Clinical · Special populations · continued

Second pass at: Pregnancy and pregnancy planning: contraindication and washout posts 31–60

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This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.

appeals_deskTL3Regular22 Jan 2026#31

septum_check, post #23: Post #21 describes the usual case. This is about the unusual one. Pregnancy and planning: these compounds are not approved for use in pregnancy. Planning windows (how long to wait before attempting pregnancy) are not formally established. Conservative approaches wait several months to allow clearance. Anyone with a larger sample, please… Go to post

Building on post #30 rather than restating it.

A methods point on Pregnancy and pregnancy planning rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.

0 likes in reply to #23 6mo

a.kirchnerTL222 Jan 2026#32

appeals_desk, post #31: Building on post #30 rather than restating it. A methods point on Pregnancy and pregnancy planning rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method. Go to post

Body weight at the extremes of the studied range affects exposure and the trials rarely reported enough to say by how much.

That is the shape of it. The detail is where I would expect to be corrected.

5 likes in reply to #31 6mo

preregisteredTL3Research methods22 Jan 2026#33

Nothing in this subcategory is medical advice and the questions asked here are precisely the ones that need an individual assessment.

The general case is well covered; this is the awkward specific one.

14 likes 6mo

y.rahimiTL222 Jan 2026#34

Agreed on Pregnancy and pregnancy planning, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.

29 likes 6mo

retention_indexTL2Analytical chemist22 Jan 2026#35

e.coelho, post #30: Pregnancy and pregnancy planning: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know which. Go to post

Taking post #32 at face value and following it one step further.

Taking Pregnancy and pregnancy planning seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.

0 likes in reply to #30 6mo

j.vogelTL222 Jan 2026#36

Extrapolating a point estimate to somebody well outside the enrolled range should be described as an extrapolation every time it is done.

I have written this out at length because the short version keeps being misread.

2 likes 6mo

chromatogramTL4Analytical chemist22 Jan 2026 · edited#37

Pregnancy and pregnancy planning is well covered in the tag pages, and the older discussions are better than the recent ones because they were argued out properly. Worth twenty minutes before adding to this one.

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m.adeyemiTL222 Jan 2026#38

The reason Pregnancy and pregnancy planning keeps being re-asked is that the answer is conditional and people quote it without the condition. It is not that the answer is unknown.

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j.mwangiTL4 Moderator23 Jan 2026#39

Pregnancy and breastfeeding are the clearest cases where the answer is that the trials excluded them and the labelling reflects that exclusion.

I would treat that as a working assumption and revisit it.

5 likes 6mo

e.kuuselaTL223 Jan 2026#40

m.restrepo, post #8: Confirming post #5 from a second method, which matters more than confirming it from a second person. Having read the whole Pregnancy and pregnancy planning thread before replying: the question in the first post has not actually been answered yet, and three of us have answered a nearby one instead. Go to post

I had written a reply contradicting post #38 and deleted it. Here is what survived.

Reading back through the Pregnancy and pregnancy planning threads from last year, the same three questions come up every time and only one of them has ever been answered properly. That seems like a documentation gap rather than a knowledge gap.

13 likes in reply to #8 6mo

l.vukovicTL223 Jan 2026#41

Collapsed as off-topic by two members at trust level 3 or above

Genetic and ancestry-related differences in response are asked about regularly and the published evidence is thin enough that the honest answer is short.

weekly_pinTL2Regular23 Jan 2026#42

b.teixeira, post #1: Second pass at: Pregnancy and pregnancy planning: contraindication and washout Writing it up because I had to work it out twice and would rather nobody else did. Something about Pregnancy and pregnancy planning does not reconcile and I would like a second pair of eyes before I decide which half is wrong. Two sources, both reputable,… Go to post

Useful. I had the fact and not the reason, which turns out to be the important half.

0 likes in reply to #1 6mo

s.adebayoTL223 Jan 2026#43

Worth separating two things that post #39 runs together.

Pregnancy and planning: these compounds are not approved for use in pregnancy. Planning windows (how long to wait before attempting pregnancy) are not formally established. Conservative approaches wait several months to allow clearance.

I have separated what I observed from what I concluded, which does not always happen.

20 likes 6mo

formulary_notesTL3Regular23 Jan 2026#44

This follows post #43 rather than contradicting it.

Reading this Pregnancy and pregnancy planning thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.

8 likes 6mo

h.lindqvistTL223 Jan 2026#45

I read post #43 twice before replying, because I had assumed the opposite.

The number people quote for Pregnancy and pregnancy planning is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

0 likes 6mo

TL4_HalvorsenTL4Leader · Journal club23 Jan 2026#46

weekly_pin, post #42: Useful. I had the fact and not the reason, which turns out to be the important half. Go to post

Medullary thyroid carcinoma history: an absolute contraindication because of the preclinical findings in rodent toxicology. The history (personal or family, especially multiple endocrine neoplasia type 2) is an important screening question.

0 likes in reply to #42 6mo

r.ekstromTL223 Jan 2026 · edited#47

a.kirchner, post #32: Body weight at the extremes of the studied range affects exposure and the trials rarely reported enough to say by how much. That is the shape of it. The detail is where I would expect to be corrected. Go to post

Filing a mild objection to the consensus on Pregnancy and pregnancy planning. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.

14 likes in reply to #32 6mo

endo_fellow_rkTL3Endocrinology fellow23 Jan 2026#48

Taking post #47 at face value and following it one step further.

What I would check first on Pregnancy and pregnancy planning is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.

5 likes 6mo

f.piresTL223 Jan 2026#49

Noted, and I have changed what I was going to do on the strength of it.

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NicolaidesTL3Regular23 Jan 2026#50

Narrowing post #47, because the general version has more than one answer.

Being outside the studied population does not mean a treatment is unsafe. It means the usual evidence is not available and the reasoning has to be explicit.

Posted with less confidence than the sentence structure implies.

28 likes 6mo

m.lehtinenTL223 Jan 2026#51

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c.cardosoTL223 Jan 2026 · edited#52

This settles it for me, at least until somebody posts a reason it should not.

24 likes in reply to #31 6mo

f.sjobergTL223 Jan 2026#53

s.adebayo, post #43: Worth separating two things that post #39 runs together. Pregnancy and planning: these compounds are not approved for use in pregnancy. Planning windows (how long to wait before attempting pregnancy) are not formally established. Conservative approaches wait several months to allow clearance. I have separated what I observed from what I… Go to post

Pregnancy and pregnancy planning came up in a thread eighteen months ago and was answered well. I cannot find it, which is itself the problem, so here is the reconstruction.

0 likes in reply to #43 6mo

dr_okonkwoTL4 Moderator23 Jan 2026#54

A note on how Pregnancy and pregnancy planning gets discussed rather than on Pregnancy and pregnancy planning itself: the confident posts get the replies and the careful ones get ignored, and the careful ones have been right more often.

3 likes 6mo

m.lindqvistTL223 Jan 2026#55

Post-surgical populations, particularly after procedures affecting the gastrointestinal tract, interact with a delayed-emptying mechanism in ways that need specialist input.

The step people skip is the one I have spelled out.

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r.restrepoTL224 Jan 2026#56

n.szabo, post #28: Marking my place. If it changes for me I will come back and say so. Go to post

Post #53 and I disagree about the size of the effect, not about the direction.

On Pregnancy and pregnancy planning I would separate what is worth knowing from what is worth acting on. The first list is long and the second is short, and conflating them is how threads get heated.

33 likes in reply to #28 6mo

c.lundgrenTL224 Jan 2026#57

Post #54 answers the question as asked. The question underneath it is different.

Reporting rather than recommending, on Pregnancy and pregnancy planning. What happened is above. Whether it should have is a different question and not one I am qualified to answer.

1 like 6mo

n.nybergTL224 Jan 2026#58

Dedicated trials in under-studied populations are the only real remedy and several are ongoing, which is worth saying rather than speculating.

That much is documented. The rest is how I have interpreted it.

7 likes 6mo

i.almeidaTL224 Jan 2026#59

y.rahimi, post #34: Agreed on Pregnancy and pregnancy planning, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states. Go to post

Seconded. It reads as careful rather than confident, which is the right register.

23 likes in reply to #34 6mo

dr_seongTL3Physician24 Jan 2026#60

endo_fellow_rk, post #48: Taking post #47 at face value and following it one step further. What I would check first on Pregnancy and pregnancy planning is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph. Go to post

Offering a way to settle Pregnancy and pregnancy planning rather than another opinion about it. Two measurements, taken the same way, a fortnight apart. If the difference is within the noise, the question was not answerable at this precision.

0 likes in reply to #48 6mo