Medicine During Pregnancy


 

Most medicines are safe to take during pregnancy, but a few can harm a baby. Sometimes a woman needs to take a medicine because her illness could hurt her baby so taking the medicine is safest.

How can I tell if a medicine is safe to take during pregnancy?

For many years, the US Food and Drug Administration (FDA) had a letter system for medicines used during pregnancy. Medicines were placed into one of 5 groups: A, B, C, D, or X. The letter groups were based on known effects the medicine has on a developing baby during pregnancy. The safest groups were A and B, because studies showed these medicines were safe. Medicines in the D group might be harmful to a baby but might be needed because of how serious the illness was for the woman. Medicines in the X group were medicines that should never be used in pregnancy. Unfortunately, most medicines were in the C group, which was the letter used when there were not enough studies to know if a medicine was safe or not.

As of the end of 2018, no medicines will be put in a letter group. Instead, more information about the medicine is given out with the medicine. The new system includes a lot of information, and it uses the terms “safe” or “not safe” for new medicines. Medicines that are in the A, B, C, D, or X letter system will be moved to the new system over the next several years.

What medicines are not safe during pregnancy?

There are not many medicines that are harmful if taken when you are pregnant. Some of the medicines that are not safe to use include birth control pills, the acne medicine isotretinoin (Accutane), a few of the medicines called statins that are used for high cholesterol, and the antibiotics tetracycline (Teramycin) and doxycycline (Adoxa). In addition, ergotamine (Cafregot) which is used for migraine headaches and the ulcer medicine misoprostol (Cytotec) should not be used during pregnancy. Most vaccines are safe during pregnancy.

Are there some times during pregnancy when it is more dangerous to take medicines?

Your baby develops most rapidly in the first 12 weeks of your pregnancy. This is the time when you want to avoid exposing the baby to anything that could be harmful, such as alcohol. To be safe, check with your health care provider before taking any medicine when you are pregnant, including herbs and drugstore medicines. Before conception and during early pregnancy you should take folic acid to help protect your baby from some spinal birth defects.

I’ve been taking medicines that my health care provider gave me before I got pregnant. Are they still okay to take?

Tell your health care provider what medicines you are taking if you want to get pregnant or if you might be pregnant. Most medicines that you need to take regularly are safe. But some medicines can be changed to a lower dose or a different medicine to lower the risk to your baby.

Are medicines I can buy without a prescription (over-the-counter) safe to take in pregnancy?

Check with the pharmacist or your health care provider before you take any medicines during pregnancy, even ones you can buy without a prescription.

Here are some common ailments and safe things to try:

  • Colds and Coughs
    • Get plenty of rest.
    • Drink lots of fluids.
    • Wash your hands often.
    • Gargle with warm salt water and drink honey with lemon for a sore throat.
    • Rub Vicks on your chest and throat before you go to bed at night to clear your stuffy nose.
    • Stuffy nose: Take chlorpheniramine (Chlor-Trimeton) or pseudoephedrine (Sudafed).
      • An oxymetazoline (Afrin or Vicks Sinex) or phenylephrine (like Dristan) nasal spray may work well. If you use a medicated nasal spray, stop after 3 days. Using it for a longer time may cause your stuffy nose to get worse.
    • Cough: Take guaifenesin and dextromethorphan (Robitussin DM). Choose a cough syrup with the lowest amount of alcohol.
  • Headaches
    • Drink plenty of water, at least 6 big glasses a day.
    • Get someone to massage your neck and shoulders for you.
    • Acetaminophen (Tylenol) is safe during pregnancy.
    • Don’t take ibuprofen (Motrin), naproxen (Aleve), or aspirin.
  • Yeast Infections
    • Don’t use douches.
    • If you are sure you have a yeast infection, use a vaginal yeast treatment like clotrimazole (Gyne-Lotrimin) or miconazole (Monistat).
  • Allergies
    • First, do the things listed under colds and coughs.
    • Use an antihistamine like diphenhydramine (Benadryl) or loratadine (Claritin). Some antihistamines have alcohol included so check labels and avoid these.
  • Heartburn
    • Eat 5–6 small meals per day and do not lie down right after eating. Avoid foods that are acidic, like tomatoes, and fried foods.
    • Drink or eat something soothing like milk before you lie down. Chew gum after eating.
    • If you need an antacid, take a chewable tablet that has calcium (Tums) or magnesium (Maalox).
    • Don’t take antacids that have an aspirin (Alka-Seltzer, Pepto-Bismol) or soda bicarbonate (baking soda).
  • Constipation
    • Drink plenty of fluids, at least 6 big glasses of water a day is best. Eat lots of fruit and vegetables for fiber.
    • Stool softeners like docusate sodium (Colace) and psyllium (Metamucil) are safe in pregnancy.
    • Don’t take mineral oil or senna (Senokot).
  • Diarrhea
    • Drink lots of clear liquids.
    • If you have diarrhea for more than one day, call your health care provider.
    • Bismuth subsalicylate (Kaopectate) and loperamide (Imodium) are safe in pregnancy.