doc says NO to inhaled tobi while pregnant...

tinamarie4685 · Feb 13, 2008

So I have been inhaling Colistin (coly mycin) for a month, I usually do one month on, one month off... but while I have been inhaling it, I also noticed my cough still increasing and my mucus changing to the taste & color & thickness that means something no good is brewing in there - I also have this blackish grey fungus coming out of my nose when I blow it. So basically, the oral pills that work for me, I can't take while pregnant because they are bad for baby (Cipro, Levaquin, Zyvox).. my CF doctor said to try inhaled TOBI and I agreed, despite having vestibular damage from Gentamycin I.V. a few years ago.. I figured inhaling the TOBI is such a less amount actually going into the bloodstream (I tried inhaling it about 1 year ago and it did make me dizzy & ringing ears) so I started it up yesterday because there seems to be nothing else to take...

So today I called my high risk ob/gyn and she looked up inhaled TOBI, 1 vial twice a day while pregnant, and she said it is a class D drug while pregnant, which means it is known to cause problems to the baby... and it has a black label warning also, which means danger to the baby. She read to me that it can cause hearing loss in the baby, kidney damage and vision problems... so obviously I am not going to inhale it knowing it *can* harm my baby.

So now I am going to have a PICC line placed on Friday morning, and will most likely be on Aztreonam and Zosyn, which are both class B drugs.. I was on those 2 when my fiance and I conceived and my doctor said they are safe while pregnant... I was just wondering if anyone else was on these while pregnant, or just on I.V. while pregnant in general? Did it have any effect on your baby?

The 2 bacteria's they are treating me for are the MRSA & Pseudomonis..

tinamarie4685 · Feb 13, 2008

So I have been inhaling Colistin (coly mycin) for a month, I usually do one month on, one month off... but while I have been inhaling it, I also noticed my cough still increasing and my mucus changing to the taste & color & thickness that means something no good is brewing in there - I also have this blackish grey fungus coming out of my nose when I blow it. So basically, the oral pills that work for me, I can't take while pregnant because they are bad for baby (Cipro, Levaquin, Zyvox).. my CF doctor said to try inhaled TOBI and I agreed, despite having vestibular damage from Gentamycin I.V. a few years ago.. I figured inhaling the TOBI is such a less amount actually going into the bloodstream (I tried inhaling it about 1 year ago and it did make me dizzy & ringing ears) so I started it up yesterday because there seems to be nothing else to take...

So today I called my high risk ob/gyn and she looked up inhaled TOBI, 1 vial twice a day while pregnant, and she said it is a class D drug while pregnant, which means it is known to cause problems to the baby... and it has a black label warning also, which means danger to the baby. She read to me that it can cause hearing loss in the baby, kidney damage and vision problems... so obviously I am not going to inhale it knowing it *can* harm my baby.

So now I am going to have a PICC line placed on Friday morning, and will most likely be on Aztreonam and Zosyn, which are both class B drugs.. I was on those 2 when my fiance and I conceived and my doctor said they are safe while pregnant... I was just wondering if anyone else was on these while pregnant, or just on I.V. while pregnant in general? Did it have any effect on your baby?

The 2 bacteria's they are treating me for are the MRSA & Pseudomonis..

tinamarie4685 · Feb 13, 2008

So I have been inhaling Colistin (coly mycin) for a month, I usually do one month on, one month off... but while I have been inhaling it, I also noticed my cough still increasing and my mucus changing to the taste & color & thickness that means something no good is brewing in there - I also have this blackish grey fungus coming out of my nose when I blow it. So basically, the oral pills that work for me, I can't take while pregnant because they are bad for baby (Cipro, Levaquin, Zyvox).. my CF doctor said to try inhaled TOBI and I agreed, despite having vestibular damage from Gentamycin I.V. a few years ago.. I figured inhaling the TOBI is such a less amount actually going into the bloodstream (I tried inhaling it about 1 year ago and it did make me dizzy & ringing ears) so I started it up yesterday because there seems to be nothing else to take...

So today I called my high risk ob/gyn and she looked up inhaled TOBI, 1 vial twice a day while pregnant, and she said it is a class D drug while pregnant, which means it is known to cause problems to the baby... and it has a black label warning also, which means danger to the baby. She read to me that it can cause hearing loss in the baby, kidney damage and vision problems... so obviously I am not going to inhale it knowing it *can* harm my baby.

So now I am going to have a PICC line placed on Friday morning, and will most likely be on Aztreonam and Zosyn, which are both class B drugs.. I was on those 2 when my fiance and I conceived and my doctor said they are safe while pregnant... I was just wondering if anyone else was on these while pregnant, or just on I.V. while pregnant in general? Did it have any effect on your baby?

The 2 bacteria's they are treating me for are the MRSA & Pseudomonis..

tinamarie4685 · Feb 13, 2008

So I have been inhaling Colistin (coly mycin) for a month, I usually do one month on, one month off... but while I have been inhaling it, I also noticed my cough still increasing and my mucus changing to the taste & color & thickness that means something no good is brewing in there - I also have this blackish grey fungus coming out of my nose when I blow it. So basically, the oral pills that work for me, I can't take while pregnant because they are bad for baby (Cipro, Levaquin, Zyvox).. my CF doctor said to try inhaled TOBI and I agreed, despite having vestibular damage from Gentamycin I.V. a few years ago.. I figured inhaling the TOBI is such a less amount actually going into the bloodstream (I tried inhaling it about 1 year ago and it did make me dizzy & ringing ears) so I started it up yesterday because there seems to be nothing else to take...

So today I called my high risk ob/gyn and she looked up inhaled TOBI, 1 vial twice a day while pregnant, and she said it is a class D drug while pregnant, which means it is known to cause problems to the baby... and it has a black label warning also, which means danger to the baby. She read to me that it can cause hearing loss in the baby, kidney damage and vision problems... so obviously I am not going to inhale it knowing it *can* harm my baby.

So now I am going to have a PICC line placed on Friday morning, and will most likely be on Aztreonam and Zosyn, which are both class B drugs.. I was on those 2 when my fiance and I conceived and my doctor said they are safe while pregnant... I was just wondering if anyone else was on these while pregnant, or just on I.V. while pregnant in general? Did it have any effect on your baby?

The 2 bacteria's they are treating me for are the MRSA & Pseudomonis..

tinamarie4685 · Feb 13, 2008

So I have been inhaling Colistin (coly mycin) for a month, I usually do one month on, one month off... but while I have been inhaling it, I also noticed my cough still increasing and my mucus changing to the taste & color & thickness that means something no good is brewing in there - I also have this blackish grey fungus coming out of my nose when I blow it. So basically, the oral pills that work for me, I can't take while pregnant because they are bad for baby (Cipro, Levaquin, Zyvox).. my CF doctor said to try inhaled TOBI and I agreed, despite having vestibular damage from Gentamycin I.V. a few years ago.. I figured inhaling the TOBI is such a less amount actually going into the bloodstream (I tried inhaling it about 1 year ago and it did make me dizzy & ringing ears) so I started it up yesterday because there seems to be nothing else to take...

So today I called my high risk ob/gyn and she looked up inhaled TOBI, 1 vial twice a day while pregnant, and she said it is a class D drug while pregnant, which means it is known to cause problems to the baby... and it has a black label warning also, which means danger to the baby. She read to me that it can cause hearing loss in the baby, kidney damage and vision problems... so obviously I am not going to inhale it knowing it *can* harm my baby.

So now I am going to have a PICC line placed on Friday morning, and will most likely be on Aztreonam and Zosyn, which are both class B drugs.. I was on those 2 when my fiance and I conceived and my doctor said they are safe while pregnant... I was just wondering if anyone else was on these while pregnant, or just on I.V. while pregnant in general? Did it have any effect on your baby?

The 2 bacteria's they are treating me for are the MRSA & Pseudomonis..

Keepercjr · Feb 13, 2008

I just had a message written out and I somehow lost it. Anyway, I think what your doc looked up was the basic info on tobramycin. The reference I found about inhaled TOBI and pregnancy is as follows from the Merk Website :
<a target=_blank class=ftalternatingbarlinklarge href="http://www.merck.com/mmpe/lexicomp/tobramycin.html
">http://www.merck.com/mmpe/lexicomp/tobramycin.html
</a>
"Aminoglycosides, including tobramycin, cross the placenta. The manufacturers of Nebcin® and TOBI® have a labeled pregnancy category of D based on reports of bilateral congenital deafness in children whose mothers used streptomycin during pregnancy. The risk of teratogenic effects and deafness following in utero exposure to tobramycin is considered to be small and some resources consider the pregnancy risk factor to be C. The manufacturer of Tobrex® states that animal studies have not shown harm to the fetus; however, no adequate and well-controlled studies have been conducted in pregnant women."

And from what I can find about serum levels, the average serum level 1 hour after inhalation of TOBI was .86 mg/ml and .32 4 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.uniklinikum-giessen.de/pneumologie/Tobramycin%20im%20Serum.html?m=12
">http://www.uniklinikum-giessen...0im%20Serum.html?m=12
</a>
For IV tobra, the ideal serum concentration is 5.5 mg/ml 6 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.imvs.sa.gov.au/gentamicin.htm
">http://www.imvs.sa.gov.au/gentamicin.htm
</a>
So clearly a big difference in serum levels.

I know that several women on this board have used TOBI while pregnant and none of them have had babies affected (from what I know). I don't remember if I took TOBI while pregant with Logan but I very well may have. And I won't hesitate to do it this time except that I don't think I'm sensitive to tobra anymore (I'm only sensitive to 2 antibiotics, 1 of which is Cipro - so can't be used in pregnancy).

Just as an aside, something that totally bugs me is that many of the sites I looked at before writing this reply said that tobra wasn't safe for breastfeeding - totally WRONG! Tobra isn't absorbed via the digestive tract (otherwise we'd have tobra pills) so any tobra in a mother's milk isn't actually absorbed by her baby.

Anyway, I'm not telling you what to do, but if I were in your shoes and facing IVs, I'd probably do the TOBI first, especially since you are 24 weeks now and your baby is basically done developing. But of course it is only something you and your doctors can decide <img src="i/expressions/face-icon-small-smile.gif" border="0">

Keepercjr · Feb 13, 2008

I just had a message written out and I somehow lost it. Anyway, I think what your doc looked up was the basic info on tobramycin. The reference I found about inhaled TOBI and pregnancy is as follows from the Merk Website :
<a target=_blank class=ftalternatingbarlinklarge href="http://www.merck.com/mmpe/lexicomp/tobramycin.html
">http://www.merck.com/mmpe/lexicomp/tobramycin.html
</a>
"Aminoglycosides, including tobramycin, cross the placenta. The manufacturers of Nebcin® and TOBI® have a labeled pregnancy category of D based on reports of bilateral congenital deafness in children whose mothers used streptomycin during pregnancy. The risk of teratogenic effects and deafness following in utero exposure to tobramycin is considered to be small and some resources consider the pregnancy risk factor to be C. The manufacturer of Tobrex® states that animal studies have not shown harm to the fetus; however, no adequate and well-controlled studies have been conducted in pregnant women."

And from what I can find about serum levels, the average serum level 1 hour after inhalation of TOBI was .86 mg/ml and .32 4 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.uniklinikum-giessen.de/pneumologie/Tobramycin%20im%20Serum.html?m=12
">http://www.uniklinikum-giessen...0im%20Serum.html?m=12
</a>
For IV tobra, the ideal serum concentration is 5.5 mg/ml 6 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.imvs.sa.gov.au/gentamicin.htm
">http://www.imvs.sa.gov.au/gentamicin.htm
</a>
So clearly a big difference in serum levels.

I know that several women on this board have used TOBI while pregnant and none of them have had babies affected (from what I know). I don't remember if I took TOBI while pregant with Logan but I very well may have. And I won't hesitate to do it this time except that I don't think I'm sensitive to tobra anymore (I'm only sensitive to 2 antibiotics, 1 of which is Cipro - so can't be used in pregnancy).

Just as an aside, something that totally bugs me is that many of the sites I looked at before writing this reply said that tobra wasn't safe for breastfeeding - totally WRONG! Tobra isn't absorbed via the digestive tract (otherwise we'd have tobra pills) so any tobra in a mother's milk isn't actually absorbed by her baby.

Anyway, I'm not telling you what to do, but if I were in your shoes and facing IVs, I'd probably do the TOBI first, especially since you are 24 weeks now and your baby is basically done developing. But of course it is only something you and your doctors can decide <img src="i/expressions/face-icon-small-smile.gif" border="0">

Keepercjr · Feb 13, 2008

I just had a message written out and I somehow lost it. Anyway, I think what your doc looked up was the basic info on tobramycin. The reference I found about inhaled TOBI and pregnancy is as follows from the Merk Website :
<a target=_blank class=ftalternatingbarlinklarge href="http://www.merck.com/mmpe/lexicomp/tobramycin.html
">http://www.merck.com/mmpe/lexicomp/tobramycin.html
</a>
"Aminoglycosides, including tobramycin, cross the placenta. The manufacturers of Nebcin® and TOBI® have a labeled pregnancy category of D based on reports of bilateral congenital deafness in children whose mothers used streptomycin during pregnancy. The risk of teratogenic effects and deafness following in utero exposure to tobramycin is considered to be small and some resources consider the pregnancy risk factor to be C. The manufacturer of Tobrex® states that animal studies have not shown harm to the fetus; however, no adequate and well-controlled studies have been conducted in pregnant women."

And from what I can find about serum levels, the average serum level 1 hour after inhalation of TOBI was .86 mg/ml and .32 4 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.uniklinikum-giessen.de/pneumologie/Tobramycin%20im%20Serum.html?m=12
">http://www.uniklinikum-giessen...0im%20Serum.html?m=12
</a>
For IV tobra, the ideal serum concentration is 5.5 mg/ml 6 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.imvs.sa.gov.au/gentamicin.htm
">http://www.imvs.sa.gov.au/gentamicin.htm
</a>
So clearly a big difference in serum levels.

I know that several women on this board have used TOBI while pregnant and none of them have had babies affected (from what I know). I don't remember if I took TOBI while pregant with Logan but I very well may have. And I won't hesitate to do it this time except that I don't think I'm sensitive to tobra anymore (I'm only sensitive to 2 antibiotics, 1 of which is Cipro - so can't be used in pregnancy).

Just as an aside, something that totally bugs me is that many of the sites I looked at before writing this reply said that tobra wasn't safe for breastfeeding - totally WRONG! Tobra isn't absorbed via the digestive tract (otherwise we'd have tobra pills) so any tobra in a mother's milk isn't actually absorbed by her baby.

Anyway, I'm not telling you what to do, but if I were in your shoes and facing IVs, I'd probably do the TOBI first, especially since you are 24 weeks now and your baby is basically done developing. But of course it is only something you and your doctors can decide <img src="i/expressions/face-icon-small-smile.gif" border="0">

Keepercjr · Feb 13, 2008

I just had a message written out and I somehow lost it. Anyway, I think what your doc looked up was the basic info on tobramycin. The reference I found about inhaled TOBI and pregnancy is as follows from the Merk Website :
<a target=_blank class=ftalternatingbarlinklarge href="http://www.merck.com/mmpe/lexicomp/tobramycin.html
">http://www.merck.com/mmpe/lexicomp/tobramycin.html
</a>
"Aminoglycosides, including tobramycin, cross the placenta. The manufacturers of Nebcin® and TOBI® have a labeled pregnancy category of D based on reports of bilateral congenital deafness in children whose mothers used streptomycin during pregnancy. The risk of teratogenic effects and deafness following in utero exposure to tobramycin is considered to be small and some resources consider the pregnancy risk factor to be C. The manufacturer of Tobrex® states that animal studies have not shown harm to the fetus; however, no adequate and well-controlled studies have been conducted in pregnant women."

And from what I can find about serum levels, the average serum level 1 hour after inhalation of TOBI was .86 mg/ml and .32 4 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.uniklinikum-giessen.de/pneumologie/Tobramycin%20im%20Serum.html?m=12
">http://www.uniklinikum-giessen...0im%20Serum.html?m=12
</a>
For IV tobra, the ideal serum concentration is 5.5 mg/ml 6 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.imvs.sa.gov.au/gentamicin.htm
">http://www.imvs.sa.gov.au/gentamicin.htm
</a>
So clearly a big difference in serum levels.

I know that several women on this board have used TOBI while pregnant and none of them have had babies affected (from what I know). I don't remember if I took TOBI while pregant with Logan but I very well may have. And I won't hesitate to do it this time except that I don't think I'm sensitive to tobra anymore (I'm only sensitive to 2 antibiotics, 1 of which is Cipro - so can't be used in pregnancy).

Just as an aside, something that totally bugs me is that many of the sites I looked at before writing this reply said that tobra wasn't safe for breastfeeding - totally WRONG! Tobra isn't absorbed via the digestive tract (otherwise we'd have tobra pills) so any tobra in a mother's milk isn't actually absorbed by her baby.

Anyway, I'm not telling you what to do, but if I were in your shoes and facing IVs, I'd probably do the TOBI first, especially since you are 24 weeks now and your baby is basically done developing. But of course it is only something you and your doctors can decide <img src="i/expressions/face-icon-small-smile.gif" border="0">

Keepercjr · Feb 13, 2008

I just had a message written out and I somehow lost it. Anyway, I think what your doc looked up was the basic info on tobramycin. The reference I found about inhaled TOBI and pregnancy is as follows from the Merk Website :
<a target=_blank class=ftalternatingbarlinklarge href="http://www.merck.com/mmpe/lexicomp/tobramycin.html
">http://www.merck.com/mmpe/lexicomp/tobramycin.html
</a>
"Aminoglycosides, including tobramycin, cross the placenta. The manufacturers of Nebcin® and TOBI® have a labeled pregnancy category of D based on reports of bilateral congenital deafness in children whose mothers used streptomycin during pregnancy. The risk of teratogenic effects and deafness following in utero exposure to tobramycin is considered to be small and some resources consider the pregnancy risk factor to be C. The manufacturer of Tobrex® states that animal studies have not shown harm to the fetus; however, no adequate and well-controlled studies have been conducted in pregnant women."

And from what I can find about serum levels, the average serum level 1 hour after inhalation of TOBI was .86 mg/ml and .32 4 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.uniklinikum-giessen.de/pneumologie/Tobramycin%20im%20Serum.html?m=12
">http://www.uniklinikum-giessen...0im%20Serum.html?m=12
</a>
For IV tobra, the ideal serum concentration is 5.5 mg/ml 6 hours after dose. <a target=_blank class=ftalternatingbarlinklarge href="http://www.imvs.sa.gov.au/gentamicin.htm
">http://www.imvs.sa.gov.au/gentamicin.htm
</a>
So clearly a big difference in serum levels.

I know that several women on this board have used TOBI while pregnant and none of them have had babies affected (from what I know). I don't remember if I took TOBI while pregant with Logan but I very well may have. And I won't hesitate to do it this time except that I don't think I'm sensitive to tobra anymore (I'm only sensitive to 2 antibiotics, 1 of which is Cipro - so can't be used in pregnancy).

Just as an aside, something that totally bugs me is that many of the sites I looked at before writing this reply said that tobra wasn't safe for breastfeeding - totally WRONG! Tobra isn't absorbed via the digestive tract (otherwise we'd have tobra pills) so any tobra in a mother's milk isn't actually absorbed by her baby.

Anyway, I'm not telling you what to do, but if I were in your shoes and facing IVs, I'd probably do the TOBI first, especially since you are 24 weeks now and your baby is basically done developing. But of course it is only something you and your doctors can decide <img src="i/expressions/face-icon-small-smile.gif" border="0">

semperfiohana · Feb 13, 2008

you sound a bit luckier than me. my doctor told me i wasn't allowed to inhale colistin while i'm pregnant. anyways my doctor told me to try to inhale tobi while i'm pregnant, but i can't tolerate it inhaled, it gives me really bad headaches. anyways i just came off iv's a month ago, i was on fortaz and tobra. and of course the tobra can cause deafness, they have me really watch for ringing in my ears because of the deafness it can cause in the baby. i culture pa and that's what i'm senstive to. actually about a week and a half after i got off my iv's i caught a freaking cold. i've tried fighting it off, but i can't and like you said there is nothing oral we can take. so i have a clinic appt on friday to see where my pft's are and probably getting a picc too. since my doctor isn't really sure of what medicines are truely safe, she hasn't given much options, but giving me the fortaz and tobra is better than me coughing up a lung. i've been waking up at night, so thats why i opted to get in touch with her, a last resort. hope you start feeling better though!!

semperfiohana · Feb 13, 2008

you sound a bit luckier than me. my doctor told me i wasn't allowed to inhale colistin while i'm pregnant. anyways my doctor told me to try to inhale tobi while i'm pregnant, but i can't tolerate it inhaled, it gives me really bad headaches. anyways i just came off iv's a month ago, i was on fortaz and tobra. and of course the tobra can cause deafness, they have me really watch for ringing in my ears because of the deafness it can cause in the baby. i culture pa and that's what i'm senstive to. actually about a week and a half after i got off my iv's i caught a freaking cold. i've tried fighting it off, but i can't and like you said there is nothing oral we can take. so i have a clinic appt on friday to see where my pft's are and probably getting a picc too. since my doctor isn't really sure of what medicines are truely safe, she hasn't given much options, but giving me the fortaz and tobra is better than me coughing up a lung. i've been waking up at night, so thats why i opted to get in touch with her, a last resort. hope you start feeling better though!!

semperfiohana · Feb 13, 2008

you sound a bit luckier than me. my doctor told me i wasn't allowed to inhale colistin while i'm pregnant. anyways my doctor told me to try to inhale tobi while i'm pregnant, but i can't tolerate it inhaled, it gives me really bad headaches. anyways i just came off iv's a month ago, i was on fortaz and tobra. and of course the tobra can cause deafness, they have me really watch for ringing in my ears because of the deafness it can cause in the baby. i culture pa and that's what i'm senstive to. actually about a week and a half after i got off my iv's i caught a freaking cold. i've tried fighting it off, but i can't and like you said there is nothing oral we can take. so i have a clinic appt on friday to see where my pft's are and probably getting a picc too. since my doctor isn't really sure of what medicines are truely safe, she hasn't given much options, but giving me the fortaz and tobra is better than me coughing up a lung. i've been waking up at night, so thats why i opted to get in touch with her, a last resort. hope you start feeling better though!!

semperfiohana · Feb 13, 2008

you sound a bit luckier than me. my doctor told me i wasn't allowed to inhale colistin while i'm pregnant. anyways my doctor told me to try to inhale tobi while i'm pregnant, but i can't tolerate it inhaled, it gives me really bad headaches. anyways i just came off iv's a month ago, i was on fortaz and tobra. and of course the tobra can cause deafness, they have me really watch for ringing in my ears because of the deafness it can cause in the baby. i culture pa and that's what i'm senstive to. actually about a week and a half after i got off my iv's i caught a freaking cold. i've tried fighting it off, but i can't and like you said there is nothing oral we can take. so i have a clinic appt on friday to see where my pft's are and probably getting a picc too. since my doctor isn't really sure of what medicines are truely safe, she hasn't given much options, but giving me the fortaz and tobra is better than me coughing up a lung. i've been waking up at night, so thats why i opted to get in touch with her, a last resort. hope you start feeling better though!!

semperfiohana · Feb 13, 2008

you sound a bit luckier than me. my doctor told me i wasn't allowed to inhale colistin while i'm pregnant. anyways my doctor told me to try to inhale tobi while i'm pregnant, but i can't tolerate it inhaled, it gives me really bad headaches. anyways i just came off iv's a month ago, i was on fortaz and tobra. and of course the tobra can cause deafness, they have me really watch for ringing in my ears because of the deafness it can cause in the baby. i culture pa and that's what i'm senstive to. actually about a week and a half after i got off my iv's i caught a freaking cold. i've tried fighting it off, but i can't and like you said there is nothing oral we can take. so i have a clinic appt on friday to see where my pft's are and probably getting a picc too. since my doctor isn't really sure of what medicines are truely safe, she hasn't given much options, but giving me the fortaz and tobra is better than me coughing up a lung. i've been waking up at night, so thats why i opted to get in touch with her, a last resort. hope you start feeling better though!!

Keepercjr · Feb 13, 2008