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5 weeks pregnant. Is it safe to take folic acid and dubagest 200mg?

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Now at the age of 40, I am again pregnant and it is my 5 W. My doc has advised me folic acid, and dubagest 200mg intra vaginal application for 10 days. I have taken two doses of this medication, but after reading on the internet I feeling like stopping it immediately. Can you please advise if I can stop taking dubagest immediately after two doses. Will it have an adverse effect?
Also are side effects of taking dubagest orally and vaginally different? Is the vaginal application safer than the oral tablet? Will it help the pregnancy?
I just don't feel like taking this drug as I have read it may have some risks on the foetus. Please advise.
Posted Tue, 30 Oct 2012 in Early Pregnancy Signs and Symptoms
Answered by Dr. Timothy Raichle 43 minutes later
Hello, I would be happy to help you with your question.

So to summarize, you are a 40 year old who is in her third pregnancy (you mentioned the anembryonic pregnancy, the full-term pregnancy, and the current pregnancy). If there are others that I am missing here, please clarify. It is appropriate to have you take folic acid, but the use of dubagest (progesterone) is usually reserved for cases of:

1. Pregnancies conceived using IVF or other assisted techniques
2. In women with a history of recurrent miscarriages (usually 3 or more unexplained first trimester losses)
3. In women with a proven deficiency of the hormone progesterone during the second half of their cycle (called a luteal phase defect)

In some couples with a history of recurrent losses, and no explanation, we sometimes put them on progesterone supplementation at the start of pregnancy and continue until up to about 10 weeks. So based on what you are saying, you don't really fit the profile of someone who needs it, and the length of time that you were told to take it does not make any sense either. That being said, we believe that the risk to the fetus is actually quite small.

Finally, if you decided to stop this medication now, it will not cause a miscarriage. In fact, if you miscarried, I would not blame it on the use of the medication OR its discontinuation.

The side effects of either route are going to be similar, and it is usually well tolerated.

I hope this helps - DR XXXXXXX
Above answer was peer-reviewed by
Follow-up: 5 weeks pregnant. Is it safe to take folic acid and dubagest 200mg? 30 hours later
Thanks Dr XXXXXXX for your prompt reply. I am very relieved now that you have mentioned that I can safely discontinue the medicine right away after two doses.
So should I be OK taking just Folic acid as of now. I am in the 5th week currently. I have been advised an ultrasound examination on 13th Oct.

My only worry is my age...40 yrs. Are there any special tests for pregnancy at this age. Please let me know more about the special screening done for pregnant women above 40 yrs. These days I am again reading the book "What to expect while you are expecting". It is a big help.

Thanks once again Dr XXXXXXX And hope to hear from you soon on the special test needed for pregnant women my age.
Answered by Dr. Timothy Raichle 3 hours later
Thank you for the followup. I want you to consider the following:

1. This site is for educational purposes only. While I said that it did not seem to be a strong indication for its use in your case, I don't want you to construe this as "medical advice". It is not medical advice. For the ultimate decision regarding stopping the Lovenox, you should confirm this with your doctor. But given your scenario that you described, it does not necessarily seem indicated.

2. Yes, the folic acid supplementation is completely safe and recommended

3. In women of "advanced maternal age", there is an increased risk of problems related to chromosomes, such as Down's Syndrome. This can easily be screened for in the first trimester, by 12 weeks.

I hope this helps to clarify!!
Above answer was peer-reviewed by
Follow-up: 5 weeks pregnant. Is it safe to take folic acid and dubagest 200mg? 14 hours later
Thanks Dr. XXXXXXX

I have been advised an ultrasound both abdominal & TVS on 13th Oct, when I complete 6W. Is it OK to do the TVS ultrasound at the 6W. Isn't it too early?

Please let me know

Answered by Dr. Timothy Raichle 7 hours later
In patients where clarification of dating and viability of a pregnancy is in question, and where a prior ultrasound showed a viable pregnancy but dating was difficult to determine based on the small size of the fetus, a followup ultrasound in one week from the prior ultrasound is clearly an appropriate choice.

So, in answer to your question, I think that the scan on 10/13 is appropriate and will add significant information and clarity to your situation. And no, it is not too early to perform the followup.

I hope this helps.
Above answer was peer-reviewed by
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