been taking "Thyroxine sodium Tablets". Should I stop this too before planning? Is it safe to take any of the above medicine during pregnancy in future? Please suggest what should I avoid if I get headache during pregnancy.
Posted Wed, 4 Dec 2013 in Women's Health
Answered by Dr. Aarti Abraham 58 minutes later
Brief Answer: PLAN AFTER 3 MONTHS - AVOID MOST DRUGS. Detailed Answer: Hello XXXXX Thanks for writing to us with your health concern. Thyroxine sodium should be continued during the pre conceptional period as well as during pregnancy. It is vital to keep your TSH levels in control , as uncontrolled TSH levels will adversely affect the baby. Most women find that migraine improves during pregnancy, it might worsen postpartum due to hormonal drop off effect. Rather than taking recourse to any medications, firstly non drug treatment should be tried ( sleep, avoiding specific triggers, massage, ice packs ). For an acute attack, paracetamol is the best option. This can be used as a suppository to make it more safe. Classic migraine treatment drugs of the " triptan " group should be specifically avoided. Anti vomiting medications are safe. For prophylaxis ( long term preventive therapy ) - the only allowed medications belong to the beta blocker group ( propranolol, metoprolol ) , and even these come with some side effects. It is best to avoid medication for prophylaxis . Both Amitryptiline and Flunarizine are best avoided in pregnancy. It is best to avoid specific triggers ( lights, noise, wine , chocolate, cheese, any other specific food ) - and take treatment only episodically for acute attacks. Also, after stopping the medication, wait for 3 months, meanwhile take regular folic acid supplements, and then plan for a pregnancy. Take care. All the best, and please feel free to ask for any clarifications.