Confused as CRAP about taking Tamiflu while pregnant

In My Humble Opinion
1

First things first: I have seen both my OB and my GP about this.

There. Now, the story: I am 27 weeks pregnant. I came down with what I thought was a cold a week ago Friday. Typical scratchy throat, sneezing, mild fatigue kind of thing that progressed into stuffy nose and mild fever (99.5, the only fever I swear I ever get). After a few days, I felt a little better. I took a day off, rested, drank tea, took Tylenol, the whole thing. Groovy.

I saw my OB for a routine appointment mid-week (when all that remained was nasal congestion), and when I mentioned I felt sick he acted like I was typhoid Mary. He had a nurse examine me, and when it showed I had no fever, he just urged me to go to my GP after seeing him. He was concerned, of course, about H1N1. I felt silly, but I dutifully and a bit apologetically saw my GP. My GP figured I was fine after examining me; seemed to just be a chest cold. She gave me a flu shot since I wasn’t feverish.

Two days later (Saturday) I noticed I was dragging–not overly fatigued, just dragging. Yesterday (Sunday) I wake up feeling like my chest is on fire, and my throat felt like I’d spent hours screaming. I was more fatigued and more sore, but no fever. It got worse as the day progressed, and I grew a little concerned. Today my voice sounds like Kathleen Turner’s, and I have an occasional (painful) cough when I try to talk. I called my GP’s nurse today, when my temperature started inching back toward 99.5 (a fever as far as my body goes…I don’t go over 100), and via voicemail phone tag, the GP prescribed Tamiflu. I called my OB (just to keep him informed), and he agreed to go with the Tamiflu. Hubby picks up my prescription, and the pharmacist balks–he says it’s not recommended for pregnant women.

I do a little Googling, and the info is confusing. It is not, indeed, recommended for pregnant women. It also should be started with 72 hours of onset of symptoms–when did my symtoms start? A week ago Friday, or…Sunday? UGH. I do NOT want to harm my baby boy and take something unnecessarily, but I don’t want to not take something my compromised immune system could use. Even with my OB and GP agreeing it’s okay to take, I’m spooked. Where is the balance? My spookiness has kept me from taking that first dose, but I know the clock may be ticking. Mmmmppphhh. Sure wish I could think clearly through this UGH.

FWIW, I’m taking tomorrow off work, too. More herbal tea, more sleep.

2

Can having the flu harm the baby? If not, then don’t take it. Or, if it highly unlikely, don’t take it.

3

Most pregnant women who get/are suspected of having the H1N1 influenza and are diagnosed in the early stages of it should take Tamiflu. All available evidence shows it to be safe in all trimesters, while the evidence also clearly indicates that influenza during pregnancy significantly raises the risk of bad outcomes for baby and mom.

http://www.cdc.gov/H1N1flu/pregnancy/antiviral_messages.htm

4

BAD advice. See above.

5

Just took my first dose. I know Qagdop is our resident MD, and with my two MDs (GP and OB) saying I should take it–oh, and with confirmed H1N1 cases in my area–I’m taking the pill. It just makes me a tad bit nervous, but so does winding up on a respirator.

My OB had sent me to the GP to see if I could be tested for swine flu, but the GP didn’t think I had it (at the time), and also mentioned they weren’t doing cultures right now simply because of demand. They were just treating everyone like they had H1N1.

The reason I started this thread was just the confusion out there about all this. And when pregnant AND sick, well, it’s easy to be confuzzled.

This, BTW, is the second time in recent memory our pharmacist has questioned a prescription. The other time was a month ago, when our 3yro son was violently ill with a stomach virus. He was prescribed an anti-vomitting medication that the pharmacist said was not safe for a child our son’s age; we called the doctor back, and she specifically went over the dosing, safety rules, etc. She was very reassuring. Our son was becoming severely dehydrated quickly, so the medication was needed–we gave it to him, he stopped vomitting, and managed a few bites of Jello. Definitely better than winding up in the ER getting IV fluids, which is where the doc said he would end up if the vomitting (and refusal to drink) persisted.

6

While there seems to be a default “don’t take anything while pregnant” meme in our society, in the case of H1N1 the risk to a pregnant woman (and, by extension, her child) is MUCH higher than originally expected, MUCH higher than for normal flu.

As always, consult your own doctor, but around here a high proportion of H1N1 flu deaths have been in pregnant women. Yes, that serious. Tamiflu is the lesser risk here, IMO. You may not have flu, but in this case don’t take the chance. There’s a reason your two docs said you should take it.

The pharmacist does, actually, have a duty to ask questions when there is a risk associated with a medication. I’m assuming you look pregnant by this point, and he might just be over cautious. Ditto for your kid. As long as you get what you need I’d take that pharmacist in preference to someone who dispenses without giving a damn.

7

FWIW, I’m 29 weeks pregnant, and I asked my OB the same questions. She said that if it is suspected that I’ve contracted H1N1 before the vaccine is available, I’m to call her or my GP and either will prescribe Tamiflu or another anti-viral right away.

Apparently, this is not a virus to screw around with when your pregnant.

And like you, I just came down with either a really crappy cold (sore throat, achy) or a mild form of the flu, so I’m going to ask her about it at my regularly-scheduled appointment tomorrow. I’ll let you know what she says (just for your knowledge, not as advice to you.)

8

I have no insight into the question, but stopped by to send a wish of a speedy recovery your way. Get well soon!

9

Wait, you were feeling under the weather, recovered mostly from your cold then got a flu shot. Next you have flu like symptoms and then are told to take tamiflu? Do you have the flu now? Or just a reaction to the flu shot?

Is it normal to take tamiflu after a flu shot?

10

The vaccine needs (IIRC) two weeks to build up your immunity, so it’s entirely possible to get influenza soon after vaccination.

It might also just be a severe cold or other respiratory infection, but due to her pregnancy, the doctor is not taking any chances.

Hijack: I got the seasonal flu vaccine late last week; I get it every year due to working in a hospital. My husband brought home a cold early last week. I am now suffering from an apparent cold, with similar symptoms to what he had, and people keep saying “Oh you got that from the vaccine!” No, I didn’t. I’m certainly going to catch what my husband brings home. I’ve gotten the influenza vaccine for years and only get an achy arm around the injection site.

11

A local pregnant woman recently died of the H1N1 virus. They were able to save the baby. This is not one to be fucking around with if you’re pregnant.

12

Swallowed my second pill. Whee! I slept hard last night and slept in about an hour, and my chest doesn’t have that on-fire feeling (though the cough sounds unpleasant). My limbs do feel like they’re made of lead, though. Staying home and sleeping will be nice today.

chela, I had that thought but it did seem too soon to have a reaction to the shot. My guess is it’s my, erm, special needs students who has to sit not just front and center, but right next to the stool where I sit frequently during lessons. Kiddo has a seriously wet cough, and we all know what exquisite hygiene 11yro boys have. Or, really, it could be any of the other sniffling 6th graders I teach. I think my body was just recovering from one illness when a second came around with arms swinging.

Pocito, your OB’s approach has been pretty much the same as my OB’s–until the H1N1 vaccine is available, call them ASAP with any flu symptoms and get started on Tamiflu. As you and Zsofia said–this is apparently not something to fuck around with when pregnant. Yikes. I hope you’re feeling better soon. And yes, I’d like to know what the doctor says.

Broomstick, you make a good point about the pharmacist. Better that I have someone who is doing his job and checking and cross-checking medications than someone who just fills prescriptions. FWIW, hubby picked up the prescription for me–I was home resting. I called the pharmacist when the only directions on the package said “Take as directed;” I didn’t know what “as directed” was. It was in that conversation I mentioned I was pregnant, and he expressed concern. But, all good (and all Tamiflued) now.

And…thanks, Khadaji. :slight_smile:

13

I come from a family of pharmacists, so I’ve seen the other side of such conversations. There are times when it is appropriate to prescribe off-label or under less than ideal circumstances, but it is equally important that a risk assessment has been done and all parties are aware of the situation. One of the way in which the pharmacy profession is more than just counting out pills.

14

Update: My OB just said to call if I got a significant fever and they’d prescribe Tamiflu. I should call my husband’s doctor or son’s pediatrician if either of them exhibit the same. They’ll probably get a swab to check.

15

Huh, Pocito. Another confusing thing is even the CDC’s website says the flu (and H1N1) doesn’t always come with a fever. It often does, but not always. Thankfully my docs are listening to me when I say a fever for me is 99.5…100.4 just doesn’t happen. (Ooh, 99.7 right now–no wonder I’m sweating, heh.) I think that, and my symptoms and exposure to GERMS EVERYWHERE! in my job have them dispensing the meds. Watch yourself carefully, okay?

29 weeks–so you’re due about 12/18ish? I’m due 1/2, but will be having a C-section 12/21 (two back surgeries since my son was born have me paranoid about natural delivery). Congratulations to you–may the remainder of your pregnancy be uneventful. :slight_smile: Nice thing about being home–I’m going to do some Baby Stuff online shopping.

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Ruffian, feel better soon. Sorry for the “bad advice” - even though it was more of a statement based on the question whether or not having the flu is actually dangerous for the unborn child, but whatever. I mean shit, it’s just the flu.

I’m extremely wary of medications and their effects on children and even more so for pregnant women, regardless of what the all knowing doctors say, but that is neither here nor there. Another huge reason that my hubby and I have decided not to procreate.

Anyway, best wishes on a speedy recovery and keep that little Ruffian safe! Good luck! :slight_smile:

17

Which just kills about 20,000 people in the US every year.

18

Are you serious? If you obviously don’t know anything about the subject matter at hand, why make offhand and inaccurate statements about it?

19

The problem is, H1N1 seems particularly dangerous for pregnant women, and if the mom is dead then that’s worse for baby than exposure to tamiflu, don’t you think? It is also associated with premature labor (bad for baby) and pneumonia in pregnant women (also bad for baby if mom is having trouble breathing).

Latest CDC info for pregnant women

20

I’m going to tell my experience just because it relates so well to the OP, and not because I think you shouldn’t listen to your doctor, k?

I was diagnosed with H1N1 back in June (officially…had the cultures, talked to the health department, etc.), and I was in my first trimester at the time. (I’m due in January.) The doctor at the minor emergency prescribed Tamiflu for my husband and daughter to help prevent them getting it, but he told me that pregnant women should not take Tamiflu as it presents of a risk of birth defects in the baby.

So, here we have a doctor recommending no Tamiflu for pregnant women. But…this is a doctor I had never seen before or since, I have no idea if he’s any good at what he does, etc. I did call my OB and talk to the nurse, but as my symptoms were not severe she recommended I stick to over the counter meds on my “approved” list and get lots of rest. I was to call back if I took a turn for the worse, which I didn’t. I don’t recall us discussing Tamiflu specifically.

But you’re right to be confused…there *is *conflicting information out there.

Qadgop, while we’re here–I don’t need to get the H1N1 vaccination shot since I’ve had it, right? I am planning on getting the regular flu shot at my next OB visit, but I forgot to ask him about the swine flu shot last time.