Pain during pregnancy can be frequent. As the baby grows, the pregnant woman’s body changes, the child’s weight increases and the mother’s body has to carry it, all the time.
At these times, it can be easy to turn to the medicine box and pick up that familiar friend of those in pain: dipyrone.
Sodium dipyrone is a very effective medicine against pain and fever.
It can be purchased without a prescription, it is very easy to find it in any pharmacy.
But when you’re expecting a baby, it’s important to know what you’re taking.
How does dipyrone work in the body?
Dipyrone works by inhibiting prostaglandin, a chemical signal similar to hormones but acting only on a small group of cells. This signal has several functions. Among them is signaling pain and activating the immune system when needed, causing fever.
Other effects of prostaglandin can occur during pregnancy. In these cases, the chemical signal is used to cause the contractions that cause the baby to be born.
Is using dipyrone during pregnancy safe?
The answer is yes and no . It all depends on the time of pregnancy and the woman’s health conditions. In general, for safety, the use of dipyrone is not indicated for pregnant women, as it is known that the substance crosses the placental barrier.
Especially in the first and third trimester of pregnancy, the medication should be avoided.
During the second trimester (months 4, 5 and 6), dipyrone can be taken. But remember, with medical advice. Only the doctor can tell you whether in your specific case it is dangerous or not to use a drug during pregnancy.
For the pharmacologist Dr. Francielle Tatiana Mathias, “dipyrone is not the first medication option for pregnant women. There are studies that demonstrate the possibility of blood changes, especially in defense cells. Within the risk categories of use during pregnancy, the drug demonstrates evidence of risk to the fetus and therefore its use must be evaluated by the physician, to see if the benefits outweigh the possible risk.”
Pregnancy risk categories
The Food and Drug Administration (FDA), an agency that regulates food and medication in the United States, classifies medications into 5 categories according to the risk of use during pregnancy. The risk categories are A, B, C, D and X. Dipyrone is in category D.
The excerpt below, related to each of the categories, was taken from the “Technical Regulation that establishes warning phrases for active principles and excipients in package inserts and drug labeling”. Understand the differences:
- Category A: In controlled studies in pregnant women, the drug did not demonstrate a risk to the fetus in the first trimester of pregnancy. There is no evidence of risk in later trimesters, the possibility of fetal damage being remote;
- Category B: animal studies have not shown fetal risk, but there are also no controlled studies in pregnant women; or else, animal studies have revealed risks but have not been confirmed in controlled studies in pregnant women;
- Category C : studies have not been performed on animals or on pregnant women; or else, animal studies have shown risk, but no studies performed in pregnant women are available;
- Category D: the drug showed positive evidence of human fetal risk, however, the potential benefits for the woman may eventually justify the risk, for example, in cases of serious or life-threatening diseases, and for which there are no other safer drugs;
- Category X: in studies in animals and pregnant women, the drug caused fetal abnormalities, with clear evidence of a risk to the fetus that is greater than any possible benefit to the patient.
Therefore, before using any medication during pregnancy, read the leaflet and talk to the doctor.
Does dipyrone in pregnancy harm the baby?
Use during the first trimester can be dangerous as there is a risk of causing fetal malformations, while in the last trimester, dipyrone can cause the ductus arteriosus to close prematurely.
The ductus arteriosus is a small blood channel in the fetus that diverts venous blood from the lungs that are not yet used by the unborn baby. When this duct closes prematurely, the baby suffocates since without the lungs or the arterial duct, he is not able to breathe.
What medicine can pregnant women take?
Pregnant women may prefer pain medications that do not include dipyrone. During pregnancy, complaints of and are common, two situations in which medication can be a great relief.
In these cases, paracetamol can be an alternative, as it is a drug that is classified as risk level B, being one of the least harmful to the fetus. But beware, always consult your doctor before taking a medication. The risk of using medication varies from pregnant to pregnant and several factors can increase this risk.
For example, paracetamol is not suitable for people with liver problems. Other factors such as blood pressure also influence risk. Be sure to talk to your doctor.
Marketing of dipyrone in other countries
Some places, such as the United States and countries in the United Kingdom, prohibit the sale of dipyrone. The veto is due to the possible risks associated with the drug, especially with regard to agranulocytosis — a condition that causes a drop in the levels of granulocytes (white blood cells) in the blood and that can be fatal.
However, studies that correlate these effects to substance use are controversial. The drug is also sold in some countries in Europe. In an assessment panel developed to clarify the risks of dipyrone, released in 2001, U.S. Food and Drug Administration reached some conclusions:
- The risks attributed to the use of dipyrone in our population are low, and the available scientific data pointing to the occurrence of these risks are not sufficient to indicate a change in the regulatory status (sale without prescription);
- The risks of dipyrone are similar, or lower, than other analgesics/antipyrones available on the market;
- The change in the current regulation of dipyrone would incur negative aspects for the population, increasing the risks of using other drugs indicated for the same therapeutic purpose.
These results played an important role in the decision to maintain the drug regulation in US.
If you are pregnant, even in the second trimester of pregnancy, talk to your obstetrician before using dipyrone. Also remember to tell your doctor if you are pregnant or if there is a possibility that you may be pregnant.
If you are in the first or third trimester, stay away from the medication and prefer other options that a specialist can indicate.