OTC Medication Use In Pregnancy: Wise or Worrisome?
How Should I Approach Medication Use in Pregnancy?
Women who are just starting to plan a pregnancy should discuss the need for medications with their doctor beforehand. For women with chronic conditions such as asthma, epilepsy or heart conditions, medication may need to be continued throughout pregnancy. And it's important to remember that in every pregnancy there is a 3-5% chance of having a baby with a birth defect, even if you take no medications.
Can I Take My Regular Medications in Pregnancy?
How Common is Medication Use During Pregnancy?
This raises concern as some medications used during organogenesis (the time period of organ development in the first 12 weeks) can be associated with developmental abnormalities. Although animal studies can provide some information about drug toxicity in pregnancy, these results cannot be safely extrapolated to humans. About 10 percent of birth defects result from drug exposure in pregnancy.
How Does the FDA Categorize Pregnancy Risks Now?
- Pregnancy (includes Labor and Delivery)
- Lactation (includes Nursing Mothers)
- Females and Males of Reproductive Potential
Prescription drugs submitted for approval after June 30 2015, will use the new format immediately, while labeling for prescription drugs approved on or after June 30, 2001, will be phased in gradually. Labeling for OTC medicines will not change; OTC drug products are not affected by the new FDA pregnancy labeling.
Aren't All Drugs Tested for Safety in Pregnancy?
However, drug companies may be required to set up pregnancy registries that collect information about women who have used certain medications during pregnancy. Using this data, a research study can outline the benefit-to-risk of using the drug in pregnancy. Health care professionals can look at this published literature to better determine a drug's safety in pregnancy, and compendiums can be published with the available data.
Is Tylenol Safe?
Follow dosing directions closely, as high doses of acetaminophen can be toxic to the liver or kidney, both in you and your baby. Acetaminophen is found in many other medication, both prescription and OTC, so be sure not to exceed 3,000 to 4,000 mg of acetaminophen per day from all products.
Beware with Aspirin Use
In some pregnant women, low-dose aspirin may be used for certain medical conditions, but only under the direct care a physician. If a medication for minor pain, headache or fever is required, acetaminophen is usually a safer option.
My Back Aches: NSAID Safety in Pregnancy
NSAIDs should NOT be used in the third trimester of pregnancy unless specifically prescribed by your doctor. Like aspirin, NSAIDs like ibuprofen may interfere with the closure of the ductus arteriosus in the baby's heart. Acetaminophen is usually the pain and fever reliever of choice in pregnancy.
Drug Use in Pregnancy: Cough Suppressants
The available human data have not found an association between dextromethorphan (Delsym, Vicks Formula 44) and an increased risk of birth defects in humans, and it's use has been noted as compatible with both pregnancy and breastfeeding by Briggs. However, dextromethorphan should only be given if the benefit to the mother justifies the potential risk to the fetus as determined by your doctor. Cough suppressants containing ethanol (alcohol) should be avoided.
Cough lozenges are safe, or a soothing drink of honey, lemon and warm water can be a natural help for a cough.
The Stuffy Nose and Pregnancy: What to Do?
Alternatives to oral decongestants, like nasal saline solutions (Ayr) or a decongestant spray (Neo-Synephrine) may be safer options, but limit use of decongestant sprays to no more than 3 days in a row to prevent rebound congestion.
Caffeine: Can I Still Have My Latte?
Guarana is a caffeine-containing herbal supplement often found in energy drinks, and some medications may contain caffeine, too. Ernst and colleagues suggest Guarana may lead to low birthweight, birth defects, premature birth. Experts recommend guarana not be used in pregnancy. Another herbal product with stimulant properties known as ephedra should also be avoided.
General Use of Vitamin and Herbal Supplements
However, prenatal vitamins that contain iron, calcium and folic acid are important in pregnancy, so don't skip those supplements; take as recommended by your doctor. Regular over-the-counter supplements may not have the right dose of vitamins you need, so ask your doctor if you need a prescription.
It's Flu Season - Should I Get a Shot?
If you're planning a pregnancy, talk to your health care provider beforehand about any vaccines you may need. Live vaccines should be given at least a month before attempting to get pregnant.
Is Any Amount of Alcohol Okay in Pregnancy?
Regular use or large amounts of alcohol during pregnancy can lead to Fetal Alcohol Syndrome, which can result in birth defects, and behavioral or learning problems. Be sure to check over-the-counter medication bottles for the presence of alcohol. If you are concerned that you cannot avoid alcohol intake during your pregnancy, speak with a health care provider as soon as possible.
Pregnancy During Allergy Season
Loratadine (Claritin) is a non-sedating antihistamine also used to relieve the symptoms of seasonal allergies like sneezing, runny nose, and watery eyes. Clinical data from Briggs shows that loratadine has a low risk for birth defects, adequate safety data, and may be a preferred choice over a sedating, 1st generation antihistamine. For many allergies in pregnant women, a corticosteroid nasal spray or allergy eye drop may be a 1st line option too, with low absorption into the bloodstream.
Can I Use My Acne Medication?
The prescription drug isotretinoin (Accutane) should not be used in pregnancy due to the risk of birth defects. In fact, just one dose of isotretinoin can cause severe birth defects or death of a baby. Never use this medicine if you are pregnant or may become pregnant.
Stomach Symptoms in Pregnancy
Adequate fluids (water) and exercise is always important to combat constipation, but the stool softener docusate sodium (Colace) has been reported as compatible with pregnancy by Briggs et al. Fiber supplements, such as Metamucil or FiberCon can help with constipation in pregnancy, too, if okayed by your doctor.
In the Outdoors: How to Stay Bug-Free.
Finished: OTC Medication Use In Pregnancy: Wise or Worrisome?
- Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernandez-Diaz S, and the National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol. 2011;205:51.e1-8. Accessed June 21, 2016.
- Centers for Disease Control and Prevention. Adult Vaccination. Pregnant Women. Accessed June 21, 2016 at http://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html.
- Briggs GG, Freeman RK, Yaffe SJ, eds. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2008.
- Centers for Disease Control and Prevention. Medications and Pregnancy. Updated March 14, 2103. Accessed June 21, 2016. http://www.cdc.gov/pregnancy/meds/
- Black R, Hill A. Over-the-counter medications in pregnancy. American Family Physician. 2003;67:2517-24. Accessed June 21, 2016. http://www.aafp.org/afp/2003/0615/p2517.html
- Erebara A, et al. The Hospital for Sick Children. Mother Risk. Treating the Common Cold During Pregnancy. May 2008. Accessed June 21, 2016. http://www.motherisk.org/women/updatesDetail.jsp?content_id=881
- Nakhai-Pour, H. et al. Use of nonaspirin nonsteroidal antiinflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJ 2011;DOI:10.1503 /cmaj.110454 Accessed June 21, 2016. http://www.cmaj.ca/content/early/2011/09/06/cmaj.110454.full.pdf
- Cabbage LA, Neal JL. Over-the-counter medications and pregnancy: An integrative review. Nurse Practitioner: The American Journal of Primary Healthcare. June 2011;36:22-8. Accessed June 21, 2016. http://journals.lww.com/tnpj/Fulltext/2011/06000/Over_the_counter_medications_and_pregnancy__An.8.aspx
- Black RA, et al. Over-the-counter medications in pregnancy. American Family Physician 2003;67:2517-24. Accessed June 21, 2016 at http://www.aafp.org/afp/2003/0615/p2517.html
- MotherToBaby. Organization of Teratology Information Specialists. Fact Sheets. Accessed June 21, 2016. http://mothertobaby.org/fact-sheets-parent/
- Kar S, et al. A review of antihistamines used during pregnancy. J Pharmacol Pharmacother. 2012 Apr-Jun; 3(2): 105–108. Accessed June 21, 2016 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356948/
- Ernst, E. Herbal medicinal products during pregnancy: are they safe?. BJOG: An International Journal of Obstetrics & Gynaecology. 2002:109;227–35. Accessed June 21, 2016 at doi:10.1111/j.1471-0528.2002.t01-1-01009.x