Which Medications Are Safe During Pregnancy?

Wondering which medications are safe for pregnant people? From painkillers like Advil and Tylenol to tummy-soothers like Tums and Pepto, here’s your medication safety cheat sheet for pregnancy.

Pills and capsules
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Illnesses, injuries, and good old aches and pains don't go away just because you're pregnant; in fact, they may even intensify. But your unpleasant symptoms may not be your only concern; many expectant parents worry about treating their symptoms—specifically about what medications are safe to take during pregnancy.

"One of the biggest things my pregnant patients are afraid of is ingesting something that may cause birth defects or negatively impact their baby's development," says Alane Park, M.D., mother of two sons and co-author of The Mommy Docs' Ultimate Guide To Pregnancy and Birth. "The truth is that most medications are actually OK, and while you want to minimize drug use as much as possible, the consequences of not taking a medication usually outweigh any potential risk."

To get relief and feel more at ease throughout your pregnancy, check out Dr. Park's recommendations for medications that are safe during pregnancy.

Pain Relievers That Are Safe During Pregnancy

Speaking of pregnancy aches and pains, it's important to know which painkillers are safe during pregnancy before treating your symptoms.

If non-drug options rest and cold compresses aren't doing the trick and you need a painkiller, your doctor may recommend acetaminophen, the active ingredient in Tylenol and one of the most commonly recommended over-the-counter pain relievers during pregnancy.

Though generally considered safe for use during pregnancy, multiple studies suggest that acetaminophen does have negative impacts on childhood development such as sleep and attention problems, but more research needs to be done.

Remember to talk to your doctor before taking any pain reliever, even over-the-counter options like aspirin or ibuprofen. Medications in the NSAID class, such as Motrin and Advil (brand names for ibuprofen), are often avoided in pregnancy due to the risks of decreasing in amniotic fluid levels in third trimester (which means less cushioning for baby and more pressure on its lifeline, the umbilical cord), says Dr. Park. Advil may also make a certain vessel in the baby's heart close prematurely and cause developmental issues in later stages of pregnancy.

Constipation Medications That Are Safe During Pregnancy

For pregnancy constipation, your doctor might give the green light for certain medications, like stool softeners and non-stimulant laxatives like Miralax (Polyethylene glycol) and Metamucil (psyllium fiber), or some over-the-counter magnesium. Also, try upping your fiber intake by eating more fruits and veggies and drinking plenty of fluids. Exercise, with your doctor's approval, can also help to keep constipation at bay.

If you're feeling a little plugged up, blame it on a surge in the hormone progesterone that slows down your smooth muscle cells so your bowel movements aren't as regular. (Or blame it on your growing uterus for pushing on your intestines).

Indigestion and Heartburn Medicines That Are Safe During Pregnancy

For pregnancy heartburn relief, you can start with Tums (calcium carbonate). But if reflux is significant, you might benefit from medications like Prilosec (omeprazole); talk to your doctor for more safety information.

Progesterone is the culprit again, causing heartburn by affecting your smooth muscle cells and relaxing the sphincter between your stomach and esophagus so acid comes up. (And your growing uterus is also pushing on your stomach to add to the heartburn.)

You also can (and should) eat smaller and more frequent meals, stop noshing two to three hours before you hit the sack, and steer clear of rich, fried, or spicy foods, which often trigger stomach irritation. Sleeping on an incline can also prevent the contents of your stomach from splashing into your esophagus, causing heartburn.

Medications for Infections That Are Safe During Pregnancy

If you have an infection, such as a UTI that calls for antibiotics, it is likely safe to take some of these types of medications during pregnancy. Your doctor might prescribe Macrobid (nitrofurantoin), Keflex (cefalexin), or amoxicillin.

"There have never been any birth defects associated with the penicillin family or any other issues," says Dr. Park. However, the tetracycline and doxycycline families of antibiotics have been found to cause discoloration in babies' teeth after the fourth month of pregnancy, because these meds affect the calcification—or the hardening—of their pearly whites. "It's purely a cosmetic thing, but best to avoid those types of antibiotics," says Dr. Park. Certain types of prescription medications might also cause birth defects.

At the end of the day, if your doctor prescribes any medications while pregnant, rest assured that the drug probably poses far fewer risks than the effects of an untreated illness or infection.

Medications for Yeast Infections That Are Safe During Pregnancy

If you have a yeast infection during pregnancy, it is likely safe to take antifungal medications under the guidance of a health care provider. "There is some absorption of vaginal creams into the body and bloodstream, but doses are low, and no studies show any effect on baby," says Dr. Park.

She adds that some doctors don't prescribe the oral pill Diflucan or fluconazole because observational studies show that parents who have had to take extended doses for chronic fungal infections have had babies with birth defects. (Note that birth defects are only associated with "long-term, high-dose" use, according to the Food and Drug Administration). However, it's safe to take this oral yeast infection medication when breastfeeding, especially if you get the fungal infection known as thrush from your baby.

Yeast infections are common during pregnancy, and while the condition won't harm the baby, the last thing you want to do is suffer through the itchy discomfort.

Cold Medicines That Are Safe During Pregnancy

If cold or allergy symptoms interfere with your ability to eat or sleep, it's normal to wonder, "what medicine can I take while pregnant?" But according to Dr. Park, "Pretty much all of the over-the-counter meds for the common cold are thought to be safe."

Benadryl (diphenhydramine), Sudafed (pseudoephedrine), Mucinex (guaifenesin) Robitussin (dextromethorphan), Vicks VapoRub (camphor/eucalyptus oil/menthol), and Halls cough drops (menthol) are all OK. But, the safest way to treat them is via non-drug remedies: Rest, drink lots of fluids—especially warm ones—and use a saline nasal spray to help relieve stuffiness.

One thing to keep in mind is that there are a lot of combination meds, such as Tylenol Cold, that treat multiple symptoms, such as a runny nose and cough, and fever. But if the only cold symptoms you have are a headache and stuffy nose, why would you take a medication that also treats a cough? "Rather than taking meds you don't actually need, target only the symptoms you want to treat by buying drugs for each of your specific concerns," says Dr. Park.

Medications for Flu That Are Safe During Pregnancy

The flu vaccine and the antiviral medication Tamiflu (oseltamivir) are safe during pregnancy. Since your immune system isn't as strong when you're pregnant, the flu can hit you a whole lot harder—and even lead to pneumonia or death in extreme cases. That's why it's so important to get the flu vaccine.

However, if you've been exposed to and/or tested positive for the flu, doctors say it's important to take Tamiflu to lessen the symptoms and duration (it may be taken within five days of symptom onset). "Tamiflu is thought to be safe for pregnant people, and the risks of skipping it are far greater than taking the meds," says Dr. Park. "That's because the baby's temperature is always going to be a degree higher than yours, so if you have a high fever it may cause birth defects during early development stages and pre-term labor during later stages of pregnancy."

Medicines for Pre-Existing Conditions That Are Safe in Pregnancy

If you take medication for preexisting health conditions, it's important to discuss whether they are safe during pregnancy—many are safe but some are not. Some medications, like the antihypertensive lisinopril and the mood stabilizer Depakote (sodium valproate), have known safety risks in pregnancy and will need to be switched out for safer alternatives.

Ideally, discussion of which medications to continue during pregnancy would happen during a preconception consultation with your OB-GYN or specialist. In general, it causes more harm than good to suddenly stop a medication during pregnancy, so discuss with your doctor before making any medication changes.

The goal is always to give the minimum dosage necessary to keep your symptoms under control, because there may be greater risks if you're affected by say, asthma or seizures, than by the effects of taking those meds on the baby.

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