Drug half-life vs duration of effects?

[sandandsun]

Okay, so no one may be able to answer this question, but I figured it was worth a shot. Who knows, there may be a pharmacist or health professional on this forum!

I had an exposure to a "bad" medication early in pregnancy (in the 3rd week) before I knew I was pregnant. I have spoken to a maternal-fetal specialist and someone from OTIS (Teratology Information Specialists) about this. While I feel much better, I can't help but still have some worries.

One thing I'm confused about...

The difference between a drug's half-life and duration of effects. I understand what a drug's half-life is. I was told the drug's half-life was not a concern due to how early I took it in pregnancy. HOWEVER, I've read that this drug's effects can last well beyond the time it takes for the drug to be eliminated from the body.

So, my question is: Does a drug's duration of effects impact the risk of birth defects, or is it only the drug's half-life? In other words, could a drug cause a birth defect AFTER it has been eliminated from the body because of the drug's longer-lasting effects?

I know this is a little complicated, but thought it couldn't hurt to ask to calm my worries or give me more information. Any info. is appreciated! Having this drug exposure during pregnancy, regardless of how early, has been rather traumatic for me.

 

[LadyHutch]

I was exposed to Depakote in my 6-7th week of pregnancy with my first. I did not know I was pregnant at the time.

I was told that once the medication is out of your system, you are ok. However, my son did have a sacral dimple, which I am convinced is a result of the depakote. The most common birth defect with depakote is spinal.

But I also took the medication for about 10 days before I stopped.

I'm really not sure on the answer to your question, but thought I'd let you know you aren't alone.

 

[sandandsun]

I was exposed to Depakote in my 6-7th week of pregnancy with my first. I did not know I was pregnant at the time.

I was told that once the medication is out of your system, you are ok. However, my son did have a sacral dimple, which I am convinced is a result of the depakote. The most common birth defect with depakote is spinal.

But I also took the medication for about 10 days before I stopped.

I'm really not sure on the answer to your question, but thought I'd let you know you aren't alone.

Thanks for sharing your experience - it does make me feel better to know I'm not alone. Was everything okay with the sacral dimple?

It's so scary to think about. I'm hoping once the medication was out of my system, it was fine. I may call OTIS again just to verify. Although I'm trying to focus on what my specialist told me (all positive) and just enjoy the pregnancy, I definitely have "moments" where all I can do is think about the what-ifs...... and of course it's killer waiting until the anomaly scan to really know anything for sure!

 

[LoveMy2Boys2]

What was the medication ? I was also on a medication I'm so nervous about....it was a heart medication....I started whining off of it when I found out at 3 wks,but took it until 4 weeks I have an apt tues, I'm now 6 wks....I just need to know .....

 

[sandandsun]

What was the medication ? I was also on a medication I'm so nervous about....it was a heart medication....I started whining off of it when I found out at 3 wks,but took it until 4 weeks I have an apt tues, I'm now 6 wks....I just need to know .....

I'm so sorry. You're definitely not alone and I'm sure everything will be fine. I'm currently almost 10 weeks and so anxious for my 12-week scan to make sure everything is developing properly. If it makes you feel better, normally there is an "all-or-nothing effect" of medications in terms of causing birth defects. Typically, when taken before 18-20 days post-fertilization, the baby either dies (miscarriage) or the pregnancy remains healthy. This is usually BEFORE 4.5 weeks of pregnancy, before the organs start developing. So, since you did not miscarry, this means your baby is likely fine! I would look into the half-life of the drug you took, too - that's my concern. You can read more about the all-or-nothing effect here:

https://www.merckmanuals.com/profes...cs/drugs_in_pregnancy/drugs_in_pregnancy.html

I took my medication during that time, so it gives me some reassurance. However, my drug has a rather long half-life/duration of effects, so that's what still has me worried. I was given triamcinolone acetonide, a strong (category D) steroid for a severe allergic reaction. Needless to say, after finding out I was pregnant, I panicked.

HOWEVER, I spoke to a genetic counselor from OTIS who was SUPER knowledgeable and helpful. Basically, her job is to make the public/doctors aware of medication risks in pregnancy. She talked to me for almost an hour and got information on the dose of my med, when I took it, how far along in pregnancy I was, etc. She gave me so much information about potential risks based on that info. and made me feel SOOO much better. I highly recommend calling and talking to someone from OTIS. Here's the website link: https://www.mothertobaby.org/

You can call the toll-free number anytime. They only work part-time, but are so incredibly helpful. I hope this helps...

 

[LadyHutch]

Thanks for sharing your experience - it does make me feel better to know I'm not alone. Was everything okay with the sacral dimple?

It's so scary to think about. I'm hoping once the medication was out of my system, it was fine. I may call OTIS again just to verify. Although I'm trying to focus on what my specialist told me (all positive) and just enjoy the pregnancy, I definitely have "moments" where all I can do is think about the what-ifs...... and of course it's killer waiting until the anomaly scan to really know anything for sure!

Everything did turn out ok, but it was a bit frightening at first. Sacral dimple is a high indicator for spina bifida or other meningocele. At 3 days old, we had an ultrasound of his spine, which showed it was indeed, closed (thank Jesus, Amen).

Other than having to be extra careful to keep it clean, it should pose no problem. He's very smart, healthy and well adjusted.

But I do blame the depakote, and the idiot doctor that prescribed it to me rather than listening to my symptoms and thinking "Hmmm... maybe she's pregnant" and having me pee in a cup.

 

[sandandsun]

Thanks for sharing your experience - it does make me feel better to know I'm not alone. Was everything okay with the sacral dimple?

It's so scary to think about. I'm hoping once the medication was out of my system, it was fine. I may call OTIS again just to verify. Although I'm trying to focus on what my specialist told me (all positive) and just enjoy the pregnancy, I definitely have "moments" where all I can do is think about the what-ifs...... and of course it's killer waiting until the anomaly scan to really know anything for sure!

Everything did turn out ok, but it was a bit frightening at first. Sacral dimple is a high indicator for spina bifida or other meningocele. At 3 days old, we had an ultrasound of his spine, which showed it was indeed, closed (thank Jesus, Amen).

Other than having to be extra careful to keep it clean, it should pose no problem. He's very smart, healthy and well adjusted.

But I do blame the depakote, and the idiot doctor that prescribed it to me rather than listening to my symptoms and thinking "Hmmm... maybe she's pregnant" and having me pee in a cup.

I can imagine how scary that must have been. I'm so glad everything turned out okay!

Hearing your story makes me sad and angry...because I experienced something similar. I am so angry at the doctor who gave me that medication. I understand doctors are human and make mistakes, but in this case, it was just negligent if you ask me. The doctor KNEW I was trying to conceive (so there was always a chance I was pregnant) and assured me that the medication she was giving me was SAFE. It wasn't until later I found out it was a category D drug. The doctor could have saved me from nights of crying and worrying by simply looking into this quickly. I was so sick at the time I just trusted what the doctor said was true and didn't think twice. NEVER AGAIN.