Flovent Inhaler During Pregnancy: Is It Safe?

What does the evidence say about flovent during pregnancy?

1. Inhaled fluticasone (Flovent) delivers medication directly to the lungs rather than through the bloodstream, and it isn't expected to increase the chance of birth defects; several small studies also haven't found an increased chance of miscarriage. 1
2. Asthma complicates an estimated 4 to 8 percent of pregnancies (8.4 to 8.8 percent in the US), inhaled corticosteroids are the preferred controller medication and are considered safe to use in pregnancy, and about 5.8 percent of pregnant women with asthma need hospitalization for a flare-up. 2
3. Uncontrolled asthma in pregnancy is linked to preeclampsia, preterm labor, low birth weight, and congenital anomalies, and stopping controller medication out of safety concerns is itself identified as a risk factor for asthma flare-ups. 2
4. Managing asthma with an inhaled corticosteroid may lower the chance of preterm delivery compared with leaving asthma unmanaged, though some data suggests inhaled corticosteroids might slightly raise the chance of miscarriage; most, including fluticasone, haven't been formally studied during breastfeeding, though the amount reaching milk is expected to be small. 3
5. In a national cohort of more than 1.3 million pregnancies, inhaled corticosteroid use in the 180 days before the outcome date wasn't linked to a higher risk of gestational diabetes across models, and an early signal for pregnancy-induced hypertension didn't hold up once other health factors were accounted for. 4

Is flovent safe in each trimester?

• First trimester. Asthma complicates an estimated 4 to 8 percent of pregnancies, and continuing a controller inhaler like Flovent in the first trimester matters because studies haven't found an overall increase in birth defects with inhaled corticosteroids, while stopping controller medication out of safety worry is itself a known risk factor for flare-ups.
• Second trimester. A cohort of more than 1.3 million pregnancies found inhaled corticosteroid use wasn't linked to a higher risk of gestational diabetes, and an early signal for pregnancy-induced hypertension didn't hold up once other health factors were accounted for, which supports staying on a working asthma regimen through the second trimester.
• Third trimester. Uncontrolled asthma is linked to preeclampsia, preterm labor, and low birth weight, and managing asthma with an inhaled corticosteroid may lower the chance of preterm delivery compared with leaving symptoms unmanaged. If you're breastfeeding after delivery, only a small amount of inhaled fluticasone is expected to reach milk.