Can You Take Albuterol While Pregnant? Safety Considerations

When you're pregnant, keeping your health in check matters more than ever. Your developing baby shares your blood supply, so making sure that you can keep a consistent blood level of vital nutrients such as oxygen and glucose is essential. Some medical conditions can get in the way of your health status while pregnant, including asthma. Just as your health matters more than ever while pregnant, so do your asthma medications. So, can you take albuterol while pregnant? Read on to learn more.

Is albuterol safe in pregnancy?

Is albuterol safe during pregnancy? To put it simply, yes. Using albuterol sulfate while pregnant is safe. In fact, not keeping your asthma under good control while pregnant is likely to be more harmful than taking your albuterol as needed. However, like any medication, albuterol does come with side effects and potential harms. Some of these are unique to a pregnant woman. Similarly, there is a lack of clear research regarding the direct evaluation of albuterol and pregnancy safety and outcomes. Still, medical professionals recommend that women with asthma continue using albuterol during pregnancy to help keep their condition under good control.

Albuterol in pregnancy warnings

Can I use albuterol while pregnant? The answer to this question is yes. Using albuterol when pregnant is generally considered safe. However, it is crucial to understand the warnings about using albuterol in pregnancy so that you are fully aware of the potential effects of this medication and you can weigh the risks and benefits with your healthcare provider. Albuterol is a short-acting beta agonist (SABA) medication that acts on the smooth muscle cells of the bronchioles. As such, it can help you keep delivering oxygen to your baby during an asthma flare, preventing fetal hypoxia, which can be dangerous. However, it's essential to understand the following warnings, as well.

 

Warning 1: There are no randomized clinical trials evaluating albuterol use in pregnancy

While no direct research has been performed using the gold standard research methodology of a double-blinded randomized controlled trial, postmarketing research does not show an overwhelming connection between albuterol use and miscarriage or congenital disabilities. However, some reports of congenital anomalies and albuterol use do exist.

Warning 2: Albuterol crosses the placenta

When albuterol is inhaled, it is eventually absorbed into the bloodstream. Research shows that albuterol can cross from your bloodstream into the fetal bloodstream via the placenta. This may affect your baby's heart rate and glucose level.

Warning 3: Albuterol can affect uterine contractility

Taking albuterol can affect the contraction strength of your uterus, which can have implications as you reach the final stages of pregnancy and delivery. In fact, albuterol has been used in other countries to help reduce uterine contractions and prevent preterm delivery (although this is not an indication for its use in the United States).

Warning 4: Albuterol can affect glucose levels in a newborn

Suppose a mother has used albuterol to help with bronchospasms during her labor and delivery. In that case, her baby should be monitored closely for 24 hours for a potential drop in blood glucose levels.

Warning 5: There is no clear albuterol pregnancy category

The US Food and Drug Administration (FDA) had previously categorized albuterol as a Pregnancy Category C. However, the FDA no longer uses the alphabetized rating system for prescription drugs, opting instead for more descriptive language to support clinical decision making.

Albuterol and breastfeeding

Similar to the exploration of whether albuterol is safe for pregnancy, there have been no studies directly evaluating women who are using albuterol and concurrently breastfeeding. It is unclear whether albuterol is excreted in breast milk. However, medical professionals recommend continuing as-needed albuterol while breastfeeding to keep asthma under reasonable control.

Practical tips to reduce the impact of asthma on your baby

Albuterol and pregnancy can be an intimidating combination. The answer to the question of "Is albuterol safe during pregnancy?" is yes. However, limiting your exposure to albuterol in the first place can help provide you with more peace of mind. Follow these tips to help keep your underlying asthma under control, reduce your need for albuterol, and reduce the overall impact of asthma on your baby.

 

Tip 1: Recognize and avoid triggers

When you're pregnant, you're probably already on high alert about threats in your environment. Things that normally wouldn't cross your mind as being particularly dangerous, such as soft cheeses and processed meats, suddenly pose a greater threat. You should think of asthma triggers in the same way. Even though you may have been less vigilant about avoiding cat and dog dander before pregnancy, for example, you may be particularly wary while pregnant, to prevent a potential asthma flare.

Tip 2: Have a concrete and predetermined asthma plan

Preparation and planning are key, especially when it comes to asthma management in pregnancy. Using an albuterol nebulizer while pregnant, or an albuterol inhaler as needed, can be stressful. However, having a specific action plan can help you make treatment decisions in a pinch and then help rationalize them later on.

Tip 3: Talk to your medical provider beforehand about how asthma might affect your pregnancy

It's not a given that your asthma will get worse with pregnancy. In fact, according to Global Initiative for Asthma (GINA) guidelines, about one-third of women will experience an improvement in their asthma symptoms during pregnancy, one-third of women will experience a worsening in their symptoms, and the remaining third will not experience any change. Talking to your medical provider about your specific case in advance can help you feel more prepared.

Can you take albuterol while pregnant? Key takeaways

Can pregnant women take albuterol? Yes. The answer to the question of whether albuterol is safe for pregnancy is that there are no clear associations between albuterol use during pregnancy and an increased risk of congenital disabilities or miscarriages. When you're pregnant, it's important to keep asthma symptoms under good control, and using your albuterol inhaler as needed can help you accomplish this.

FAQs

 

Can pregnancy make asthma worse?

Yes, your asthma symptoms may worsen with pregnancy. However, it's not universally true. In fact, asthma symptoms worsen in pregnancy for only one-third of women. The other two-thirds of pregnant women either see no change in their asthma symptoms or improvement in their symptoms.

Can you use albuterol while pregnant in the first trimester?

Can pregnant women use albuterol in the first trimester? Absolutely. Albuterol use is not contraindicated in any trimester of pregnancy, including the first. However, like any medication, albuterol should be used sparingly during pregnancy and only on an as needed basis.

Does taking albuterol increase the chance of miscarriage?

No, there is no apparent connection between albuterol use and an increased risk of miscarriage. On the whole, medical experts believe that the risks of uncontrolled asthma to a fetus are more severe than the risks of using albuterol as needed.

Does taking albuterol increase the chance of congenital disabilities?

In short, no, medical professionals do not believe that albuterol significantly increases the risk of congenital disabilities. Some research has pointed to a possible connection between albuterol exposure in utero and congenital disabilities. Still, the studies cannot determine whether the defects were related to the severity of a woman's asthma condition itself or her asthma medications.

Should you use your albuterol inhaler during pregnancy the same way you'd typically use it before pregnancy?

Can you have albuterol while pregnant? Yes, you should plan to continue your asthma control plan during pregnancy the same way that you had before. Albuterol and pregnancy are not enemies—in fact, using albuterol when pregnant is an important way to keep your asthma well-controlled and prevent potential pregnancy complications of pre-eclampsia, preterm delivery, low birth weight, and increased perinatal mortality.

Does taking albuterol in pregnancy increase the chance of other pregnancy-related problems?

No, taking albuterol in pregnancy reduces the chance of other pregnancy-related problems. This is because albuterol can help effectively relieve asthma symptoms. Poorly controlled asthma, on the other hand, can increase the risk of other pregnancy-related problems, such as pre-eclampsia. So, can you use an albuterol inhaler while pregnant? Yes.

Does taking albuterol in pregnancy affect future behavior or learning for the baby?

When it comes to the impact of albuterol exposure in utero on a child's future behavior and learning, no direct research has been performed using the gold standard research methodology of a double-blinded randomized controlled trial.

References

https://www.ncbi.nlm.nih.gov/books/NBK482272/

https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/4100bce5-096c-42e4-9e4e-d11a0ab597d5/spl-doc#ID71

https://www.uptodate.com/contents/albuterol-salbutamol-drug-information?search=albuterol%20inhaler&source=panel_search_result&selectedTitle=1~150&usage_type=panel&kp_tab=drug_general&display_rank=1#F130961 (Subscription Required)

https://mothertobaby.org/fact-sheets/albuterol-pregnancy/

https://pmc.ncbi.nlm.nih.gov/articles/PMC5893143/

https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021457s021lbl.pdf

https://www.fda.gov/drugs/labeling-information-drug-products/pregnancy-and-lactation-labeling-resources