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Should you be taking medicines while pregnant?

Unfortunately for most women, pregnancy comes with a few side effects. These can range from slightly annoying to being disruptive to your daily routine. You might have a raging headache or relentless morning sickness, and if so, you’re probably wondering what the cure is! Can you take over-the-counter medicines while pregnant?

While you should always consult a physician for any medical-related questions, we have the basics on medication during pregnancy laid out for you.

Pregnany woman talking with pharmacist
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Ranking medicine safety

Some medications are perfectly fine to take while pregnant, while others should be avoided at all costs. This is because some medicines reach your unborn child and can affect their growth or development negatively. For a majority of medications — more than 90% — there is little data on their safety during pregnancy. Those medicines that have been adequately researched are placed into a pregnancy category.

In the United States, category A is considered the safest, and is reserved for medications that have not been linked to any risk during pregnancy in controlled human trials. On the other hand, the benefits of a category X medication are outweighed by its drawbacks; these are medicines that have been shown to cause fetal abnormalities and should not be taken by anyone while pregnant.

Category D medications are also associated with some risk, but there may be some cases in which they are medically necessary. Medicines that have not been classified into a particular category due to a lack of sufficient research are marked as category N.

Over-the-counter (OTC) medications

So, it might be a given that prescription medicines are put into a pregnancy category when possible, but is the same true for over-the-counter medicines? Yes, it is. Due to the prevalence of OTC medicines, more research on their safety is available than your average prescription drug. However, a general rule is that you should not take any medication during pregnancy unless it is absolutely necessary, as nearly every drug crosses the placenta to your fetus. An exception to that rule is the daily prenatal vitamin, which is recommended for every pregnant woman.

Be very cautious of taking other medicines, though, and discuss any medicines you might want to take with your doctor ahead of time. Some medications that are perfectly fine for a non-pregnant woman can be detrimental to a baby’s growth in utero. Yet, other medicines are OK only during certain periods of your pregnancy.

OTC medications to avoid while pregnant include ibuprofen, aspirin, naproxen, and other non-steroidal anti-inflammatory drugs, as well as Pepto-Bismol and some antihistamines. These are by far the most commonly taken OTC medicines that cannot be taken while pregnant. However, this list is not exhaustive.

Prescription drugs

Similar to OTC drugs, some prescription drugs are OK to take during pregnancy while others are not. When you find out you are pregnant, you should tell your practitioner about any medications you have been prescribed. They will work with you to figure out which are safe to continue taking, and which you might have to discontinue or find an alternative for. Regardless of which drugs you are prescribed, your doctor will weigh the benefits and risks of each.

Among frequently used prescription drugs that are unsafe during pregnancy are acne medicines including oral isotretinoin and topical retinoids, thalidomide, fluconazole, tetracycline antibiotics, topiramate, and some psychiatric medications. Luckily, alternatives to many of those drugs exist.

For example, most new generation antipsychotics are thought to be safer to take during pregnancy than lithium for bipolar disorder.

Herbal supplements

In addition to your prescription medications, you should let your doctor know about any herbal supplements you take. Some of these are also unsafe to the growing fetus. Herbs that are known to negatively impact babies in utero are blue and black cohosh, ephedra, pennyroyal and large quantities of garlic, ginger, rosemary, sage, and turmeric (the amounts typically eaten are safe).

Illicit drugs

While illegal substances are harmful to you, they are even worse for a fetus. Most of them pass through the placenta and negatively affect a growing baby. This also includes alcohol, marijuana, and tobacco, which are associated with premature birth, birth defects, low birth weight, miscarriage, stillbirth, and other pregnancy-related issues.

If you abuse opiates, you should not quit them suddenly. Work with your health practitioner to switch to other drugs that will treat your addiction and are less harmful to your baby.

Obstetrician talking with a patient
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No matter the drug of concern, always ask your obstetrician/gynecologist or midwife about the safety of any medication you might take while pregnant. Do this before taking it! Keep in mind that although something might be safe for you, it’s not necessarily safe for your baby.

Meanwhile, read on further and check out healthy meals for pregnant women.

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