Q: What medications are safe?

Posted Monday, September 17, 2007 5:56 PM

Q: What over-the-counter medications can I take safely in pregnancy?

Dr. Ashley Roman: Many over-the-counter medications are safe during pregnancy, but there are a few surprising drugs that can lead to problems for your fetus. In general, always speak with your doctor prior to taking any medication (prescription, over-the-counter, or herbal). Also, keep in mind that certain vague symptoms you wouldn’t think twice about in normal times (a headache, for example) can actually indicate serious pregnancy-related complications. And, before taking any over-the-counter medication, think about what other medications you are taking. Even medications that are considered safe in pregnancy can become dangerous when they interact with others.

Here are some common pregnancy problems, along with a quick summary of related meds that are probably safe... and ones that probably aren't.

Aches and pains: Acetaminophen (Tylenol) appears to be safe during pregnancy for treating general aches, pains and headache. Medications in the NSAIDS (non-steroidal anti-inflammatory drugs) class, including ibuprofen (Advil and Motrin) and naproxen (Aleve) may be associated with congenital heart defects, specifically septal defects, when taken during the first trimester.  NSAIDS have also been linked to other heart abnormalities and low amniotic fluid levels when used in the third trimester. 

Congestion and allergy symptoms: Antihistamines such as diphenhydramine (Benadryl) and loratidine (Claritin) appear to be safe during pregnancy.  Pseudoephedrine (Sudafed) may be associated with birth defects involving the abdominal wall. Also, decongestants (such as phenylephrine) may affect blood flow to the placenta, and should generally be avoided throughout your pregnancy.

Cough: Two major cough medication ingredients -- dextromethorphan (a cough suppressant) and guaifenesin (an expectorant, which means it loosens up thick mucus) -- both appear to be safe during pregnancy, although both have been tested in relatively few studies. 

Constipation: Both Metamucil and stool softeners like Colace appear to be safe in pregnancy. Laxatives, mineral oils and rectal suppositories may stimulate labor, so should only be used after speaking with your doctor.

Heartburn: Antacids such as Tums and Mylanta appear to be safe in pregnancy, and for most women, they significantly improve heartburn symptoms. If antacids aren't enough, famotidine (Pepcid) and ranitidine (Zantac) do not appear to be associated with any pregnancy complications.

All this said, there are situations where the potential benefit of taking a medication outweighs any potential risk to the fetus. The most important piece of advice regarding medication -- talk with your doctor! Be honest about your questions, concerns and medical history, and you should be just fine.