Been Given Cat D drug today!

[CarolineF]

I was admitted today for my IV iron infusion.

Arrived at the hospital and had a dreadfully painful time as2 nurses made 3 attempts to insert the canula into my hands, then they gave a dose of Lorazepam (a Cat D drug - not safe for use in pregnancy as highly likely to cause defects, I now find out).

they then get another nurse who manages to insert it.

Then they give me IV hydrocortisone and phenergan as premeds.

As I am starting to relax finally, about 1 hour later, the Consultant walks in and says that i can't have my iron infusion cos the pharmacy have said it is unsafe in the first trimester !!!!! I am to go back in 2 weeks when I shall be 13 weeks. Further research though has said it is not safe throughout pregnancy at all unless the treament is absolutely necessary and the risk of not proceeding outweighs the risk to the unborn baby.

I'm not happy. In fact I am wondering how come a person can be consultant Haematologist and not have checked any of this.

I now do not know what to do about the infusion, and I am hoping that the single dose of Lorazepam has done no damage, although they also want me to take it next time too.

Any thoughts?

[Funkychicken]

Who recommended you have the transfusion? Was it your GP, OB or someone else?

[CarolineF]

endocrinologist recommended it cos my levels were so low. The GP said, good idea I shall refer you to a haematologist. Haematologist said - good idea we shall have you in next week. But Haemo did not check it was OK and not contraindicated. But still gave me a Cat D drug as well.

Then today happens. Supplements are not doing the job cos they cannot come close to replacing the iron I am constantly losing and will lose faster now I am pregnant.

Its a mess.

[Funkychicken]

My iron levels are low at the best of times. The problem with me is my iron stores-I seem to be able to get my level up but my stores won't stay stored! My last pregnancy the level dropped from 12 to 4 in a matter of days. I thought I had sever morning sickness-but it was my iron-or lack of. I was able to bring it up with a liquid supplement though. I refuse to take iron tablets-did it once and was in more pain (blocked up) than labour!
Yours must be really low to get to where you are. Maybe you could talk to your GP about the pros/cons of this transfer and how he/she rates it in the necessity dept.

[sueb31]

I am surprised to hear that lorazepam is Cat D, is this a recent change? As MIMS, the Therapeutic Guidelines in Pregnancy and the British National Formulary all suggest it is Cat C, which is that there is no evidence of malformations but should be avoided.

Don't know if any of that helps. Anyway I would think that a one-off dose would be much less likely to cause problems than regular use.

Sue

[♥Heaven Sent♥]

Have you tried the injections as well as the tablets worked for me and i had no iron left in my body at all?

[CarolineF]

Its Cat D with the FDA according to google.

The docs said I would need 12-15 iron injections to bring my levels anywhere near normal and that that would not be good during the pregnancy cos I would have no chance of raising them sufficiently to be healthy throughout.

[CarolineF]

Wikipedia says its Cat D so means high risk in pregnancy.

[OscarTheGrouch]

Lorazepam is a Catorgory C drug in Australia.

[CarolineF]

That is interesting cos every web site I have found that deals with it on google says its high risk and should not be given in the 1st trimester, if at all. I find that concerning that the general consensus of opinion is that it can cause feotal damage during pregnancy but Australia clearly disagrees.

I think i shall go with the majority and refuse it at my next admission.

Please everyone, feel free to google it and you will see what I mean. Can all references to it be wrong?:detective:

It may just be the odd dose I am being given, but would any of you really want to take the risk in the face of all the recommendations?

[OscarTheGrouch]

As a health professional I'd trust the MIMS before I'd trust google. But that's your decision. Good luck with further treatments in regards to your Iron deficiency.

[CarolineF]

I'm not stupid enough to just rely on google.:thumbsdown:

As a search engine it helps you find the links to the main websites for research. I have checked the FDA website, MedicineNet etc they all say the same. I have also been in contact with my OB/GYN in the UK who is clear that it should be avoided at all costs in pregnany due to a "perceived studied risk of birth defects in the first trimester in particular, but also throughout pregnancy as a whole".

Are Australians immune to these drugs or something that make other countries with larger populations question the efficacy but we say "no, its OK"?:detective:

Studies are studies. I doubt we can test these drugs on the same scale as the US or Europe purely based on our population level alone.:no:

Thanks for your kind thoughts though. Better to be safe than sorry.

[sueb31]

Hi, I hope I didn't offend you, I just thought it might make it less worrying for you to know that lorazepam is Cat C here - since you have already been given it! To my knowledge, the risks were suggested by other similar drugs (diazepam was one) in one study. (And these drugs have been used a lot in the world - one study is not necessarily significant.)

Of course, that doesn't mean I think you should rush out and have it! I'm sure I'd be pretty wary in your place. I hope you don't need it next time.

Its all so complicated isn't it.

I agree with you about your google search, I got similar results when I looked it up there. That's why I checked my textbooks etc as I have noticed that general google searches can give quite misleading info on medical matters.

Anyway, all the best with it all!!

Sue