Pregnancy in chronic pain patients - use of co-codamol 30/500 safe in the first trimester?

[bassgirl]

Hi
Iv found out I am pregnant which was unplanned but we are thrilled. Having being on 4 different types of medication for a brain tumour I was immediately told to stop these. I have arthritis and hypermobility in my hips, knees and shoulders and have taken co-codamol 30/500 s in the evening after getting home from work for several years as i am waiting for big operations and have suffered many dislocations of my knees. I have given up everything and was told by the doctor that if i need it I can take co-codamol in the evenings to kill the pain if I need it. Obviously she said she couldn't guarentee that it would not cause any defects and with having been on everything else i am now a bit worried - as you would be. I would be really interested to hear from other pregnant women who have taken co-codamol during the first trimester.
Whether your story is good or bad , :-)
Thanks , Cat

That's quite a large dose. I'll share my story and explain how they're managing me.

This time last year I started with abdo pain. Long story short, a urologist thinks I have a urinaty tract blockage and need an op to go in and clear it. I was on 30mg codiene and 1g paracetamol 4 times a day with oramorph for breakthrough pain. My date was set for September, I got pregnant in August. I was told I was ok to continue on the codiene bit would be monitored (they won't operate while I'm pregnant).

The risks are basically - respiratory problems for the baby at birth and withdrawal symptoms. I was sent to see a paediatrician who said I have to have the baby in the hospital, the paeds resus team will be on stand by when its born (there's a warning flag in my notes) and we will have to stay in for 48 hours after its born for monitoring.

I really hated the idea of taking the drugs and possibly harming my (much longed for baby) but couldn't cope with the pain. I carried on but went for acupuncture as well. After 6 sessions I have been able to cut right down - most days I only need 2 x 15mg codienes and regular paracetamol. O have stepped down very gradually (like 3 x 30mg and 1 x 15mg to start with). Today I haven't taken any yet although its starting to nag now. I'm really glad I had the acupuncture because it really helped me.

My advice would be to discuss it with your MW/GP, look at alternatives - tramadol suits some people better (it made me think the walls were bouncing!) and do consider alternative medicine - not saying it will help but it might!

Hope that helps a bit!

Hi I was in ci codamol before my BFP but when I saw my doctor she asked if swapping to tramadol with extra paracetamol would be ok with me. I tried it and found it was just as helpful as the co codamol so continued. I'm 35 weeks today and so far all looks good for baby.
The main reason the doctor wanted me to swap to tramadol was the possible respiratory issues. Although tramadol is a atronger drug it isn't associated with respiratory issues in babies.
In the end though, you can't go through 8 months of pain and if the co codamol is helping and your doctors (and you) are ok taking it, I'd say go ahead. If the swap hadn't worked for me, like faith, I'd be comfortable taking them knowing it was a need. :).

Thanks so much for getting back to me it's really good to know other ppl are in the same sort of position. I am trying to cut back. I have been on tramadol before it does make me a bit sick which is why I stick to codeine but I will talk to the docs about it . I think right before birth I will try my best to come off it if I can in the same way as you mentioned above. I am trying to cut back now even but paracetamol doesn't come close to killing any pain. I was concerned also about birth defects but are ur babies so far ok? Keep me posted at the moment I have flu as well which is making everything a bit harder but I think after my first scan I will feel much better if everything looks ok. If anything else happens please keep me updated xx

Yes everything on scans showed a healthy baby (its certainly wriggly enough!). There's no clear evidence of birth defects or baby survival rates as such, it's more about withdrawal and breathing problems if you use it in the third trimester. From what I've read, the breathing problems are really related to use in the last four weeks (which is why I've tried to stop at 35 weeks!).

There was a big study here which I found quite reassuring. It's definitely worth talking it through with your healthcare team about your options and how to manage - clearly if you have flu now is not the time to stop! You might find you can wean down a bit. Do not try to go cold turkey because this is bad for you and the baby. (I went cold turkey first time - before I was pregnant - and I had diarrhoea, hot and cold sweats and paranoia!). You might find it helpful to get the codiene prescribed separately so you can try taking 30mg codiene and two paracetamol some nights.

I'll certainly update when I have my baby to let you know what happens during/after birth in the circumstances - hopefully in about 4 weeks!

I hope you feel better soon

No problems on my scans so far and I've had lots (for unrelated reasons).
I think withdrawal would be horrible in top of flu and your baby needs you to feel as well as possible so you can eat/drink and keep yourself as well as possible so she/he can grow :).
Growth is looking good here too, usually around 40th - 50th centile and very very wriggly!

I had it during pregnancy in hospital when I had pre eclampsia so it must be ok .