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What are the side effects of Alivher?

Answered by
Dr.
Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5068 Questions

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Posted on Wed, 7 Oct 2015 in Pregnancy
Question: I am 28 weeks pregnant and my AFI is 5.7 with baby weight 1079+-10%. I have been prescribed 3 drips of Hermin injection which I have taken with 2 dosage of Bestrenol. Also,taking almost 5 ltrs water dater daily. Also, doctor has advised to take 2 tablets of ALIVHER daily. Can anyone please suggest if anything going to affect my baby and his growth. And is there any side effect of Aliver tablet in baby if taken during pregnancy. I am too worried. Please advise.
doctor
Answered by Dr. Deepti Verma 43 minutes later
Brief Answer:
Get Doppler ultrasound done, renal anomalies should be ruled out in fetus

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns. An AFI of 5.7 indicates low levels of amniotic fluid around the fetus. However, the fetal growth is adequate as fetal weight is corresponding to the gestational age.
Oligohydramnios with normal fetal growth can be due to:
1. Renal anomalies in the fetus
2. Congenital anomalies or genetic syndrome
3. Decreased fluid intake by the mother
4. Idiopathic, in which no cause is found.
Hermin is amino acid containing fluid, given in order to increase the fluid, betnesol is the drug given to accelerate fetal lung maturity if it has to be delivered earlier in view of oligohydramnios, while alivher is sildenafil which is currently in experimental stage, shown in several studies to increase the blood supply to the placenta and hence increase the fluid. It is not to cause any adverse effects on the fetus.
However, I will suggest you to get a fetal Doppler ultrasound to assess the blood flow, and rule out any renal anomaly in the fetus by a ultrasound, preferably by a fetal medicine specialist.
You should continue taking4-5 litres of fluids, high protein diet and adequate rest, as these are known to increase the amniotic fluid levels sufficiently, if no other pathology is detected.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma 20 minutes later
Thank you for your reply doctor. My usg Pregnancy has already been done. I have attached the report for you reference with few other reports which are for NT Nb scan and double marker. Would request you to please review them. Also, please confirm the probability of increased AFI with Hermin. I very worried about my baby and if I am taking all the medicines correctly.
doctor
Answered by Dr. Deepti Verma 1 hour later
Brief Answer:
Please upload all reports

Detailed Answer:
Hi dear, I have reviewed the report of the NT/NB scan, and it is completely normal. The report of anomaly ultrasound and double marker is not uploaded. Kindly upload them so that I can review them. Also please tell whether you got your glucose tolerance test done and whether you are suffering from any chronic illness like renal disease, autoimmune disease or high blood pressure.
There is no clear percentage of how much the AFI will increase with hermin, however it is shown to increase the amniotic fluid levels in most of the patients.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma 1 hour later
Hi, I have provided some attachments. Please review them.

I have attached all the reports for your reference.kindly review them and confirm if everything is ok with the reports and baby growth and should I continue taking ALIVHER twice a day with other medicines mentioned in my first query. I hope there is no side effect of anything.basically I am worried about ALIVHER and if two tablets a day is ok or I need to increase or decrease the dosage for it.
Also, please check whether the renal functions of the baby are ok.
doctor
Answered by Dr. Deepti Verma 2 hours later
Brief Answer:
Sildenafil is safe

Detailed Answer:
Hi dear, I have reviewed your reports. All the reports are normal except low AFI in recent ultrasound.
You have not uploaded the complete report of level 2 scan, so I am unable to comment upon the fetal renal system.
The basic effect of alivher or sildenafil is that it increases blood flow and perfusion by dilating the blood vessels. So yes, it will significantly increase blood flow to the baby, and is a proven treatment agent for treating oligohydramanios ( decreased amniotic fluid levels ).
The dose prescribed to you is ok. There would be no side effects to the baby. Get the ultrasound and Doppler repeated in a week. If the amniotic fluid levels further decline or the colour changes on Doppler deteriorate, the baby would need to be delivered urgently by C section. Keep a count of the baby's movements ( count for one hour each after breakfast, lunch and dinner - totally 3 hours , by lying on the left lateral side , the total of the 3 hours should be atleast 10 movements ). Drink atleast 4 - 5 litres of fluids daily, maximizing water intake, take high protein diet and rest.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma 1 hour later
Hi, I have provided some attachments. Please review them.

Hi,

I have attached Part 2 of Level II ultrasound. Please check the health of renal system of the baby.
doctor
Answered by Dr. Deepti Verma 3 hours later
Brief Answer:
Renal system is completely normal

Detailed Answer:
Hi dear, according to the ultrasound report, the renal system of the fetus is completely normal.
You can get back to me for further queries later by asking a direct question to me on health care magic portal.
Wishing you all the best.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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