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For two years I have been treating high blood pressure and tachycardia with Lokren 20 in a dose of half a tablet a day. I am currently in my second pregnancy at 9 weeks and my doctor is telling me to take this drug all the time. I recently read that Lokren is dangerous to the fetus and I got very scared. My question - is the drug really safe in this low dose during pregnancy? If not, what other medications could I take to keep my blood pressure from rising again? I would like to add that in my first pregnancy I took Dopegyt and Cordafen, but the blood pressure did not decrease. As a consequence, I gave birth to my son in the 38th week of pregnancy, weighing 2 kg, and I spent practically half of my pregnancy in the hospital. Can this be avoided in this pregnancy? Please reply as soon as possible and thank you in advance.
The use of any medications in a pregnant woman is a difficult issue and requires a lot of care. The official position of the Lokren manufacturer with regard to the use of this preparation is as follows: "Use during pregnancy only when the potential benefits to the mother outweigh any possible risks to the fetus."
Since your attending physician recommends the use of this drug, being informed that you are pregnant, it can be assumed that he has made such a risk-benefit assessment. Untreated tachycardia in a pregnant woman is also unfavorable and may also adversely affect the development of the fetus, so you have to make a choice.
Understanding your concern, I reviewed the resources of specialized detailed literature on the physicians' experience with the use of Lokren, available on Medline. There are two reports on this topic in the literature.
The first is a report by Dr. Boutroy M.J. and WSP. titled "Betaxolol: a pilot study of its pharmacological and therapeutic properties In pregnancy" published in the European Journal of Clinical Nutrition Pharmacology 1990, 38, (6) 535-9 from France. The authors of this report followed 22 pregnant women who were treated for hypertension (mild or moderate) with betaxolol (this is the chemical name for Lokren). The drug was used at a dose of 10 to 40 mg / day. The blood pressure in women using this drug dropped by 11.8 / 8.3 mmHg. The safety of the drug for the fetus has been assessed by periodic ultrasound and ultrasound examinationsfetal cardiotocography. All pregnancies were successful and 22 women gave birth to 23 he althy children, as one pregnancy was twins. The mean Apgar rate of babies born was 8.3 in the first minute and 9.1 in the 5th minute after birth. The children were examined 9 months after giving birth and all were he althy.
Second report presented by Dr. Morselli P.L. et al from France was also published in the Eur. J.Clin. Pharmacol in 1990, 38 (5), 477-83 and is en titled "Placental transfer and perinatal pharmacokinetics of betaxolol". She discusses the results of betaxolol treatment in 28 pregnant women due to arterial hypertension. Examination of indicators such as blood concentration of the drug and its distribution in the maternal and placental (fetal) parts of the circulatory system were carried out. All parameters were within the normal range. The authors write in the conclusions that the so-called The pharmacokinetics, i.e. the metabolism of the drug in the body, does not change during pregnancy as compared to the metabolism in a non-pregnant woman. We can therefore conclude that there is no increased or abnormal drug concentration in the placental and fetal circulation. However, careful observation of babies born to mothers taking betaxolol for 72-96 hours after birth is recommended.
I was able to find this much data in specialist literature. However, with regard to other drugs lowering blood pressure that can be used in pregnant women, only Methyldopa and Dopegyt have officially registered the indication "Mild and moderate arterial hypertension, especially in pregnancy". Regards, Dr. n.med. Krystyna Knypl
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Krystyna KnyplInternist, hypertensiologist, editor-in-chief of "Gazeta dla Lekarzy".
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