Asthma and chronic rhinitis in pregnancy

[sciencepotato]

Hi all,

I've been wondering how those of you struggling with asthma and chronic nasal congestion managed during pregnancy.Did you continue use of nasal antihistamine and steriod spray in pregnancy too? My doctors officially advise only saline spray citing the lack of research on the medication but it's of course useless in my chronic condition. Any experience would be appreciated. I understand of course that it's just sharing the experience and not giving medical advice :)

I find that saline nasal rinse works better than the sprays. I use Neilmed when I've got a cold - really helps to flush out the mucous.

I also bought nasal strips to help me sleep at night when I had pregnancy rhinitis in late pregnancy. The breathe right ones are expensive but I found cheaper ones that did the same thing in Wilko. Really helped.

Sorry, tried all that, does nothing to me. Even strong antihistamines do little.

@sciencepotato oh no, sorry I don't have anything further.

Do intranasal antihistamines act as systemically as taking a tablet? Just wondering because I know sodium cromoglycate eye drops are deemed safe to use. I suffer from chronic urticaria and although I didn't need to medicate during pregnancy, if I had needed to, the benefit was deemed to outweigh the risk. I know cetirizine is used in pregnancy despite being on the C list for pharmaceuticals.

They shouldn't do no, intranasal is considered topical application, hence dont have systemic effects like oral form does. I was just frustrated that my ENT said no to using dymista in pregnancy since there's enough studies to support it's safety (well it's all great but what am I supposed to do as asthma patient? Saline rinse my nose for 9 months?!)

It's alright, just will hopefully get some other doc to prescribe me the antihistamine plus steroid spray :)

I've got chronic rhinitis and I continued to use over the counter loratidine and beconase for both my pregnancies, and clenil for (mild) asthma. I was also prescribed Pirton for skin problems.

Hi, thanks a lot, relieved to hear that someone in similar sitiation is managing using similar type of meds. I hope the babies were all fine?
I think the fact that we have asthma should be an indicator that we must take our allergy symptoms particularly seriously at all times, incl.pregnancy

Do you think that your rhinitis and asthma are linked?.. I got asthma only last year, as a 35yo, and currently on all possible meds but oral steroids to manage it. I take montelukast, fostair 4 times a day, dymista and barely manage it. And chronic nose congestion is linked to chest congestion. So much fun! 😅

@sciencepotato

Do you think that your rhinitis and asthma are linked?.. I got asthma only last year, as a 35yo, and currently on all possible meds but oral steroids to manage it. I take montelukast, fostair 4 times a day, dymista and barely manage it. And chronic nose congestion is linked to chest congestion. So much fun! 😅

Am planning a pregnancy. Am on Fostair and Montelukast for asthma and my GP surgery wants me off it for pregnancy! Am currently on my 2nd exacerbation and 2nd course of antibiotics and prednisolone in 3 weeks so am reluctant to switch to a less potent preventer.

I also have chronic nasal congestion, in my case due to a deviated septum. I'm currently using an anti snoring thing you put in your nose and it helps a lot at night. It's just a rubber thing which widens your nasal passages, it's not medicated so may be worth looking at? I find the nasal strips help but they come off in the night or don't stick on at all, I have quite a wide nose but DH has the same issue with them - he has allergies and a deviated septum.

You've probably looked at this website already, but the Best Use of Medicines in Pregnancy site is really useful:

www.medicinesinpregnancy.org/

I have chronic rhinosinusitis with nasal polyps and co-existing asthma. It's a real thing apparently! It got much worse in my second pg and sorry to say it hasn't gone away and DS is now 6. Yes rhinitis and asthma are linked for sure.

I use NeilMed sinus rinse daily with a liquid steroid called Budesonide in it. You should persevere with the sinus rinse, it takes a while to get used to it and without it my symptoms would be worse. Ask your ENT consultant about Budesonide.

@ 33goingon64 So sorry to hear you are struggling. I know your pain! :( but glad you were still taking the asthma meds and steroid nasal sprays when pregnant and clearly you and baby were okay? Are you on montelukast too? I do all the nasal rinses every morning but they are only good in terms of preparing and clearing out the nose before using Dymista. Ent said use only saline rinse when pregnant. Rubbish advice in my case of chronic nasal problems and difficult to control asthma. Felt a bit like er sorry we don't want to be sued if something happens while you take something other than salty water. 🙈

Thanks, never heard, only used nhs guidelines.

Hi FeedMeSantiago, thanks for the tip for nasal issues, will check it out! I am on Fostair 4 times a day and montelukast too, best inhaler I've tried so far.
Why would they want to put you on a less potent preventer and make you go off montelukast?.. Have you been needing to use antibiotics and oral steroid prednisolone because you came off it? Asthma poses a serious risk if not well controlled, I hope your gp practice realises that. I tried to skip montelukast just for one day and ended up using fostair by at least two puffs more and my nose was very stuffy... Did you consult with your lung specialist regarding what meds to take in your case during pregnancy?

And yes, I have a deviated septum too, although in my case nasal problems only started after I developed asthma a year ago.

@sciencepotato (great username, btw). I don't have a lung specialist. Only ever seen the GP and asthma nurse. Asthma was first suspected when I was 11. I was diagnosed at 29. Apparently as I don't wheeze it wasn't asthma and I was just unfit... so many GP's said 'it can't possibly be asthma'. The asthma nurse diagnosed me very quickly once I persuaded a GP to get me in front of one.

So in the 4 years since diagnosis I've had 3 courses of prednisolone, 2 in the last month and one in 2019 (given by urgent care who also gave antibiotics for a chest infection).

I'm the same with Montelukast, everytime they take me off it I get worse within a day. Everytime they say I can take 2 puffs of Fostair instead of 4 I'm back in for an asthma review in days and back on 4 puffs.

I think the surgery are grumpy because they told me to come off certain meds for pregnancy and then they contacted my Rheumatologist who said my GP's advice was wrong and that the risk of harm to me from not being on the meds was greater than the risk to a baby and I need pain relief as I have 3 chronic pain conditions. GP weren't happy but have prescribed.

So I think they looked again at my other meds and decided that the asthma meds needed to go instead.

I'm ringing asthma uk on Monday.

www.amazon.co.uk/Airmax-Anti-Snoring-Nasal-Dilator/dp/B00STPNB90?tag=mumsnetforu03-21

This is what I now use.

I am not asthmatic but have chronic rhinitis. I’m 34 weeks and honestly nothing helps at all. If not pregnant I’d use a steroid spray but they do advise against it. It’s really disturbing my sleep I hate it! Sorry no help x

I spoke to my midwife about this, I use the Vicks sinex soother spray from home bargains for £2.99 I took it with me and she said it was fine to use, I just use it once a day, normally before bed so I can sleep without a stuffy nose, clears it up after a couple of minutes. It does say online not normally recommended during pregnancy, or use with caution, or talk to midwife/doctor but me and baby are fine, and midwife also doctor said it could be used. I couldn't use there's as if contained steroids! Talk to your midwife to see if she thinks it could work for you?

Thanks, am a neuroscientist who loves potatoes 😆 FeedMeSantiago, it all sounds pretty grim to be honest. Glad you're trying to look for help elsewhere, if changing the surgery isn't an option. The rheumatologist sounds sane at least: it's always about weighing the risks for you when you (don't) take the neds. As for asthma inhalers, even official nhs line is to continue using them in pregnancy as asthma must be well controlled : www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/asthma/
I don't have an asthma nurse here but went to see a lung specialist since even on meds my asthma keeps reminding of itself every day. I've had lung function tests, cardio pulmonary exercise test, and waiting for CT now. I've developed bad lining in the nose too now and the only thing that helps me now is a steroid spray and ent said that a surgery might be necessary to improve it. So if you havent been seen by ent, you might want to ask for a referral if the nose issues are bugging you.
As for montelukast, my gp mentioned that it's category b medicine, so no evidence of safety in pregnancy, but asked me if I wanted it nevertheless.

Hi, thanks, midwives arent qualified on ent and lung issues, sadly. Vicks is great but I have a serious nose inflammation that tracks back to my lung inflammation and allergies hence nothing else helps just steroids and antihistamines, even they don't provide a full relief to me. I've tried Vicks and countless otc nasal sprays but sadly it's not for my condition.

Argh, so annoying, so frustrating all this suffering. I probably would tolerate it if not for my asthma but when my nose isnt under control of steroids my asthma is flaring up and this is something i want to avoid as dangerous. Plus nhs says using nasal steroids is generally safe in pregnancy so I am hoping my gp would agree www.nhs.uk/conditions/steroid-nasal-sprays/

I have chronic asthma and allergic rhinitis plus various other allergies (previous anaphylaxis) and I'm currently 36 weeks pregnant. I came of pretty much everything to conceive and for the duration of the pregnancy. I also have complex pain disorder and came off all pain relief for that too. I occasionally take loratedene and will take my reliever inhalers when absolutely necessary but otherwise I try my best to avoid triggers and manage as best I can. I have monthly reviews with the asthma nurse to make sure I'm on the right side of ok. It's been unpleasant and uncomfortable but I needed help to conceive and wasn't prepared to take any risks.

Hi, it must be really really difficult for you! How do you still manage your asthma in terms of preventers?

@sciencepotato it's not easy and I am looking forward to restarting some of the meds in a few weeks I will admit. I also realise that my previous post doesn't read quite as I intended. When I say 'I was not prepared to take the risk', its in the context of 4 rounds of IVF and various other failed fertility treatments before that.

In terms of a preventor I'm not actually taking one. I've taken a basic one for a week or two when things got really bad and it was just a basic one - seritide I think its called. I realise that's not how they should be used. I have also had short spells on a green inhaler to supplement the steroid but again just a week or two at a time. I do have a nebuliser at home which I use daily with just a saline solution which helps the chest congestion move, and I was given some chest physio exercises (similar to what is used by those with cystic fibrosis I think) to try and keep things moving to reduce infection. Obviously I have the proper nebuliser meds for if things get unmanageable and have a number to the respiratory ward if I need urgent advice or review.