Effects of Medications During Pregnancy
Content
Effects of Medications during Pregnancy
We know little about the effects of taking most medications during pregnancy. This is
because pregnant women are often not included in studies to determine safety of new
medications before they come on the market. Less than 10% of medications approved by the
U.S. Food and Drug Administration (FDA) since 1980 have enough information to determine
their risk for birth defects.1
Because of studies conducted after medications come on the market, we do know that taking
certain medications during pregnancy can cause serious birth defects. Examples are
thalidomide (also known as Thalamid®) and isotretinoin (also known as Accutane®). Such
medications should be avoided by all women who are or might become pregnant. While some
medications are known to be harmful when taken during pregnancy, we don’t know the safety
or risk of most medications, including women who are not consistently using effective
contraception. The effects depend on many factors, such as:
How much medication is taken (sometimes called the dose).
When during the pregnancy the medication is taken.
Other health conditions a woman might have.
Other medications a woman takes.
The important thing to remember is to talk to your doctor. Be sure to tell your doctor about all
medications and herbal or dietary supplements you’re taking or planning to take, so you can
make sure you’re taking only what is necessary.
There may come a time during your pregnancy when you’re feeling under the weather and
aren't sure if you can take your regular over-the-counter (OTC) medication. Some
medications are safe to take during pregnancy. But others are not, or their effects on your
baby may not be known.
When you meet with your doctor to confirm you're pregnant, ask what meds are OK to take
and what meds you need to find alternatives for. Your health care provider will weigh the
risks and benefits to help you know what's safe.
Also, tell your doctor about any alternative medicines or supplements you take, even if the
label says "natural." And if you get any new prescriptions while you're pregnant, make sure
the people who prescribe them know that you're pregnant.
What Medications Are Safe to Take During Pregnancy?
Prenatal vitamins are safe and important to take when you're pregnant. Ask your health care
provider about the safety of taking other vitamins, herbal remedies, and supplements. Most
herbal preparations and supplements have not been proven to be safe during pregnancy.
Generally, you should not take any OTC medication while pregnant unless it is necessary.
The following medications and home remedies have no known harmful effects during
pregnancy when taken according to the package directions. Contact your doctor for additional
information on their safety or for medications not listed here.
Safe Medications to Take During Pregnancy*
Allergy
Benadryl (diphenhydramine)
Claritin
Check with your doctor before taking these in the first trimester.
Cold and Flu
Tylenol (acetaminophen)
Saline nasal drops or spray
Warm salt/water gargle
Check with your doctor before taking any other medications, especially in the first trimester.
Constipation
Colace
Metamucil
First Aid Ointment
Bacitracin
J&J First-Aid Cream
Neosporin
Polysporin
Rashes
Benadryl cream
Caladryl lotion or cream
Hydrocortisone cream or ointment
Oatmeal bath (Aveeno)
*Note: No drug can be considered 100% safe to use during pregnancy.
What Alternative Therapies Are Considered Safe During Pregnancy?
Some alternative therapies have been shown to be safe and effective for pregnant women to
relieve some of the uncomfortable side effects of pregnancy. Talk it over with your doctor
first before using any of them. And remember, “Natural” doesn’t always equal “safe” when
you’re pregnant.
Nausea in early pregnancy: Acupuncture, acupressure, ginger root (250 milligram capsules
4 times a day), and vitamin B6 (pyridoxine, 25 milligrams two or three times a day) work
well. Sipping the thick syrup from inside a can of peaches, pears, mixed fruits, pineapples, or
orange slices may also help.
Backache: Chiropractic manipulation holds the best track record.
Turning a breech baby: Exercise and hypnosis may help.
Pain relief in labor: Epidurals are most effective, but immersion in a warm bath can also
relieve tension. Relaxation and breathing techniques, emotional support, and self-hypnosis
are widely used in labor. Acupuncture can also work for some women.
Problem
Safe to take
Antacids for heartburn (Maalox, Mylanta, Rolaids, Tums)
Heartburn, gas and
bloating, upset stomach
Cough or cold
Simethicone for gas pains (Gas-X, Maalox Anti-Gas, Mylanta
Gas, Mylicon)
Guaifenesin, an expectorant (Hytuss, Mucinex, Naldecon
Senior EX, Robitussin)
Dextromethorphan, a cough suppressant (Benylin Adult,
Robitussin Maximum Strength Cough, Scot-Tussin DM,
Vicks 44 Cough Relief)
Guaifenesin plus dextromethorphan (Benylin Expectorant,
Robitussin DM, Vicks 44E)
Cough drops
Vicks VapoRub
Not safe to take:
Cold remedies that contain alcohol
The decongestants pseudoephedrine and phenylephrine,
which can affect blood flow to the placenta
Pain relief, headache, and
fever
Acetaminophen (Anacin Aspirin-Free, Tylenol)
Chlorpheniramine, an antihistamine (Chlor-Trimeton allergy
tablets)
Allergy relief
Loratadine, an antihistamine (Alavert, Claritin, Tavist ND,
Triaminic Allerchews)
Diphenhydramine, an antihistamine (Banophen, Benadryl,
Diphenhist, Genahist)
Psyllium (Konsyl-D, Metamucil, Modane Bulk, Perdiem)
Polycarbophil (Equalactin, Fiber-Lax, FiberNorm, KonsylFiber, Mitrolan)
Constipation,
hemorrhoids, and
diarrhea
Methylcellulose (Citrucel, Unifiber)
Other laxatives and stool softeners (Colace, Dulcolax,
Maltsupex, milk of magnesia)
Hemorrhoid creams (Anusol, Preparation H, Tucks)
Loperamide, anti-diarrhea medication (Imodium, Kaopectate
II, Maalox Anti-Diarrheal, Pepto Diarrhea Control)
Yeast infections and other
fungal infections such as
athlete's foot
Clotrimazole (Cruex, Gyne-Lotrimin 3, Lotrimin AF, Mycelex
7)
Miconazole (Desenex, Femizol-M, Micatin, Monistat 3)
Terbinafine (Lamisil AT)
Tioconazole (Monistat 1, Vagistat 1)
Butoconazole (Femstat 3, Mycelex 3)
Butenafine (Lotrimin Ultra)
Tolnaftate (Absorbine Athlete's Foot Cream, Absorbine
Footcare, Genaspor, Tinactin)
Undecylenic Acid and derivatives (Cruex, Desenex, Fungi
Cure, Tinacide)
Not safe to take:
Certain antifungal products not listed here
(Certain Cruex, Desenex, and Fungi Cure products may
contain other antifungal agents not listed here that should
not be used during pregnancy. Check labels carefully.)
Diphenhydramine (Benadryl, Maximum Strength Unisom
SleepGels, Nytol, Sominex)
Insomnia
Doxylamine succinate (Unisom Nighttime Sleep-Aid)
Itching
Hydrocortisone (Cortaid, Lanacort)
Cuts and scrapes
Polysporin
Prescription medicines
The FDA chooses a medicine's letter category based on what is known about the medicine
when used in pregnant women and animals.
Definition of medicine categories
Pregnanc
y
category
A
B
Definition
In human studies, pregnant
women used the medicine and
their babies did not have any
problems related to using the
medicine.
In humans, there are no good
studies. But in animal studies,
pregnant animals received the
medicine, and the babies did not
show any problems related to the
medicine.
Examples of drugs
Folic acid
Levothyroxine (thyroid
hormone medicine)
Some antibiotics like
amoxicillin.
Zofran (ondansetron)
for nausea
Glucophage
(metformin) for
diabetes
Some insulins used to
treat diabetes such as
regular and NPH
Or
In animal studies, pregnant
animals received the medicine,
and some babies had problems.
But in human studies, pregnant
Definition of medicine categories
Pregnanc
y
category
Definition
Examples of drugs
women used the medicine and
their babies did not have any
problems related to using the
medicine.
C
In humans, there are no good
studies. In animals, pregnant
animals treated with the medicine
had some babies with problems.
However, sometimes the
medicine may still help the
human mothers and babies more
than it might harm.
insulin.
Diflucan (fluconazole)
for yeast infections
Ventolin (albuterol) for
asthma
Zoloft (sertraline) and
Prozac (fluoxetine) for
depression
Paxil (paroxetine) for
depression
Lithium for bipolar
disorder
Dilantin (phenytoin) for
epileptic seizures
Some cancer
chemotherapy
Accutane (isotretinoin)
for cystic acne
Thalomid (thalidomide)
for a type of skin
disease
Or
No animal studies have been
done, and there are no good
studies in pregnant women.
D
X
Studies in humans and other
reports show that when pregnant
women use the medicine, some
babies are born with problems
related to the medicine. However,
in some serious situations, the
medicine may still help the
mother and the baby more than it
might harm.
Studies or reports in humans or
animals show that mothers using
the medicine during pregnancy
may have babies with problems
related to the medicine. There are
no situations where the medicine
can help the mother or baby
enough to make the risk of
Definition of medicine categories
Pregnanc
y
category
Definition
Examples of drugs
problems worth it. These
medicines should never be used
by pregnant women.
The FDA is working hard to gather more knowledge about using medicine during pregnancy.
The FDA is also trying to make medicine labels more helpful to doctors. Medicine label
information for prescription medicines is now changing, and the pregnancy part of the label
will change over the next few years. As this prescription information is updated, it is added
to an online information clearinghouse called DailyMed that gives up-to-date, free
information to consumers and health care providers.
Reference
1. Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of
medications in human pregnancy. Am J Med Genet Part C. 2011;157:175-82.
2. Peters SL, Lind JN, Humphrey JR, Friedman JM, Honein MA, Tassinari MS, Moore
CA, Mathis LL, Broussard CS. Safe lists for medications in pregnancy: inadequate
evidence base and inconsistent guidance from Web-based information, 2011.
Pharmacoepidemiol Drug Saf. 2013;22(3):324-8.
We know little about the effects of taking most medications during pregnancy. This is
because pregnant women are often not included in studies to determine safety of new
medications before they come on the market. Less than 10% of medications approved by the
U.S. Food and Drug Administration (FDA) since 1980 have enough information to determine
their risk for birth defects.1
Because of studies conducted after medications come on the market, we do know that taking
certain medications during pregnancy can cause serious birth defects. Examples are
thalidomide (also known as Thalamid®) and isotretinoin (also known as Accutane®). Such
medications should be avoided by all women who are or might become pregnant. While some
medications are known to be harmful when taken during pregnancy, we don’t know the safety
or risk of most medications, including women who are not consistently using effective
contraception. The effects depend on many factors, such as:
How much medication is taken (sometimes called the dose).
When during the pregnancy the medication is taken.
Other health conditions a woman might have.
Other medications a woman takes.
The important thing to remember is to talk to your doctor. Be sure to tell your doctor about all
medications and herbal or dietary supplements you’re taking or planning to take, so you can
make sure you’re taking only what is necessary.
There may come a time during your pregnancy when you’re feeling under the weather and
aren't sure if you can take your regular over-the-counter (OTC) medication. Some
medications are safe to take during pregnancy. But others are not, or their effects on your
baby may not be known.
When you meet with your doctor to confirm you're pregnant, ask what meds are OK to take
and what meds you need to find alternatives for. Your health care provider will weigh the
risks and benefits to help you know what's safe.
Also, tell your doctor about any alternative medicines or supplements you take, even if the
label says "natural." And if you get any new prescriptions while you're pregnant, make sure
the people who prescribe them know that you're pregnant.
What Medications Are Safe to Take During Pregnancy?
Prenatal vitamins are safe and important to take when you're pregnant. Ask your health care
provider about the safety of taking other vitamins, herbal remedies, and supplements. Most
herbal preparations and supplements have not been proven to be safe during pregnancy.
Generally, you should not take any OTC medication while pregnant unless it is necessary.
The following medications and home remedies have no known harmful effects during
pregnancy when taken according to the package directions. Contact your doctor for additional
information on their safety or for medications not listed here.
Safe Medications to Take During Pregnancy*
Allergy
Benadryl (diphenhydramine)
Claritin
Check with your doctor before taking these in the first trimester.
Cold and Flu
Tylenol (acetaminophen)
Saline nasal drops or spray
Warm salt/water gargle
Check with your doctor before taking any other medications, especially in the first trimester.
Constipation
Colace
Metamucil
First Aid Ointment
Bacitracin
J&J First-Aid Cream
Neosporin
Polysporin
Rashes
Benadryl cream
Caladryl lotion or cream
Hydrocortisone cream or ointment
Oatmeal bath (Aveeno)
*Note: No drug can be considered 100% safe to use during pregnancy.
What Alternative Therapies Are Considered Safe During Pregnancy?
Some alternative therapies have been shown to be safe and effective for pregnant women to
relieve some of the uncomfortable side effects of pregnancy. Talk it over with your doctor
first before using any of them. And remember, “Natural” doesn’t always equal “safe” when
you’re pregnant.
Nausea in early pregnancy: Acupuncture, acupressure, ginger root (250 milligram capsules
4 times a day), and vitamin B6 (pyridoxine, 25 milligrams two or three times a day) work
well. Sipping the thick syrup from inside a can of peaches, pears, mixed fruits, pineapples, or
orange slices may also help.
Backache: Chiropractic manipulation holds the best track record.
Turning a breech baby: Exercise and hypnosis may help.
Pain relief in labor: Epidurals are most effective, but immersion in a warm bath can also
relieve tension. Relaxation and breathing techniques, emotional support, and self-hypnosis
are widely used in labor. Acupuncture can also work for some women.
Problem
Safe to take
Antacids for heartburn (Maalox, Mylanta, Rolaids, Tums)
Heartburn, gas and
bloating, upset stomach
Cough or cold
Simethicone for gas pains (Gas-X, Maalox Anti-Gas, Mylanta
Gas, Mylicon)
Guaifenesin, an expectorant (Hytuss, Mucinex, Naldecon
Senior EX, Robitussin)
Dextromethorphan, a cough suppressant (Benylin Adult,
Robitussin Maximum Strength Cough, Scot-Tussin DM,
Vicks 44 Cough Relief)
Guaifenesin plus dextromethorphan (Benylin Expectorant,
Robitussin DM, Vicks 44E)
Cough drops
Vicks VapoRub
Not safe to take:
Cold remedies that contain alcohol
The decongestants pseudoephedrine and phenylephrine,
which can affect blood flow to the placenta
Pain relief, headache, and
fever
Acetaminophen (Anacin Aspirin-Free, Tylenol)
Chlorpheniramine, an antihistamine (Chlor-Trimeton allergy
tablets)
Allergy relief
Loratadine, an antihistamine (Alavert, Claritin, Tavist ND,
Triaminic Allerchews)
Diphenhydramine, an antihistamine (Banophen, Benadryl,
Diphenhist, Genahist)
Psyllium (Konsyl-D, Metamucil, Modane Bulk, Perdiem)
Polycarbophil (Equalactin, Fiber-Lax, FiberNorm, KonsylFiber, Mitrolan)
Constipation,
hemorrhoids, and
diarrhea
Methylcellulose (Citrucel, Unifiber)
Other laxatives and stool softeners (Colace, Dulcolax,
Maltsupex, milk of magnesia)
Hemorrhoid creams (Anusol, Preparation H, Tucks)
Loperamide, anti-diarrhea medication (Imodium, Kaopectate
II, Maalox Anti-Diarrheal, Pepto Diarrhea Control)
Yeast infections and other
fungal infections such as
athlete's foot
Clotrimazole (Cruex, Gyne-Lotrimin 3, Lotrimin AF, Mycelex
7)
Miconazole (Desenex, Femizol-M, Micatin, Monistat 3)
Terbinafine (Lamisil AT)
Tioconazole (Monistat 1, Vagistat 1)
Butoconazole (Femstat 3, Mycelex 3)
Butenafine (Lotrimin Ultra)
Tolnaftate (Absorbine Athlete's Foot Cream, Absorbine
Footcare, Genaspor, Tinactin)
Undecylenic Acid and derivatives (Cruex, Desenex, Fungi
Cure, Tinacide)
Not safe to take:
Certain antifungal products not listed here
(Certain Cruex, Desenex, and Fungi Cure products may
contain other antifungal agents not listed here that should
not be used during pregnancy. Check labels carefully.)
Diphenhydramine (Benadryl, Maximum Strength Unisom
SleepGels, Nytol, Sominex)
Insomnia
Doxylamine succinate (Unisom Nighttime Sleep-Aid)
Itching
Hydrocortisone (Cortaid, Lanacort)
Cuts and scrapes
Polysporin
Prescription medicines
The FDA chooses a medicine's letter category based on what is known about the medicine
when used in pregnant women and animals.
Definition of medicine categories
Pregnanc
y
category
A
B
Definition
In human studies, pregnant
women used the medicine and
their babies did not have any
problems related to using the
medicine.
In humans, there are no good
studies. But in animal studies,
pregnant animals received the
medicine, and the babies did not
show any problems related to the
medicine.
Examples of drugs
Folic acid
Levothyroxine (thyroid
hormone medicine)
Some antibiotics like
amoxicillin.
Zofran (ondansetron)
for nausea
Glucophage
(metformin) for
diabetes
Some insulins used to
treat diabetes such as
regular and NPH
Or
In animal studies, pregnant
animals received the medicine,
and some babies had problems.
But in human studies, pregnant
Definition of medicine categories
Pregnanc
y
category
Definition
Examples of drugs
women used the medicine and
their babies did not have any
problems related to using the
medicine.
C
In humans, there are no good
studies. In animals, pregnant
animals treated with the medicine
had some babies with problems.
However, sometimes the
medicine may still help the
human mothers and babies more
than it might harm.
insulin.
Diflucan (fluconazole)
for yeast infections
Ventolin (albuterol) for
asthma
Zoloft (sertraline) and
Prozac (fluoxetine) for
depression
Paxil (paroxetine) for
depression
Lithium for bipolar
disorder
Dilantin (phenytoin) for
epileptic seizures
Some cancer
chemotherapy
Accutane (isotretinoin)
for cystic acne
Thalomid (thalidomide)
for a type of skin
disease
Or
No animal studies have been
done, and there are no good
studies in pregnant women.
D
X
Studies in humans and other
reports show that when pregnant
women use the medicine, some
babies are born with problems
related to the medicine. However,
in some serious situations, the
medicine may still help the
mother and the baby more than it
might harm.
Studies or reports in humans or
animals show that mothers using
the medicine during pregnancy
may have babies with problems
related to the medicine. There are
no situations where the medicine
can help the mother or baby
enough to make the risk of
Definition of medicine categories
Pregnanc
y
category
Definition
Examples of drugs
problems worth it. These
medicines should never be used
by pregnant women.
The FDA is working hard to gather more knowledge about using medicine during pregnancy.
The FDA is also trying to make medicine labels more helpful to doctors. Medicine label
information for prescription medicines is now changing, and the pregnancy part of the label
will change over the next few years. As this prescription information is updated, it is added
to an online information clearinghouse called DailyMed that gives up-to-date, free
information to consumers and health care providers.
Reference
1. Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of
medications in human pregnancy. Am J Med Genet Part C. 2011;157:175-82.
2. Peters SL, Lind JN, Humphrey JR, Friedman JM, Honein MA, Tassinari MS, Moore
CA, Mathis LL, Broussard CS. Safe lists for medications in pregnancy: inadequate
evidence base and inconsistent guidance from Web-based information, 2011.
Pharmacoepidemiol Drug Saf. 2013;22(3):324-8.
