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Are Gabapentin and Warfarin safe to take while trying to conceive?

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Posted on Mon, 30 May 2016
Question: Hello
My husband and I are wanting to try for a baby, but have concerns over the effect of the medications he takes for his Complex Regional Pain Syndrome and the health of his sperm. Currently he takes 62mcg fentanyl patch every 72 hours, 3200mg Gabapentin daily, alternating 5 and 7mg warfarin (has hereditary thrombophilia and had had two blood clots in his keg in the past), 20mg cipralex, and up to 6mg dilaudid as needed. If in fact we were able to get pregnant, which I imagine will be a challenge, will there be effects on the baby, such as any disabilities, risk of miscarriage, developmental issues, etc.? Thank you for your time.
doctor
Answered by Dr. Vasudha Jayant Athavale (5 hours later)
Brief Answer:
Consult an infertiliry specialist.

Detailed Answer:
Hi XXXXX,
Thanks for the query through Health care magic .
I have read your query carefully. I understood & agree with your concern.. sorry for the psychological stress you both are going through. Let us discuss.. how to tackle the problem.
*All the medications your husband is taking are for pain relief, except for Cipralex.. which is to treat anxiety/ depression .. which can reflect on sperm counts/ quality.
* Actually each of the medicine taken has more or less effect on genital system.( ranging from ejaculatory problems/ constant rection(Priapsm)/testicular pain or impotence in few cases. )
* Fetal abnormalities are transferred to fetus..from maternal or paternal genes / abnormal sperm/ ovum .IT's fortunate that most of the drugs do not affect spermatogenesis( process of sperm making )-- so abortion / fetal abnormality seems to be less possible due to the drugs taken by your husband.
- Mainly intake of harmful medications by mother / viral infections in first three months of the mother/ psychological or physical stress of mother during pregnancy/ deficiencies in mother's body in pregnancy... are predominant causes of fetal malformations/ abnormal development/ abortions... (as they are directly carried to fetus through mother's blood).
* IN such a case when withdrawal of drugs seems to be difficult ( looking at the severity of pain & dose of multiple drugs needful to control it )... we can assess the possibility of conception by-
- absence of ejaculatory problems in your husband/ treatment of the condition ( if present ) by A sexologist /alternative therapies ( Spemen & Tentex forte by Himalaya drugs )
- Semen analysis to see actual quality & gravity of side effects.
. - Artificial insemination using sorted out healthy sperms of your husband / using healthy unknown doner sperm .
- test tube baby...could be the last preference.
* Please don't be stressed.. there are ways when there is will. So get an expert fertility advise & follow the best advise given. You will be blessed with a child.
I hope, you find the answer both informative & useful. Any follow up query is welcome.
Thanks.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vasudha Jayant Athavale (8 hours later)
Hello
Thank you so much for all of this information. Just to make sure I am understanding you correctly, the fetus/baby has very little chance of being miscarried or having disabilities or abnormalities because the medications don't affect the sperm quality. The main obstacle is getting pregnant for us, so we may need to explore fertility treatment due to medications affecting sperm count and motility?
Do these medications produce abnormal sperm, or sperm with fragmented DNA? What happens if one of those sperm fertilizedAnn egg (or is that unlikely to happen since it is unhealthy)?
doctor
Answered by Dr. Vasudha Jayant Athavale (2 hours later)
Brief Answer:
Semen assessment & treatment by Fertility specialist's advise would help.

Detailed Answer:
Hi XXXXX,
Thanks for the follow up query.
As I have already mentioned , the pain medicine your husband is taking (Fentanyl,Gabapentine,Dilaudid,& anti coagulant Warfarrin are reported to have erectile dysfunctions & ejaculatory problems.They do not have effect on sperm quality.
Only anti depressant/ anxiolytic drug -Cipralex he is taking, is known to cause impotence.. ( due to low/ abnormal sperm forms.)..that too he is taking as per need ( as you had informed earlier ), thus possibly reducing the chances of the side effect of the drug.
* So before planning for pregnancy it's better to check-
- Your own ovulation study to determine ovulation
- His semen analysis & know about his sperm quality.
-get proper fertility treatment.
Fertility specialist would decide about-
- withdrawal of the drug (for improving sperm quality) while replacing it with less harmful anxiolytic.OR may offer him medication to improve his sperm counts & quality as per need OR may advise artificial insemination after selecting & using a healthy sperm in his semen OR he may advise for another healthy donor's sperm use..( in case other things fail to help.)
* Thus, Provided above regime is possible in his case.. the possibility of abnormal sperm can be bypassed A healthy pregnancy would be there & baby would be normal.
- As I have already explained.. once there is conception with a healthy sperm & ovum.. possibility of developmental defect is only when mother faces health problems( already detailed in previous answer ) during pregnancy .. & this can be prevented by good pregnancy care/ check ups/ investigations & healthy lifestyle of mother.
* IN case an abnormal sperm fertilizes an ovum.. there is possibility of fetal congenital malformation. Such defects can be detected in pregnancy by specialized tests like triple guard test/ USG fetal anomaly scanning / chromosomal analysis... & pregnancy can be terminated to avoid further trauma.
I feel that answers all of your doubts. Any follow up query is welcome.
In case you find it helpful & convincing.. please grade the answer before you close it.
Wish you all the best,
Thank you.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
Answered by
Dr.
Dr. Vasudha Jayant Athavale

General & Family Physician

Practicing since :1970

Answered : 8874 Questions

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Are Gabapentin and Warfarin safe to take while trying to conceive?

Brief Answer: Consult an infertiliry specialist. Detailed Answer: Hi XXXXX, Thanks for the query through Health care magic . I have read your query carefully. I understood & agree with your concern.. sorry for the psychological stress you both are going through. Let us discuss.. how to tackle the problem. *All the medications your husband is taking are for pain relief, except for Cipralex.. which is to treat anxiety/ depression .. which can reflect on sperm counts/ quality. * Actually each of the medicine taken has more or less effect on genital system.( ranging from ejaculatory problems/ constant rection(Priapsm)/testicular pain or impotence in few cases. ) * Fetal abnormalities are transferred to fetus..from maternal or paternal genes / abnormal sperm/ ovum .IT's fortunate that most of the drugs do not affect spermatogenesis( process of sperm making )-- so abortion / fetal abnormality seems to be less possible due to the drugs taken by your husband. - Mainly intake of harmful medications by mother / viral infections in first three months of the mother/ psychological or physical stress of mother during pregnancy/ deficiencies in mother's body in pregnancy... are predominant causes of fetal malformations/ abnormal development/ abortions... (as they are directly carried to fetus through mother's blood). * IN such a case when withdrawal of drugs seems to be difficult ( looking at the severity of pain & dose of multiple drugs needful to control it )... we can assess the possibility of conception by- - absence of ejaculatory problems in your husband/ treatment of the condition ( if present ) by A sexologist /alternative therapies ( Spemen & Tentex forte by Himalaya drugs ) - Semen analysis to see actual quality & gravity of side effects. . - Artificial insemination using sorted out healthy sperms of your husband / using healthy unknown doner sperm . - test tube baby...could be the last preference. * Please don't be stressed.. there are ways when there is will. So get an expert fertility advise & follow the best advise given. You will be blessed with a child. I hope, you find the answer both informative & useful. Any follow up query is welcome. Thanks.