OTC Medicines and Pregnancy

Over-the-counter (OTC) medicines are drugs that you can buy without a prescription from your doctor. Many OTC medicines have not been well studied for safety in pregnant mothers. Talk to your doctor before taking any OTC medicine, vitamin, or supplement. If you are pregnant, there is a risk of them affecting your baby. If you are breastfeeding, there is a risk of them getting into your breast milk.

Path to improved health

All women who are pregnant, trying to get pregnant, or breastfeeding, should take a prenatal pill each day. The following are some basic guidelines for taking other OTC medicines.

If you are pregnant or trying to get pregnant:

  • Do not take OTC medicines without talking to your doctor first. This includes medicines to treat cough, cold, diarrhea, constipation, or nausea.
  • Avoid taking OTC medicines during your first trimester (first 12 to 13 weeks of pregnancy). This is when the risk to your baby is highest.
  • Acetaminophen (brand name: Tylenol) is safe for short-term pain relief during pregnancy.
  • In general, avoid taking aspirin unless your doctor tells you to take it.
  • Avoid taking NSAIDs (non-steroidal anti-inflammatory drugs), especially during the third trimester. They can cause heart defects in your baby. Examples of NSAIDs are ibuprofen (brand names: Advil, Motrin) and naproxen (brand name: Aleve).
  • Avoid combination medicines that treat several symptoms at once. You do not want to expose your baby to too many medicines. If your doctor says it’s safe, use 1 medicine to treat 1 symptom. For example, you might use acetaminophen for a headache. But don’t use acetaminophen combined with other active ingredients, such as decongestants or antihistamines.

If you are breastfeeding:

  • Take oral medicines after you breastfeed or before your baby’s longest sleep period. This lets the medicine go through your system before you feed your baby again.
  • Acetaminophen and NSAIDs are safe for pain relief.
  • Avoid taking aspirin because it can cause rashes and bleeding problems in nursing babies.
  • Limit long-term use of antihistamines. They may cause side effects in nursing babies, such as irritability, crying, drowsiness, and trouble sleeping. They also can decrease the amount of milk you produce. If you are not sure whether an OTC medicine contains antihistamines, ask your doctor or pharmacist.
  • Watch your baby for signs of side effects or reactions. These may include a rash, trouble breathing, or other symptoms that your baby didn’t have before you took the medicine.
  • Keep all medicines out of the sight and reach of your baby and other children.

Things to consider

Conception occurs about 2 weeks after your last period. That means you may not know you are pregnant until you’re more than 3 or 4 weeks along. Your baby is most vulnerable 2 to 8 weeks after conception. This is when your baby’s facial features and organs begin to form. Any medicines you take can affect your baby. (So can anything you eat, drink, smoke, or are exposed to.) This is why you should avoid these things if you are trying to become pregnant.

If you need to take medicine regularly because of a health problem, talk with your doctor before you try to get pregnant. There may be other ways to treat your condition rather than taking medicine.

Questions to ask your doctor

  • Do you have a list of OTC medicines I can take while pregnant?
  • What are the risks of taking OTC medicines while pregnant?
  • What are the risks of taking OTC medicines while breastfeeding?
  • How much folic acid do I need to take?
  • Are supplements and vitamins safe for me while I am pregnant?
  • I currently take an OTC medicine for a health problem. Is there another treatment option while I am pregnant?

Resources

American Academy of Family Physicians, Over-the-Counter Medications in Pregnancy

Centers for Disease Control and Prevention, Treating for Two