Is taking Lipitor while pregnant safe?

Credit: Blaine Moats

Lipitor (atorvastatin calcium) is a prescription medicine used to treat high cholesterol. When taken along with a healthy diet and exercise, Lipitor has been proven to reduce LDL cholesterol levels and triglycerides. It can raise HDL cholesterol and also helps to lower risk for heart attack, stroke and heart disease.

Lipitor has been known to cause fetal harm in pregnancy, so it's important to know about the potential hazards. If you are planning or hoping to conceive, you should not be taking the drug. If you discover that you are pregnant while taking Lipitor, discontinue use of the medication and call your doctor right away. Lipitor should also not be taken by nursing mothers, as the drug can pass to the newborn baby through breast milk and may have damaging effects.

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The Dangers

"Lipitor in pregnancy is a class X because there are rare reports of congenital abnormalities in the fetuses of women who used Lipitor in pregnancy," explains board-certified obstetrician and gynecologist Marra Francis, M.D.

The U.S. Food and Drug Administration (FDA) uses a category system to classify potential risks to the fetus when a specific medicine is taken during pregnancy. Category X is for medications that cause problems to the fetus in animal studies and in humans who have taken the medication when pregnant. Category X medicines like Lipitor should not be used in pregnancy.

"Women who are given Lipitor should not be considering pregnancy and should be warned against getting pregnant while on this medication," says Dr. Francis. "If a woman does become pregnant while on Lipitor, she should stop it immediately and should be warned of potential adverse developmental effects."

There is evidence that links prenatal exposure to statins (cholesterol-lowering drugs) with congenital abnormalities. Lipitor is also thought to cause problems in pregnancy because cholesterol and triglyceride levels increase during a normal pregnancy and cholesterol is essential for fetal development.

Although high cholesterol can lead to dangerous conditions like atherosclerosis (a thickening of the artery wall as a result of cholesterol build-up), chronic diseases take a while to develop and stopping Lipitor for a pregnancy should not have a significant impact on the long-term treatment of high cholesterol. Because there are potential hazards to the fetus from Lipitor and no known clinical benefit from continuing to take the drug in pregnancy, it should be stopped immediately.

The Alternatives

"If I have a patient who has taken any class X drug I immediately set them up for a consultation with a Maternal Fetal Medicine specialist," says Dr. Francis. "That way, they can determine if the potential abnormalities are so severe that they want to consider whether to continue with or terminate the pregnancy."

If you normally take Lipitor because you suffer from high cholesterol and have discontinued the drug because you are pregnant, there are other ways to control your cholesterol to help ensure a healthy pregnancy.

Cholesterol levels can increase by as much as 20 to 35 percent during pregnancy, says nutritionist and founder of Maternal Health Matters, Maria Pari-Keener, M.S., R.D.

"Since there is an increased risk of developing pre-eclampsia when cholesterol levels are high, I would suggest improving diet and encouraging physical activity, along with following doctor's orders about medications." Pre-eclampsia, a condition that can develop in pregnancy, is associated with very high blood pressure, swelling and the presence of protein in the urine and can be dangerous if not treated and monitored carefully.

One simple way to help keep your cholesterol levels under control in pregnancy is through your diet. Pari-Keener recommends adding more fiber by eating fruits, vegetables, whole grains, beans and legumes. "It's also important to limit saturated fat by using monounsaturated oils like olive and canola, forgoing processed foods, fried foods and whole- milk dairy products. Eating less fatty meats is a good idea, too," explains Pari-Keener.

She also recommends that you do aerobic exercise during your pregnancy -- even if it's just walking -- as long as your ob-gyn has given the OK.

Copyright © 2011 Meredith Corporation.

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