Pain Medications

Acetaminophen, or Tylenol®, is the gold standard for pain relief (and also some flu symptoms) for pregnant individuals. It’s widely recommended for those experiencing mild to moderate pain, like headaches or backaches, as well as fever.

Meanwhile, pain relief medications to nix while pregnant include:

• Aspirin – Aspirin can increase the risk of bleeding complications for both you and your developing baby.
• Ibuprofen (Advil®, Motrin®) – Ibuprofen, a type of NSAID, has been linked to fetal kidney and heart issues when taken in the later stages of pregnancy.
• Naproxen (Aleve®) – Risks with naproxen are similar to ibuprofen, especially when taken after 20 weeks.

Allergy Medications

The American College of Obstetricians and Gynecologists (ACOG) recommends two main antihistamines to combat allergies:

• Chlorpheniramine
• Dexchlorpheniramine

Several other pregnancy safe medicines may also be used, depending on your healthcare provider’s recommendation. These include:

• Allegra® (Fexofenadine) – A non-drowsy option which many providers consider safe.
• Claritin® (Loratadine) – Another non-drowsy option; just be sure to confirm with your healthcare provider before using it.
• Benadryl® (Diphenydramine) – Safe when used occasionally, according to your provider’s recommendation.
• Zyrtec® (Cetrizine) – An antihistamine that’s typically safe, but it’s recommended you consult with your provider.
• Flonase® (Fluticasone) – Nasal steroid spray used as an anti-congestive, though it’s best to check with your provider first.
• Sudafed® (Pseudoephedrine) – Another option for relieving nasal congestion. However, it shouldn’t be used during the first trimester (the first 12 weeks of pregnancy); it’s best to consult with your provider thereafter.

Cold and Flu Medications

Catching a cold during pregnancy can feel especially challenging. Fortunately, the following remedies are considered relatively safe:

• Mucinex® (Guaifenesin) – For breaking up congestion, typically considered safe in the first trimester.
• Robitussin® (Dextromethorphan) – For suppressing coughing, and generally safe when taken in moderation.
• Vitamin B6 – Often recommended for NVP (nausea and vomiting during pregnancy), otherwise known as morning sickness. The typical protocol is 25 mg three times per day, though it’s important to get your healthcare provider’s dosage recommendations.

Digestive Aids and Supplements

One of the most common symptoms of pregnancy? Major digestive changes. These medications are usually safe to use for digestive issues during pregnancy:

• Miralax® (Polyethylene glycol) – A gentle laxative to relieve constipation.
• Colace® (Docusate sodium) – A stool softener that’s fairly safe for regular use.
• Fiber – Well-known brands like Metamucil® are excellent options for using fiber to help regulate digestion.
• Tums®, Mylanta®, or Maalox®) – These antacids help alleviate heartburn; some also provide calcium, a crucial nutrient throughout pregnancy.
• Mylicon® or Gas-X® (Simethicone) – Helps relieve gas buildup safely.
• Pepcid® (Famotidine) – A safe option for longer-lasting heartburn relief.

Other Safe Medications

The following types of medications are also considered safe to use during pregnancy:

• Thyroid medication – Levothyroxine, prescribed for people living with hypothyroidism, is considered safe to use during pregnancy if you take it.
• Insulin – If you have diabetes, it’s safe and crucial to keep taking insulin during pregnancy. Be sure to discuss any pregnancy-related changes to your doctor’s nutrition and exercise treatment protocol.
• Certain antibiotics – Penicillin, cephalosporins, and amoxicillin are generally considered safe to take as prescribed during pregnancy. Other antibiotics can harm fetuses or cause pregnancy loss, so be sure to let your prescribing physician know you’re pregnant.

Psychiatric Medication During Pregnancy: A Discussion

Mental health is just as important as physical health when you’re pregnant. For people who rely on psychiatric prescription medications, decisions about whether to continue, adjust, or halt treatment during pregnancy can feel overwhelming.

Research on the safety of psychiatric drugs is still emerging, and findings sometimes conflict. Even so, it helps to have a sense of the most current findings on the following medication types:

• SSRIs (selective serotonin reuptake inhibitors) – SSRIs are the most commonly prescribed antidepressants. According to the ACOG, “Robust evidence has shown that SSRIs are safe in pregnancy and that most do not increase the risk of birth defects.” Still, other studies suggest potential risks. As such, it’s best to discuss your regimen with your doctor to determine the best course of action for you.
• SNRIs (serotonin-norepinephrine reuptake inhibitors) – While more research is needed, most evidence suggests no definitive link between SNRIs and major birth defects. Most providers clear SNRIs if their benefits outweigh their potential harms.
• Bupropion – Wellbutrin®, Aplenzin®, and Forfivo® are used to treat depression, nicotine cessation, and other mental health conditions. Generally, research suggests a low risk to pregnancy; other studies have addressed possible connections to heart defects or pregnancy loss. Like SSRIs and SNRIs, bupropion is only recommended if its benefits outweigh the risks.
• Bipolar medications – Treating bipolar disorder in pregnant patients is a challenge for individuals and psychiatrists alike. Lithium carries a small risk of cardiac defects, though many people safely use it with careful monitoring. Lamotrigine may also be a safe option if monitored closely. Valproate and carbamazepine are resolutely discouraged for patients with bipolar disorder, as both have been linked to significant birth defects and developmental issues.
• Benzodiazepines – These are usually prescribed to treat anxiety, though their use is typically discouraged during pregnancy.

As mentioned, it’s crucial to consult with your care team if you’re used to taking psychiatric prescription medication. In most cases, keeping up with your treatment plan is recommended, but ultimately, these choices should be made in close consultation with your care team.

Medications to Avoid During Pregnancy, and Why

Some medications are inadvisable to take while you’re pregnant. The shortlist includes:

• ACE inhibitors and ARBs (blood pressure medication) – These can adversely affect fetal kidney development.
• Isotretinoin (Accutane®) – Isotretinoin and other oral retinoids are frequently used to treat acne. They are also strongly linked to major birth defects, miscarriage, and preterm labor, making it important to avoid them altogether during pregnancy. You should also be aware of other common skincare ingredients to avoid while pregnant when building your daily regimen.
• Warfarin – A blood thinner suspected to contribute to fetal bleeding and developmental defects.
• NSAIDs and high-dose aspirin – These are linked with both maternal and fetal health complications.
• Methotrexate – Used to treat autoimmune disorders, this medication is teratogenic, meaning it causes birth defects.
• Anti-seizure medications – Anti-seizure medications like valproic acid, phenobarbital, carbamazepine, and topiramate should generally be avoided during pregnancy unless the benefits of taking these medications outweigh the risks or you’re having seizures during pregnancy.

5 Safety Guidelines for Taking Medicine While Pregnant

It’s important to note that the “medications you can take while pregnant” list doesn’t paint the full picture: even if a medicine is generally approved, it’s best to review and run your roster by your care team. They can help you decide how to navigate your regimen while maintaining a healthy pregnancy.

Some other safety guidelines to remember include:

1. Using the lowest effective dose – High dosages can be risky, and taking medication longer than advised can cause drugs to build up in your system. Whenever possible, take the lowest effective dose for the shortest time recommended by your physician.
2. Reducing medication use in the first trimester – The first trimester is a tender time when your baby’s organs are just beginning to develop. As such, it’s best to limit your medication use to the essentials.
3. Checking your labels carefully – Many medications, like cold and flu formulas, combine multiple drugs. Always vet your labels to make sure you’re taking what you think.
4. Checking herbal supplements – Herbal supplements can be powerful, and they aren’t regulated by the FDA. For now, it’s best to treat your herbal supplements just like your meds, and get your doctor’s input on the ones you’re taking. Additionally, if you’re interested in using other natural remedies, like pregnancy safe teas, be sure to research and discuss them with your care team.
5. Considering medication interactions – Medications interact. As early as you can, be sure to show your provider a complete list of the ones you regularly take so you can avoid any potential for adverse interactions.

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