Handling medicines and pregnancy – who is at risk?
Handling medicines in veterinary practice - keeping staff and clients safe
Why keeping up to date on medicines is essential
Keeping up to date on new medicines, and with changes to existing medicines, includes being aware of new or changing risks for people who handle the products, whether they are veterinary professionals or clients.
In the product literature for two of the newest products – Librela (bedinvetmab) for dogs and Solensia (frunevetmab) for cats – there is advice for pregnant women to take extreme care to avoid accidental self-injection; these two monoclonal antibodies block nerve growth factor, a protein involved in embryogenesis and nervous system development. And for an older product – Laurabolin (nandrolone) for cats and dogs – advice has recently been added to say that pregnant women should not administer the product; nandrolone a testosterone derivative could cause virilisation of a fetus.
The people who need to be aware of this advice are women who handle veterinary medicines at work and vets who prescribe medicines for administration by clients. Employers of people who handle veterinary medicines also need to be aware in order to comply with COSHH Regulations, so they can assess the risks of medicines (which can be done using the information in the SPCs), decide what precautions are needed, prevent or adequately control exposure, and ensure employees are properly informed and trained.
SPC wording on pregnancy risk is too narrow
However the wording in veterinary medicine SPCs aimed at protecting pregnant women is too restricted and could mean that some women who are at risk are not recognised as being so. In the case of the three products already mentioned, the SPCs state:
for Librela and Solensia “ Pregnant women, women trying to conceive, and breastfeeding women should take extreme care to avoid accidental self-injection” and Laurabolin “should not be administered by pregnant women or women trying to conceive”.
There are two reasons why the scope of these warnings is too narrow:
First, a high proportion of pregnancies are not planned: according to the latest government figures for England, 45% of pregnancies are unplanned (Gov.uk 2018)
Second, a woman may be unaware that she is pregnant for several weeks after conception: the first sign of pregnancy is usually the first missed period, which is about 2 weeks after conception.
Think of all women of child-bearing potential
If women, prescribers and employers only think of women as being at risk if they are known to be pregnant or are trying to conceive, a lot of women might potentially be left at risk. The potential for drugs to harm a fetus must be considered in all women of child-bearing potential. This means that people who make risk management decisions and women themselves must have in mind that a women who is at risk is any woman who is, or potentially could be, pregnant.
Andrea Tarr, Founder and Director, Veterinary Prescriber
References
Gov.uk. (2018). Health matters: reproductive health and pregnancy planning.
SPCs for Laurabolin, Librela and Solensia
Veterinary Prescriber CPD module. Handling veterinary medicines and pregnancy.
Veterinary Prescriber Medicines News September 2021
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