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Thread: No Metrolotion during pregnancy???

  1. #1
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    Default No Metrolotion during pregnancy???

    Hey Guys,

    Was talking to my primary care physician today and broached the subject of possibly having children within the next few years.

    She indicated (as I expected), that she'd want me off the doxycycline (currently I take 20mg 2x daily), but then she said something else that surprised me. She said: "I'd want you off the Metrolotion, too."

    I was like: "....but it's a topical."

    She reiterated that she'd want me off it.

    Has anyone else heard this, and if so, does anyone know why?

    I am really not so sure I could go 10 months without using ANY form of rosacea treatment whatsoever. Even with maintenance VBeam treatments, I am sure my face would be an utter mess.

    Can anyone shed light on this? Are her concerns warranted, or should I be seeking a 2nd opinion?

    Thanks.

  2. #2
    Senior Member Brady Barrows's Avatar
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    "Earlier studies suggested a relation between metronidazole and various birth defects. Those studies are now considered flawed and more recent studies "do not support a significant increased risk for birth defects or other adverse effects on the fetus."
    Adverse Effects

    "
    Metronidazole has also been used in women to prevent preterm birth associated with bacterial vaginosis, amongst other risk factors including the presence of cervicovaginal fetal fibronectin (fFN). A randomised controlled trialdemonstrated that metronidazole was ineffective in preventing preterm delivery in high-risk pregnant women and, conversely, the incidence of preterm delivery was actually higher in women treated with metronidazole."
    Preterm Births
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    Quote Originally Posted by Brady Barrows View Post
    "Earlier studies suggested a relation between metronidazole and various birth defects. Those studies are now considered flawed and more recent studies "do not support a significant increased risk for birth defects or other adverse effects on the fetus."
    Adverse Effects

    "
    Metronidazole has also been used in women to prevent preterm birth associated with bacterial vaginosis, amongst other risk factors including the presence of cervicovaginal fetal fibronectin (fFN). A randomised controlled trialdemonstrated that metronidazole was ineffective in preventing preterm delivery in high-risk pregnant women and, conversely, the incidence of preterm delivery was actually higher in women treated with metronidazole."
    Preterm Births
    I mean, so what should I do? Show her the studies? She seemed quite firm about me going off it....

    It literally makes me question whether to even bother having a kid.

    Not kidding.

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    Senior Member Brady Barrows's Avatar
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    Quote Originally Posted by oopsiedaisy View Post
    I mean, so what should I do? Show her the studies? She seemed quite firm about me going off it....

    It literally makes me question whether to even bother having a kid.

    Not kidding.
    No one should determine what you should do in this matter. You are the one who should decide. You listen to what your doctor recommends. You can get a second opinion from another physician. But ultimately you decide. Each patient should learn the benefit/risk ratio of any treatment whether it is a prescription drug, surgery, etc. Even if you agree with your doctor and do what the doctor recommends, you are the one who makes the final decision. You can listen to anecdotal opinions from others but again, you are the one that decides. Taking a drug has risks. Many accept those risks. Whatever the consequences you accept the risks if you accept the treatment. Whatever the reasons your physician has for recommending your stopping metronidazole you can ask about. She has the obligation to answer you. If you don't agree, that is up to you. But it makes sense to listen to your doctor since doctors write the prescriptions and give the treatment.

    Medicine isn't exactly correct on all matters and change is constant. What if the earlier studies on metronidazole about birth defects are correct and the newer studies wrong? Who knows? In ten more years there will be even more studies to look at. Maybe your physician just wants to play it safe. She advised you to stop. Now it is your decision.
    Last edited by Brady Barrows; 11th September 2012 at 08:01 PM.
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    Quote Originally Posted by Brady Barrows View Post
    No one should determine what you should do in this matter. You are the one who should decide. You listen to what your doctor recommends. You can get a second opinion from another physician. But ultimately you decide. Each patient should learn the benefit/risk ratio of any treatment whether it is a prescription drug, surgery, etc. Even if you agree with your doctor and do what the doctor recommends, you are the one who makes the final decision. You can listen to anecdotal opinions from others but again, you are the one that decides. Taking a drug has risks. Many accept those risks. Whatever the consequences you accept the risks if you accept the treatment. Whatever the reasons your physician has for recommending your stopping metronidazole you can ask about. She has the obligation to answer you. If you don't agree, that is up to you. But it makes sense to listen to your doctor since doctors write the prescriptions and give the treatment.
    I think I will ask her what, specifically, her concerns about the topical Metrolotion and use during pregnancy are.

    She's been my PCP for many years and I really do like and trust her, so I want to at least hear what she thinks.

    I will most likely follow her advice (whatever it is)....I just worry that I will literally have NO rosacea treatment at all for like 10 months.....Yikes.

    Would be interested in hearing from any other women on here who have undergone a pregnancy and gone off topicals----or, if not, stayed on them---and how their skin reacted during pregnancy (if off meds), or whether they were able to have a healthy birth/child (if on topicals during pregnancy).

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    Senior Member Brady Barrows's Avatar
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    There are a number of other prescription treatments for rosacea and there are new ones coming down the pipeline like Sansrosa.
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    Quote Originally Posted by Brady Barrows View Post
    There are a number of other prescription treatments for rosacea and there are new ones coming down the pipeline like Sansrosa.
    Currently I take doxycycline (20mg 2x daily) and use Metrolotion 0.75% topically.

    I have also had about 10 non-purpuric VBeams.

    From what my Dr. indicated, no topicals would be acceptable during pregnancy. (And, obviously, no doxycycline or any other systemic antibiotics.)

    That leaves VBeam. Maybe if I do choose to get pregnant I can just get VBeamed every 6-8 weeks for those 10 months.

    I really have no idea, but I am confident the Dr. is not going to say that Finacea is fine but Metrolotion isn't. She wants me on basically nothing. No meds.

    PS: Every single thing you linked to here (http://members.rosacea-research-and-...on-treatments/) is contraindicated for pregnancy, ESPECIALLY stuff like Accutane, immunosuppressants, and antibiotics.

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    Quote Originally Posted by oopsiedaisy View Post

    I really have no idea, but I am confident the Dr. is not going to say that Finacea is fine but Metrolotion isn't. She wants me on basically nothing. No meds.
    My recommendation to you would be to drop all antibiotics, topical or oral, while your trying and certainly while you're pregnant. Finacea is an acid closely related to salicylic acid (common in OTC acne meds), and is a category B pregnancy drug, so it is not expected to cause harm. But I've have had better luck with sea buckthorn seed oil than I've had with Fiancea or salicylic acid.

    Back in the late 90's a pregnant co-worker had a terrible cough. I suggested she get some Robistussin since there was no evidence of harm. She was on an all natural kick - no sugar, no coffee, etc, while she was pregnant, so she declined. About 2 months later, a study comes out showing dextromethorphan (in Robitussin) causes birth defects. I read it, and ran over to her desk to ask her if she'd ever taken it. She said no...and I said "thank god. Studies have come out since that call that into question, so now it's just inconclusive.

    The moral is, you never know what they'll find out 2 months after you take something.... Better to be safe than sorry. 9 months seems like a long time, and only you can decide if the symptoms will be worth it.

    Absorption of metronidazole after topical application of metronidazole topical lotion is less complete and more prolonged than after oral administration. Detectable plasma levels were found in all subjects following the administration of a 1 gram dose of metronidazole topical lotion (containing 7.5 mg of metronidazole) applied every morning and evening for 4 days to the faces of 8 patients. The highest concentration (96 ng/mL) seen following the morning dose on Day 5 was approximately 80 times lower than the peak concentrations produced by a single 250 mg tablet of metronidazole. The mean (± SD) AUC0-24 after twice daily administration was 962 ± 373 ng.hr/mL.
    So it gets into your bloodstream. But...

    http://www.ncbi.nlm.nih.gov/pubmed/22751543

    We found no association between metronidazole treatment during the first or later trimesters of pregnancy and preterm birth, low birth weight, or congenital anomalies.
    YMMV
    Last edited by solaris; 12th September 2012 at 05:56 AM.

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    Thanks for the info., Solaris. From what I gather metronidazole is also a carcinogen---or at least it can be in rats. (This is from the insert on my Metrolotion). Perhaps the PCP is concerned about potentially carcinogenic properties for a developing fetus?

    I would really love to hear from any women on here who have been pregnant with rosacea and who've gone off all meds (including topicals) during this time --- i.e. - did they flare horribly? Was it worth it? Was it not so bad skin-wise?

    This would definitely help, if anyone on the forum can speak from personal experience.

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    Senior Member moka's Avatar
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    Hi oopsiedaisy,

    I haven't been in this forum in years... nice to see it's still here

    When I began thinking about getting pregnant i also experienced the same fears as you described. my rosacea was under control with spironolactone, metronidazole topical (rozex), Chinese acupuncture and i was really terrified that without all of these I would flare all the time, breakout and that years of improvement will all go to waste.
    I have read a lot of stories about rosacea getting worse with pregnancy and naturally it made me very worried.

    Luckily, none of that happened.

    My dermatologist advised me to go off all meds before getting pregnant. but we agreed it should be done gradually.
    First, I stopped using the spironolactone. I used to take 100mg a day so I switched to 50mg for a month or two (can't remember...) and then to 25mg for another month. my skin showed no change or aggravation, so I proceeded to the next step which was the acupuncture. This went smoothly too, so then I started to reduced my metronidazole use (which was the hardest to give up). I went from using it regularly (and generously ) twice a day to using it only on bad breakouts. I stopped using it completely about a month before actually attempting pregnancy.
    It's probably important to point out that this was all done during fall and winter which are the best months for my skin (no allergies, less sun exposure).
    I also stopped using birth control pills which I suspected would affect my skin but it was ok overall.

    Pregnancy did wonders for my skin. really.
    I hardly flushed, didn't break out at all, had considerably less allergies, and even sun exposure did not result in horrible redness like it used to (and I live in a VERY sunny country). I gave birth 8 months ago and my skin has continued to be really ok. not as great as during pregnancy, but better than before. Despite the lack of treatment (I only use moisturizer and sunscreen) and the fact that now it is MUCH harder for me to avoid the sun so I get a lot more exposure than I used too, my skin is much more 'normal' than it used to be.
    My husband even thinks that pregnancy has "cured" my rosacea, but I wouldn't go that far. I can still flush and I burn quickly so it's undoubtedly still here.

    Another thing is that now that I have a wonderful baby, I care a lot less about my appearance and skin than I used too. somehow, it just doesn't seem to matter as much as it used too...

    Anyway, that's my story.
    personally, even if it wouldn't have gone so well I would still go off all meds during pregnancy. In my opinion, it just isn't worth the risk.

    Good luck!!

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