OTC Medicines and Pregnancy

What should women who are trying to get pregnant, are pregnant or are breastfeeding know about OTC drugs?

Conception occurs about 2 weeks before your period is due. That means you may not even realize you’re pregnant until you’re more than 3 weeks along. Your baby is most vulnerable 2 to 8 weeks after conception. This is when your baby’s facial features and organs (such as the heart and kidneys) begin to form. Any medicine you take (or anything you eat, drink, smoke or are exposed to) can affect your baby. That’s why it’s best to start acting as if you’re pregnant before you actually become pregnant.

If you need to take medicine regularly because of a health problem or conditions, talk with your doctor about your treatment before you try to get pregnant. There may be other ways to treat your condition during pregnancy rather than taking medicine. The following are some general steps that can help minimize the risk of side effects during pregnancy and breastfeeding.

Folic acid alert

Women who don’t get enough folic acid during pregnancy are more likely to have a baby who has serious problems of the brain or spinal cord. These problems can occur very early in pregnancy, which is why it’s important to get enough folic acid even when you’re just trying to get pregnant. The recommended amount is 0.4 mg a day. Sources include fortified cereals, dark green leafy vegetables, oranges, bananas, milk, dry beans, grains and organ meats (such as chicken livers). Your doctor also may suggest that you take a vitamin that contains folic acid.

If you're pregnant or trying to get pregnant

The following are some basic guidelines for taking medicine when you’re pregnant:

Many OTC medicines have not been well studied for safety in pregnant mothers. Always talk with your doctor before taking any OTC medicine, vitamin or supplement
Avoid using medicines during your first trimester. This is when the risk to your baby is highest.
Acetaminophen (brand name: Tylenol) is generally considered safe for short-term pain relief.
Avoid using aspirin. It can cause birth defects, low birth weight or problems during delivery.
Avoid using other NSAIDs (non-steroidal anti-inflammatory drugs), especially during the third trimester. They can cause heart defects in your baby. NSAIDs include ibuprofen (brand names: Advil, Motrin) and naproxen (brand name: Aleve).
Do not take OTC medicines for cough, congestion, diarrhea, constipation or nausea without talking to your family doctor first.
Avoid the use of extra-strength, maximum-strength or long-acting medicines.
Avoid combination medicines that treat many different symptoms at once. If your doctor says it’s safe, use one medicine to treat one symptom. For example, you might use acetaminophen for a headache. But don’t use acetaminophen combined with other active ingredients like decongestants or antihistamines. This will help you minimize the number of medicines your baby is exposed to.

Drug Recall Information

View information on recent drug recalls.

If you are breastfeeding

The following are some basic guidelines for taking medicine when you're breastfeeding:

Take oral medicines after you breastfeed or before the infant's longest sleep period. This will give the medicine a chance to leave your system before you feed your baby again.
Acetaminophen (brand name: Tylenol) and NSAIDs (some brand names: Aleve, Advil, Motrin) usually provide safe pain relief for women who are breastfeeding.
Avoid using aspirin because it can cause rashes and bleeding problems in nursing babies.
Limit long-term use of antihistamines. Just like other medicines you take, antihistamines will pass into your breast milk. They may cause side effects in nursing infants, such as drowsiness, irritability, crying and sleep disturbances. Antihistamines may also decrease the amount of milk you produce. Antihistamines include brompheniramine (some brand names: Dimetapp Cold and Allergy Elixir), chlorpheniramine (some brand names: Singlet, Chlor-Trimeton Allergy), dimenhydrinate (brand name: Dramamine), diphenhydramine (some brand names: Benadryl Allergy, Nytol, Sominex) and doxylamine (some brand names: Vicks DayQuil, Alka-Seltzer Plus Night-Time Cold Medicine).
Watch your baby for any signs of side effects. These signs can include a rash, trouble breathing or other symptoms that your baby didn’t have before you took the medicine.

Funding and support for this material have been provided by the Consumer Healthcare Products Association.

Written by familydoctor.org editorial staff

Reviewed/Updated: 02/12
Created: 09/05