Which Medications Are Safe and Unsafe to Use While Pregnant

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There are many things you need to avoid when you’re pregnant, including drugs that are perceived harmful for you and your baby. But what if you get sick and need medication? The good news is that not all over-the-counter medicines are unsafe. You just need to know which drugs are safe for an expectant mother to use.

List of Safe and Unsafe Drugs for Pregnant Women

Safe Pain Relievers

  • Acetaminophen (Tylenol) used in prescribed doses

Unsafe Pain Relievers

  • Aspirin
  • Ibuprofen
  • Naproxen

Safe Allergy Medications

  • Diphenhydramine (Benadryl)
  • Loratadine (Claritin)
  • Steroid nasal spray (Rhinocort)

Safe Cold and Flu Meds

  • Acetaminophen (Tylenol)
  • Saline nasal drops or spray

Safe Constipation Meds

  • Colace
  • Metamucil

Safe Heartburn Meds

  • Tums
  • Mylanta
  • Famotidine (Pepcid)
  • Andranitidine (Zantac)
  • Aluminum hydroxide/magnesium hydroxide (Maalox)

Unsafe Heartburn Meds

  • Kaopectate Pepto Bismol
  • Avoid: Bismuth subsalicylate is not recommended for pregnant women
  • Nausea and Vomiting
  • Diphenhydramine (Benadryl)
  • Vitamin B6

Safe Diarrhea Meds

  • Loperamide ([Imodium®] after 1st trimester, for 24 hours only)

Unsafe Diarrhea Meds

  • Bismuth subsalicylate (Pepto Bismol)
    Avoid: Salicylate can cause fetal bleeding

Safe Meds for Hemorrhoids

  • Phenylephrine/mineral oil/petrolatum (Preparation H®)
  • Witch hazel (Tucks® pads or ointment)

Safe Meds for Yeast Infection

  • Miconazole (Monistat®)

Safe Antibiotics

  • Ampicillin
  • Safe First Aid Ointment
  • Bacitracin
  • Neomycin/polymyxin B/bacitracin (Neosporin®)

Safe Meds for Rashes

  • Diphenhydramine cream (Benadryl)
  • Hydrocortisone cream or ointment
  • Oatmeal bath (Aveeno®)

Safe Insect Repellant

  • N,N-diethyl-meta-toluamide (DEET®)

Other Drugs to Avoid When Pregnant

  • CNS Stimulant – Amphetamines
    Avoid: Cause congenital heart disease
  • CNS Depressant – Anesthetics***
    Avoid: Depresses vital fetal centers
  • Immuno-modulatory – Anti-thyroid Drugs
    Avoid: Depresses fetal thyroid
  • Controls Convulsions, epileptic attacks – Anticonvulsant Drugs
    Avoid: May cause cleft lip/palate, abnormalities of the fingers and toes, and congenital heart disease
  • Salicylate analgesic – Aspirin
    Avoid after 37 weeks: May cause fetal bleeding or miscarriage when taken more than 100mg per day and in the last trimester of pregnancy
  • Anticonvulsant, Mood Stabilizing – Carbamazepine
    Avoid: May cause neural tube defects
  • Antibiotics – Chloramphenicol
    Avoid: May cause neonatal gray baby syndrome
  • Diuretic, anti-hypertensive – Frusemide (Lasix)*
    Avoid: May cause higher birth weights
  • Steroid Hormone – Glucocorticoids*
    Avoid: May lead to early Lung maturation or may affect placental vessels
  • Antimalarial – Chloroquine
    Avoid: May cause deafness, changes in the inner ears
  • Diuretic, Antihypertensive – Chlorthiazide
    Avoid: May cause fetal or neonatal jaundice, thrombocytopenia
  • Oral Hypoglycemic – Chlorpropamide
    Avoid: May cause intrauterine or neonatal death
  • Benzodiazepine (Sedative, Antianxiety) – Diazepam (Valium)
    Avoid: Birth defects
  • Female Hormone – Estrogen
    Avoid: Increases the risk of defect in testicular formation
  • Retinoid – Isotretinoin
    Avoid: May cause birth Defects or neonatal death
  • Antipsychotic Drug – Lithium**
    Avoid: May cause goiter or heart defects
  • Hallucinogen – LSD(Lysergic Acid Diethylamide)
    Avoid: May cause brain damage or lead to low birth weight
  • Antibiotic – Metronidazole (oral)
    Avoid: May cause birth defects. Take vaginal ovules or use ointment instead.
  • Antihypertensive – Methotrexate
    Avoid: May result in neonatal death or severe fetal anomalies
  • Steroid – Prednisolone***
    Avoid: May cause cleft lip when used in early pregnancy
  • Streptomycin***
    Avoid: May cause fetal deafness (rarely)
  • Antibiotic – Sulphonamides
    Avoid: May cause neonatal jaundice. Must be avoided in the 3rd trimester
  • Reserpine
    Avoid at term: May cause fetal nasal congestion

Drugs that must be Avoided throughout your pregnancy

  • Warfarin
    Avoid: May cause skeletal and limb defects or low birth weight
  • Valproic Acid
    Avoid: May cause neural tube defects
  • Tolbutamide
    Avoid: May cause multiple deformities
  • Sedative – Thalidomides
    Avoid: May cause limb deformities
  • Antibiotic – Tetracyclines
    Avoid: Affects development of bone and teeth

*Only if needed
**Only if absolutely needed
***Use with care

Important Rules to Remember

  1. Always check with your doctor/obstetrician before taking any medication, especially during the first trimester.
  2. Don’t take medication unless absolutely necessary or deemed necessary by a medical professional.
  3. Opt for alternative methods whenever possible or available.
  4. Take prenatal vitamins and do anything possible to stay healthy while pregnant so as not get sick enough to need medication.
  5. Take extra care of yourself as this is one way to prevent the need for a cure.

In the event that you do get sick, because someone contagious was seated next to you, for example, take an alternative route before you take medications. There are many natural and safe preventive measures that you can take and alternative cures that you can look into.

Alternatives to Medications

No drug, even when labeled safe, is 100% safe for pregnant women. So, if you do get sick, opt for alternative cures before you hit the drug counter.

  • To relieve a migraine, apply a cold compress on your forehead.
  • To relieve headaches, join prenatal yoga classes.
  • To relieve body aches and pains, consider chiropractic care.
  • To relieve upset stomach, drink a cup of dandelion root tea daily.
  • To relieve heartburn and encourage regular bowel movements, take a probiotic supplement daily.
  • For cold relief, use a Neti Pot or eucalyptus steam to clear nasal decongestion.
  • Consider herbal remedies that are natural and safe to use during pregnancy. Avoid herbal energy supplements and plants that may induce uterine contractions and affect your hormone levels.

Before you do or take anything, alternative or otherwise, always consult your doctor.

More information and resources:

    http://gynaeonline.com/medicines.htm
    https://my.clevelandclinic.org/health/articles/medication-guidelines-during-pregnancy
    http://www.jocpr.com/articles/safe-and-unsafe-drugs-during-pregnancy.pdf
    https://www.cdc.gov/media/dpk/2013/docs/dpk-safe-meds-doc1.pdf
    http://www.webmd.com/baby/guide/taking-medicine-during-pregnancy#1
    https://www.babycenter.com/0_chart-over-the-counter-medicine-during-pregnancy_1486462.bc
    http://diamondobgyn.com/obstetrics-edina-mn/pregnancy/medication/
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