September 6, 2023

Your Guide to Pregnancy-Safe Medications

Always talk with your doctor for advice, too

pregnant woman holding pill container

You probably already realize that pregnancy changes things. Lots of things. Among them, the medications you should keep in stock.

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Pregnancy can bring on a host of symptoms that you may not have expected (Why didn’t anyone tell me morning sickness can last allllll day?). And some conditions you’ve already been managing may need a different approach.

Choosing pregnancy-safe medication is important to having a healthy pregnancy. It’s important for your well-being and for promoting healthy fetal development.

What should you take? What should you avoid? We asked Ob/Gyn Paul Hudock, MD, for advice about what medications are safe during your pregnancy.

Medicine and pregnancy

Some medicines are considered safe during pregnancy (or safe after the first trimester). Some have been shown to have negative effects. And then, there are others that are somewhere in between — because the effects of some medicines on a growing fetus just aren’t yet known.

“What’s considered safe to be taken during pregnancy is based on the best research we have available at this time,” Dr. Hudock explains. “So, it’s always important to talk with a healthcare provider who’s knowledgeable about pregnancy — like an Ob/Gyn or a certified nurse midwife — for the latest evidence-based advice.”

Dr. Hudock shares recommendations for various ailments you may encounter during your pregnancy and what medications may be your best choices.

Prescription medication

If you were taking prescription medicines before you became pregnant, talk with your healthcare provider about the safety of continuing these medicines — and the sooner the better.

Your healthcare provider should discuss any risks with you, and together, you can weigh the benefit to you against any risk to fetal development.

“With some prescription medicines, the risk of not taking them might be more serious than the potential risk associated with taking them,” Dr. Hudock states. “The best course of action for you and your pregnancy is a plan that considers both your well-being and any risks to the pregnancy.”

If you’re prescribed any new medicine, make sure your healthcare provider knows that you’re pregnant and ask about any risks and benefits of the newly prescribed medicine.

Nausea and vomiting

It’s no secret that nausea and vomiting are common in people who are pregnant. But that doesn’t make it any easier to deal with. In fact, some studies suggest up to 80% of pregnant people experience morning sickness.

Vitamin B6 is a pregnancy-safe choice for improving nausea.

What you eat and how often can help relieve morning sickness, too. Eat small meals and snacks frequently to avoid an empty belly. Get plenty of lean protein. Stay hydrated. And some sour candies and fruits can help, too.

If morning sickness is severely impacting your life or if it’s associated with any pain, talk with your healthcare provider about other solutions.

Allergies

If you’re prone to the sniffles and sneezes that come with seasonal and environmental allergies, you probably already have a go-to plan for allergy relief. But your allergy medication of choice may need to be reconsidered when you’re pregnant.

The best medication choices for allergy relief in pregnancy include these antihistamines:

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  • Loratadine (Claritin®).
  • Cetirizine (Zyrtec® and Alleroff®).
  • Chlorpheniramine.
  • Dexchlorpheniramine.
  • Hydroxyzine.

Steroid nasal sprays may work well for you as well, and are safe for pregnancy. That includes brands like Nasonex®, Nasacort® and Flonase®.

Remember, too, that nonmedication relief for allergies may help. Try things like:

Headaches and other aches and pains

Pregnancy headaches can be a real pain for a lot of pregnant people, especially in the first trimester. And later on, as the fetus grows, other aches and pains can be normal, too.

Dr. Hudock recommends sticking with acetaminophen (Tylenol®) as your go-to pain reliever. That’s because other pain relievers, like, ibuprofen (Advil) and naproxen (Aleve®) can affect fetal development and aren’t recommended during pregnancy.

Cold and flu

If you catch a cold or come down flu-like ick during your pregnancy, think about managing the symptoms one by one. That means that rather than an all-in-one “multi-symptom” or “cold and flu” remedy, choose medications that target your specific symptoms, like a cough or body aches.

Avoid cold and flu products that use words like “extended release,” “24-hour” or have a “D” after the brand name (such as Mucinex D®). And some night-time-specific formulas, such as Nyquil®, should be avoided due to their high alcohol content.

Avoid decongestants like pseudoephedrine (Sudafed®) in your first trimester, as they may raise the risk of birth defects.

Instead, try these pregnancy-safe cold and flu medicines:

  • Diphenhydramine (Benadryl®).
  • Dextromethorphan (Robitussin®).
  • Guaifenesin (Mucinex®).
  • Pseudoephedrine (Sudafed, only after the trimester).
  • Acetaminophen (Tylenol).

Several home remedies for colds and coughs are also good options during pregnancy. That includes things like:

  • Vicks VapoRub® mentholated cream.
  • Neti pots, saline nasal drops or saline spray.
  • Gargling with salt water.

Heartburn

Heartburn and pregnancy go together like chips and salsa. Heartburn is a very common complaint during pregnancy, especially as the fetus grows and pushes on your stomach.

Pregnancy-safe heartburn relief options include:

  • Aluminum hydroxide/magnesium carbonate (Gaviscon®) (occasional use only).
  • Famotidine (Pepcid AC®).
  • Aluminum hydroxide/magnesium hydroxide (Maalox®).
  • Calcium carbonate/magnesium carbonate (Mylanta®).
  • Calcium carbonate (Titralac® or Tums®).
  • Ranitidine (Zantac®).

Eating yogurt and drinking milk may also help counteract heartburn.

Diarrhea

The only pregnancy-safe medication for diarrhea during pregnancy is loperamide (Imodium®). But note that it shouldn’t be taken after the first trimester and shouldn’t be taken for more than 24 hours.

If you’re still experiencing diarrhea after home treatment for a day or if you’re in your first trimester and experiencing concerning diarrhea, Dr. Hudock recommends checking in with your healthcare provider.

Changes to your diet when you have “the runs” can make a big difference, too. Make sure to keep hydrated (including drinking sports drinks to keep up your electrolytes). And stick to bland foods, like bananas, rice, applesauce and toast (also called the BRAT diet).

Constipation

On the opposite end of the spectrum, pregnancy can get you a little … er … backed up. Hormones, prenatal vitamins and extra pressure on your rectum can all contribute to pregnancy constipation.

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Drinking plenty of water, increasing your fiber and keeping up a pregnancy-safe exercise routine can help keep things moving. And you can try these medications for constipation, which are safe for pregnancy:

  • Methylcellulose fiber (Citrucel®).
  • Docusate (Colace®).
  • Psyllium (Fiberall®, Metamucil®).
  • Polycarbophil (FiberCon®).
  • Polyethylene glycol (MiraLAX®) (occasional use only).

Hemorrhoids

Prolonged constipation can lead to less-than-desirable issues. Namely, hemorrhoids.

Pregnancy-safe hemorrhoid treatments include:

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

First aid

Cuts, scrapes, burns … they still happen when you’re pregnant. Here’s what you can use for those minor injuries:

  • Bacitracin ointment.
  • Neomycin/polymyxin B/bacitracin (Neosporin®).

Insect repellant

If you’re planning to spend some time outdoors, insect repellant is important to keeping you itch-free. It can also help protect you from illnesses that bugs can carry, like Zika virus, Lyme disease and more.

Opt for a repellant that includes DEET. And cover your skin as much as possible to limit your potential for bug bites.

Rash

If it’s an itchy rash that’s plaguing you, Dr. Hudock suggests:

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

Sleep aids

People probably warned you about the sleepless nights after baby comes, but trouble sleeping during pregnancy is common, too. Getting a good night’s rest is important to a healthy pregnancy. A relaxing bedtime routine, limiting caffeine and stress relief techniques might help.

If you’re looking for a medication route to better ZZZs, Dr. Hudock says diphenhydramine (found in products like Unisom SleepGels® and Benadryl) can be safe during pregnancy.

Yeast infection

Yeast infections can be a common issue during pregnancy. Rest assured that yeast infections won’t cause any pregnancy complications, but treating them will certainly help you be more comfortable.

Dr. Hudock suggests miconazole (Monistat®) for treating yeast infections during pregnancy.

Talk with your healthcare provider

Remember: No medication can be considered 100% safe to use in pregnancy for every person. If managing your symptoms without medication is an option, that might be your safest route. But that won’t always work. And that’s OK.

Talk with your healthcare provider, like your Ob/Gyn or nurse midwife about the medication you take. Talk with them before taking new medication. And know that keeping yourself healthy is an important part of having a healthy pregnancy.

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