Drugs in Pregnancy
Drugs in Pregnancy specialist advisory service
Introduction
The Regional Drug and Therapeutics Centre provides information and advice on the effect of drugs and the therapeutic options during pregnancy.
The service is staffed by a multidisciplinary team including pharmacists and medicines information scientists. The UK Teratology Information Service is also based at the RDTC and all enquiry answering staff receive UKTIS training and support.
The types of enquiry answered include:
· The effect of inadvertent early exposure to a drug, in advance of knowledge of the pregnancy.
· The therapeutic options available to a patient who needs to continue treatment for a particular indication such as epilepsy.
· The therapeutic options available to treat an acute condition that occurs during pregnancy such as threadworm
· The effect of an acute or chronic exposure to a particular drug during pregnancy such as an antibiotic
· Advice to support pre-pregnancy counselling
We do not offer advice or information in relation to the toxic effect of drugs in overdose or chemical exposures during pregnancy as this is offered by the National Poisons Information Service (NPIS) in the first instance and is supported by UKTIS.
Who can use the service?
The service is provided to all health care professionals within the NHS but is primarily used by medicines information pharmacists after they have researched their standard resources. It is expected that local MI centres would research answers in the first instance and refer to the RDTC Newcastle if necessary.
How to make enquiries.
The drugs in pregnancy specialist advisory service is available between 9am and 5.00pm Monday to Friday, excluding Bank Holidays.
For those contacting the Centre from within our MI Northern and Yorkshire Region can submit enquiries by telephone, fax, writing, e-mail, or via our website.
Tel. 0191 282 4631 (09:00 - 17:00 Mon to Fri)
Fax. 0191 261 8839 (09:00 - 17:00 Mon to Fri)
E-mail.
For those contacting the Centre outside our MI Northern and Yorkshire Region unfortunately we are not currently able to answer emailed enquiries therefore they can only be submitted via the telephone on 0844 892 0909.
Information required when making an enquiry
When contacting the centre with an enquiry, the following background information will be required to enable a full answer to be given:
· Enquiry
o Reason for the enquiry
o Is it patient specific?
· Pregnancy:
o Is the patient currently pregnant?
o Stage of pregnancy in weeks based on Last Menstrual Period (LMP).
o If not, is it a prospective or retrospective enquiry?
o Have any investigations or scans been performed?
· Drug in question:
o Dose, frequency, indication, route.
o Currently taking this drug, thinking of taking or has taken it at some stage during this pregnancy?
· Background risk factors
o Maternal age, general health and lifestyle.
o Other medicines and/or medical conditions?
o Obstetric history.
o Has the woman had any previous pregnancies?
o Were there any miscarriages or malformations in previous pregnancies?
o Did she take this drug during previous pregnancies?
o Family obstetric history
· Risk v benefit:
o Is drug therapy necessary? Have other therapies/medicines been tried?
There are limited data on the effect of drugs in pregnancy. However, good quality patient specific data from enquirers will better allow provision of a full risk assessment for each case.
If referring to UKTIS for further information, ensure you have GP or Consultant contact details and a patient identifier that will distinguish the patient if follow up is required.
Medicines information pharmacists should have looked in standard medicines information reference resources before calling the service. However, they may need to call for clarification of information found in those resources e.g. manufacturer’s information (Summary of Product Characteristics), Drugs during Pregnancy and Lactation (Schaefer), UKTIS monographs on Toxbase (www.toxbase.org ) etc. They may also contact us where information in the standard information resources is lacking.
Sources of Information.
The centre has access to a wide range of standard medicines information textbooks, journals and databases. We also hold specialist teratology textbooks, past enquiries and also the use of specialist databases.
Guidance.
The centre has prepared the following guidance documents:
UK Teratology Information Service (UKTIS) Monographs are available on Toxbase® which all NHS healthcare professionals can access via free registration (www.toxbase.org).
Summaries of the UKTIS monographs are available on the UKTIS website at www.uktis.org. Corresponding patient information leaflets can be found at www.medicinesinpregnancy.org