Science to Practice
Latest highlights on drug safety and efficacy

1.7.2025

In the treatment of asthma during pregnancy, the primary focus should be on effective asthma control, as poorly controlled asthma poses a greater risk to pregnancy than most asthma medications, especially inhaled medications used at normal doses.

Based on available clinical data and animal studies, inhaled beta-sympathomimetics do not cause malformations nor have toxic effects on the foetus or newborn. The use of systemic beta-sympathomimetics during pregnancy may cause transient tachycardia in both the foetus and the mother, but this is considered harmless. Decreases in blood pressure and transient hyperglycaemia have also been reported. Use of beta-sympathomimetics in late pregnancy may reduce uterine contractions and prolong labour. There are rarely clinical indications for systemic use of asthma medications during pregnancy, however (1).

Maintaining asthma control during pregnancy is essential for maternal and foetal wellbeing. Inhaled beta-sympathomimetics are considered safe and should not be discontinued unnecessarily.

Of these drugs, most human pregnancy data is gathered from exposures to salmeterol and formoterol, while for indacaterol and vilanterol there are no published human exposure data available so far. However, maternal and foetal risks related to uncontrolled asthma during pregnancy outweigh any theoretical harm associated with any of these drugs.

To avoid inappropriate pausing or tapering of effective asthma medications due to unjustified concerns related to pregnancy, we have updated and harmonised the Gravbase recommendation texts and classifications for the inhaled beta-sympathomimetics formoterol, salmeterol, indacaterol and vilanterol. Please see the detailed and referenced background information from our Knowledgebase -documents. Any feedback is welcomed as well as an integral part of improving our products.

For more comprehensive information, explore Gravbase and Lactbase, our specialised databases providing detailed insights on drug safety and efficacy during pregnancy and lactation.

News produced by Medbase Medical Team

References

1. Jones CE, Jamil Y. Management of asthma in pregnancy. Clin Med (Lond). 2025 Jan;25(1):100277. doi: 10.1016/j.clinme.2024.100277. Epub 2024 Dec 17. PMID: 39701495; PMCID: PMC11773012.