Expert: Dr. Ravindra Bhaskar Ghooi - 4/28/2009

Question
Good Afternoon,
I am currently 14 weeks pregnant,in February I had a ruptured cyst and was given Vicodin as a pain releiver.Before my pregnancy I was and still are taking pain meds. I take pain meds everyday, I currently take the pain medication called soma.Three to Four pills a day. I am scared to tell my doctor that I use this pain medication on a daily basis. What risks am i putting my unborn child and my self? Please I am extremely worried of the effects this medication could have on my child.

Answer
Hi Elizabeth,
I appreciate your concerns, but I think you need to talk to your doctor. Yor doctors are responsible for your health and they cannot do a good job unless you tell them what you are taking. Let us examine the effects of vicodin and Soma.
1. Vicodin:
Pregnancy Category C
There are no adequate and well-controlled studies in pregnant women. VICODIN Tablets should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nonteratogenic Effects
Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose. There is no consensus on the best method of managing withdrawal.

I would suggst you stop taking vicodin well before the birth of the baby.

2. Soma
Pregnancy Category C. There are no data on the use of SOMA during human pregnancy. Animal studies indicate that carisoprodol crosses the placenta and results in adverse effects on fetal growth and postnatal survival. The primary metabolite of carisoprodol, meprobamate, is an approved anxiolytic. Retrospective, post-marketing studies do not show a consistent association between maternal use of meprobamate and an increased risk for particular congenital malformations.

Teratogenic effects: Animal studies have not adequately evaluated the teratogenic effects of carisoprodol. There was no increase in the incidence of congenital malformations noted in reproductive studies in rats, rabbits, and mice treated with meprobamate. Retrospective, post-marketing studies of meprobamate during human pregnancy were equivocal for demonstrating an increased risk of congenital malformations following first trimester exposure. Across studies that indicated an increased risk, the types of malformations were inconsistent.

Nonteratogenic effects: In animal studies, carisoprodol reduced fetal weights, postnatal weight gain, and postnatal survival at maternal doses equivalent to 1-1.5 times the human dose (based on a body surface area comparison). Rats exposed to meprobamate in-utero showed behavioral alterations that persisted into adulthood. For children exposed to meprobamate in-utero, one study found no adverse effects on mental or motor development or IQ scores. SOMA should be used during pregnancy only if the potential benefit justifies the risk to the fetus.

Again my advice is the same. Please talk to your doctor, whle these drugs may not harm your baby, hy not consult and be free from worry. Please talk to your doctor.
Ravi Ghooi