Anthrax Q & A: Pregnancy
I'm taking
medication to prevent anthrax, and I just found out that I'm pregnant.
What should I do?
It is very important that you continue to take as directed the medication
you have been prescribed. You should also contact your doctor or local
public health officials right away to let them know that you are pregnant.
They will want to discuss which medicine would be the best choice for
you—to prevent anthrax and to be safe for both you and the fetus.
I'm pregnant.
What medicine should I take to prevent anthrax?
You should take medication to prevent anthrax only if a public health
official confirms that you have had a potential exposure to anthrax. You
and your doctor will want to discuss the risks and benefits of the various
antibiotics that can be used to prevent anthrax. Which medicine is most
appropriate for you will depend on the specific place and situation of
your exposure and on your general medical history (including other medicines
you may be taking and any medication allergies you may have). Currently,
there are three main antibiotics used to prevent anthrax: ciprofloxacin,
amoxicillin, and doxycycline. Ciprofloxacin is effective against anthrax
and is unlikely to cause major problems for the fetus, but there is not
enough experience or data involving ciprofloxacin during pregnancy to
say for certain that there is no risk to the fetus. Doctors are more confident
about the safety of amoxicillin for the fetus, but amoxicillin may not
always be effective against anthrax. Before prescribing amoxicillin for
you, your doctor would want to make sure that the anthrax you were exposed
to is not resistant to amoxicillin. Doxycycline can sometimes cause tooth
and bone problems in the fetus. Therefore, you should not take doxycycline
unless there is a specific reason why you cannot take either ciprofloxacin
or amoxicillin.
I've
heard that doctors don’t generally prescribe ciprofloxacin to pregnant
women. Why is that? Why are they recommending it for anthrax prevention?
Ciprofloxacin is not likely to cause major problems for a fetus, but there
is not enough experience and data involving ciprofloxacin during pregnancy
to say for certain that there is no risk to the fetus. Ciprofloxacin is
not commonly used during pregnancy because most infections that pregnant
women get can be treated with other drugs whose safety for pregnant women
and their fetuses is better documented. However, because anthrax is a
life-threatening disease, the benefits of using ciprofloxacin may outweigh
potential risks to the fetus.
I was
started on ciprofloxacin to prevent anthrax. I've heard that amoxicillin
may be a safer drug for me to take during my pregnancy. How do I know
if I can be switched to amoxicillin?
Doctors are often more confident about using amoxicillin than ciprofloxacin
in pregnancy because they have more information on the safety of amoxicillin
for the mother and the fetus. But in some situations, amoxicillin may
not be effective against anthrax; this is because the bacteria that cause
anthrax can sometimes develop resistance to penicillins such as amoxicillin.
Before prescribing amoxicillin for you, your doctor will want to learn
more about the specific place and situation of your exposure to anthrax
and also about your general medical history. (For instance, some women
cannot take amoxicillin because they are allergic to it.)
Doxycycline
is being recommended for my coworkers who aren't pregnant. Is doxycycline
a better medicine against anthrax than ciprofloxacin?
No. There are no data to suggest that doxycycline is better than ciprofloxacin
for preventing anthrax.
I'm having
a lot of heartburn during my pregnancy. Can I take ciprofloxacin at the
same time as I take antacids?
No. Antacids should not be taken at the same time as ciprofloxacin because
they may make ciprofloxacin less effective. (They can interfere with the
absorption of ciprofloxacin.) You should not take antacids in the 6 hours
before you take a ciprofloxacin pill or for 2 hours after you take ciprofloxacin.
I've
been trying to get pregnant and have just started taking medication to
prevent anthrax. Can I continue to try to get pregnant while taking this
medication?
Whether to try to become pregnant while taking medication to prevent anthrax
is your personal decision. When making this decision, you should discuss
the possible risks and benefits with your family and your doctor. Some
women may prefer to wait until after completing the full course of antibiotics
before becoming pregnant. If you decide not to wait, it may be best not
to take doxycycline unless there is a specific reason why you cannot take
either ciprofloxacin or amoxicillin.
I just
recently found out I'm pregnant, and I was exposed to anthrax at work.
I want to take the best medication for my fetus and me, but I don’t
yet want my employer to know that I'm pregnant. What should I do?
It is very important that you tell your doctor or local public health
officials that you are pregnant. They will not be required to tell your
employer.
- Page last updated December 2, 2002
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