INFOGRAPHICPREGNANCY

A Guide to Safe Medications During Pregnancy

By Kerry Weiss
Reviewed by Alyssa Quimby, M.D.
February 29, 2024
Safety with Medication During Pregnancy It’s important to protect your developing baby when you’re pregnant. That doesn’t always mean you have to suffer through illness or discomfort without medication. In fact, taking medication during pregnancy is common. 5.4 million pregnancies have exposure to medication each year. 90% of pregnant people take medication of some sort during pregnancy. 70% of them take at least one prescription medication while pregnant, according to the March of Dimes. Some medications are safe during pregnancy. Others have risks and are best avoided. Always talk to your doctor or midwife before taking medication. That includes prescriptions, over-the-counter (OTC) meds, vitamins, supplements, and herbal remedies. Benefits of Medications During Pregnancy If your doctor approves a medication for you, it will likely help you feel better. Many pregnant people need medication to control a health condition. Treatments that may be important to continue during pregnancy include those for: ● Asthma ● Depression ● Epilepsy ● High blood pressure Risks of Medications During Pregnancy However, some medications taken during pregnancy may increase the risk of: ● Miscarriage ● Preterm birth ● Low birth weight ● Stillbirth ● Birth defects ● Developmental disability ● Sudden infant death syndrome (SIDS) It’s important to have a conversation with your doctor about your specific medications. You can decide together whether the benefits outweigh any risks. Medications That Are Typically Safe During Pregnancy Many OTC medications are generally considered safe for use during pregnancy, including: ● Allergy medications like Benadryl (diphenhydramine), Claritin (loratadine), and Zyrtec (cetirizine) ● Antidiarrheal medications like Imodium (loperamide; after the first trimester, only for a 24-hour period) ● Cold and flu medications like Mucinex and Robitussin (guafenesin; do not use the sustained action or multisymptom formulations) and Sudafed (pseudoephedrine; after the first trimester) ● Constipation relief like Citrucel (methyl cellulose), Colace (docusate), Metamucil (psyllium), Milk of Magnesia (magnesium hydroxide), and occasional use of MiraLAX (polyethylene glycol) ● First-aid ointments like Neosporin ● Headache remedies like Tylenol (acetaminophen) ● Heartburn medications like Pepcid AC (famotidine) and Tums (calcium carbonate), and Zantac 360 (famotidine) ● Hemorrhoid medications like Preparation H (phenylephrine) and Tucks pads or ointment (witch hazel) ● Insect repellant like DEET ● Sleep aids like Unisom SleepTabs (doxylamine) ● Yeast infection medications like Monistat (miconazole nitrate) Even OTC meds should be cleared with a doctor to ensure that they’re safe for you and right for the symptoms you’re having. Medications to Avoid During Pregnancy Many prescriptions and even some OTC medications are best avoided during pregnancy because of potential risks. These include: ● Acne medications that contain isotretinoin, including Accutane, Claravis, Myorisan, and Zenatane ● The blood clotting medication warfarin (Coumadin or Jantoven) ● Certain blood pressure medications, like Capoten (captopril) and Vasotec (enalapril) ● The COVID-19 medication Lagevrio (molnupiravir) ● Some depression and mental health medications, like Paxil (paroxetine) ● Certain seizure medications, like Depakote (divalproex sodium), valproic acid, Epitol (carbamazepine), and Tegretol (carbamazepine) ● Many opioids, including Vicodin (hydrocodone), OxyContin (oxycodone), and Percocet (oxycodone) ● A prescription drug known as thalidomide, used to treat certain skin conditions, infections, cancers, and HIV-related complications ● Certain cold and flu medications, like NyQuil ● All nonsteroidal anti-inflammatory medications (NSAIDs), like Advil (ibuprofen) or Aleve (naproxen) Avoid any medication that’s used for a nonmedical reason. Already Taking Medication? Don’t stop taking any medication without talking to your provider first. Some medications can cause problems when stopped abruptly and need to be gradually reduced instead. Vitamins, Supplements, and Herbal Remedies Vitamins, supplements, and herbal remedies are not evaluated by the FDA for safety and effectiveness. Some may even contain harmful things like bacteria, chemicals, or pesticides. It’s safe (and recommended) to take a prenatal vitamin that contains folic acid during pregnancy. Ginger capsules are considered safe and may help pregnancy-related nausea and vomiting. Many other vitamins, supplements, and herbal remedies should be avoided during pregnancy. Talk to your doctor about any vitamins, supplements, or herbal remedies before taking them. Which Medications Are Safe to Take While Breastfeeding? If you nurse your baby, you’ll need to be careful about what you put into your body. Many things can pass to your baby through breast milk—including medication. In most cases, the level of medication in breast milk is so low that there’s no (or low) risk to your baby. However, some drugs can pass through at higher levels. Make sure to review any medications or supplements and discuss their safety with your provider while you’re nursing. Making Treatment Decisions During Pregnancy Pregnant people are often not included in studies on medication safety. So, the safety of most medications during pregnancy is unknown. Treatment decisions during pregnancy should be made between you and your doctor, based on your unique circumstances. Communication is key. Remember to get your doctor’s approval before starting or stopping any medication or supplement. Talk to them as soon as you can to discuss any medication you’ve been taking since before you were pregnant. Also talk to your doctor if you: ● Have any health conditions that may require medication ● Have any issues taking approved medications exactly as prescribed ● Think you might be dependent on any medication or substance ● Think you may have taken any medications or supplements before you knew you were pregnant Sources: American College of Obstetricians and Gynecologists. (Last reviewed December 2021) Tobacco, Alcohol, Drugs, and Pregnancy. Centers for Disease Control and Prevention Cleveland Clinic. (Last reviewed January 2018) Medicine Guidelines During Pregnancy. Dathe, K. & Schaefer, C. (2019) The Use of Medication in Pregnancy. Deutsches Ärzteblatt International. March of Dimes. (Last reviewed July 2022) Prescription medicine during pregnancy. Mayo Clinic Office of Research on Women’s Health. (2013) Medications and Pregnancy.

For the text version of this infographic, read on.

Safety with Medication During Pregnancy

It’s important to protect your developing baby when you’re pregnant. That doesn’t always mean you have to suffer through illness or discomfort without medication.

In fact, taking medication during pregnancy is common. 5.4 million pregnancies have exposure to medication each year.

90% of pregnant people take medication of some sort during pregnancy. 70% of them take at least one prescription medication while pregnant, according to the March of Dimes.

Some medications are safe during pregnancy. Others have risks and are best avoided.

Always talk to your doctor or midwife before taking medication. That includes prescriptions, over-the-counter (OTC) meds, vitamins, supplements, and herbal remedies.

Benefits of Medications During Pregnancy

If your doctor approves a medication for you, it will likely help you feel better.

Many pregnant people need medication to control a health condition. Treatments that may be important to continue during pregnancy include those for:

  • Asthma
  • Depression
  • Epilepsy
  • High blood pressure

Risks of Medications During Pregnancy

However, some medications taken during pregnancy may increase the risk of:

  • Miscarriage
  • Preterm birth
  • Low birth weight
  • Stillbirth
  • Birth defects
  • Developmental disability
  • Sudden infant death syndrome (SIDS)

It’s important to have a conversation with your doctor about your specific medications. You can decide together whether the benefits outweigh any risks.

Medications That Are Typically Safe During Pregnancy

Many OTC medications are generally considered safe for use during pregnancy, including:

  • Allergy medications like Benadryl (diphenhydramine), Claritin (loratadine), and Zyrtec (cetirizine)
  • Antidiarrheal medications like Imodium (loperamide; after the first trimester, only for a 24-hour period)
  • Cold and flu medications like Mucinex and Robitussin (guafenesin; do not use the sustained action or multisymptom formulations) and Sudafed (pseudoephedrine; after the first trimester)
  • Constipation relief like Citrucel (methyl cellulose), Colace (docusate), Metamucil (psyllium), Milk of Magnesia (magnesium hydroxide), and occasional use of MiraLAX (polyethylene glycol)
  • First-aid ointments like Neosporin
  • Headache remedies like Tylenol (acetaminophen)
  • Heartburn medications like Pepcid AC (famotidine) and Tums (calcium carbonate), and Zantac 360 (famotidine)
  • Hemorrhoid medications like Preparation H (phenylephrine) and Tucks pads or ointment (witch hazel)
  • Insect repellant like DEET
  • Sleep aids like Unisom SleepTabs (doxylamine)
  • Yeast infection medications like Monistat (miconazole nitrate)

Even OTC meds should be cleared with a doctor to ensure that they’re safe for you and right for the symptoms you’re having.

Medications to Avoid During Pregnancy

Many prescriptions and even some OTC medications are best avoided during pregnancy because of potential risks.

These include:

  • Acne medications that contain isotretinoin, including Accutane, Claravis, Myorisan, and Zenatane
  • The blood clotting medication warfarin (Coumadin or Jantoven)
  • Certain blood pressure medications, like Capoten (captopril) and Vasotec (enalapril)
  • The COVID-19 medication Lagevrio (molnupiravir)
  • Some depression and mental health medications, like Paxil (paroxetine)
  • Certain seizure medications, like Depakote (divalproex sodium), valproic acid, Epitol (carbamazepine), and Tegretol (carbamazepine)
  • Many opioids, including Vicodin (hydrocodone), OxyContin (oxycodone), and Percocet (oxycodone)
  • A prescription drug known as thalidomide, used to treat certain skin conditions, infections, cancers, and HIV-related complications
  • Certain cold and flu medications, like NyQuil
  • All nonsteroidal anti-inflammatory medications (NSAIDs), like Advil (ibuprofen) or Aleve (naproxen)

Avoid any medication that’s used for a nonmedical reason.

Already Taking Medication?

Don’t stop taking any medication without talking to your provider first. Some medications can cause problems when stopped abruptly and need to be gradually reduced instead.

Vitamins, Supplements, and Herbal Remedies

Vitamins, supplements, and herbal remedies are not evaluated by the FDA for safety and effectiveness. Some may even contain harmful things like bacteria, chemicals, or pesticides.

It’s safe (and recommended) to take a prenatal vitamin that contains folic acid during pregnancy. Ginger capsules are considered safe and may help pregnancy-related nausea and vomiting.

Many other vitamins, supplements, and herbal remedies should be avoided during pregnancy.

Talk to your doctor about any vitamins, supplements, or herbal remedies before taking them.

Which Medications Are Safe to Take While Breastfeeding?

If you nurse your baby, you’ll need to be careful about what you put into your body. Many things can pass to your baby through breast milk—including medication.

In most cases, the level of medication in breast milk is so low that there’s no (or low) risk to your baby. However, some drugs can pass through at higher levels.

Make sure to review any medications or supplements and discuss their safety with your provider while you’re nursing.

Making Treatment Decisions During Pregnancy

Pregnant people are often not included in studies on medication safety. So, the safety of most medications during pregnancy is unknown.

Treatment decisions during pregnancy should be made between you and your doctor, based on your unique circumstances. Communication is key. Remember to get your doctor’s approval before starting or stopping any medication or supplement.

Talk to them as soon as you can to discuss any medication you’ve been taking since before you were pregnant.

Also talk to your doctor if you:

  • Have any health conditions that may require medication
  • Have any issues taking approved medications exactly as prescribed
  • Think you might be dependent on any medication or substance
  • Think you may have taken any medications or supplements before you knew you were pregnant

Sources:

American College of Obstetricians and Gynecologists. (Last reviewed December 2021) Tobacco, Alcohol, Drugs, and Pregnancy.

Centers for Disease Control and Prevention

Cleveland Clinic. (Last reviewed January 2018) Medicine Guidelines During Pregnancy.

Dathe, K. & Schaefer, C. (2019) The Use of Medication in Pregnancy. Deutsches Ärzteblatt International.

March of Dimes. (Last reviewed July 2022) Prescription medicine during pregnancy.

Mayo Clinic

Office of Research on Women’s Health. (2013) Medications and Pregnancy.