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Chickenpox - Management
Which analgesic and antipyretic treatment is suitable for use during pregnancy or when breastfeeding?
- Paracetamol is the analgesic and antipyretic of choice because it can be used at the usual dosage and at any stage of pregnancy and during breastfeeding.
- Ibuprofen may be considered for use in breastfeeding and pregnant women, but it should not used beyond 27 weeks of gestation because of the increased risk of constriction of the ductus arteriosus.
- Constriction of ductus arteriosus:
- Constriction is related to gestational age; it is rare before week 27, but its incidence increases with advancing gestational age to 50–70% at 32 weeks and up to 100% with exposure from week 34 onwards.
- The effect appears not to be dose dependent.
- If use of ibuprofen is unavoidable, fetal circulation should be monitored regularly (once or twice weekly) with Doppler sonography, and medication use should be stopped as soon as signs of ductal constriction appear.
- Breastfeeding:
- Ibuprofen was not detected in breast milk following administration of 800–1600 mg daily in two small studies. No adverse effects on breastfed children were reported in both studies and also in a prospective study covering 21 mother-child pairs.
[Schaefer et al, 2007]
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