OTC Medicines and Pregnancy

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

Over-the-counter (OTC) medicines are medicines that you can buy without a prescription from your doctor.

Conception occurs about 2 weeks before your period would have been 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 (and 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 are already pregnant whenever you are trying to become pregnant.

If you need to take medicine regularly because of a health problem or condition, 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.

If you’re pregnant or trying to get pregnant

The following are some basic guidelines for taking OTC medicines 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 (first 12 weeks of pregnancy). This is when the risk to your baby is highest.
  • Acetaminophen (brand name: Tylenol) is generally considered safe for short-term pain relief during pregnancy.
  • 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. This will help you minimize the number of medicines your baby is exposed to. 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

The following are some basic guidelines for taking OTC medicines when you’re breastfeeding:

  • Take oral medicines after you breastfeed or before your baby’s longest sleep period. This will give the medicine a chance to leave your system before you feed your baby again.
  • Acetaminophen and NSAIDs 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 babies, such as drowsiness, irritability, crying, and sleep disturbances. Antihistamines may also decrease the amount of milk you produce. If you’re not sure whether an OTC medicine contains antihistamines, ask your family doctor or pharmacist.
  • 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.
  • Keep all medicines out of the sight and reach of your baby and any other children.

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 and breads, 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.

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