Timothy N. Gorski MD FACOG
1001 North Waldrop Drive #815
Arlington, Texas 76012
(817) 792-2000

 

 MEDICATIONS DURING PREGNANCY

As a general rule, it's better not to take any medications during pregnancy if they can be avoided. This is because, almost regardless of the drug, it's impossible to conduct good scientific studies on whether one or another medication may cause birth defects or other pregnancy complications.

There are some particular medications about which there are concerns, although it depends very much when during pregnancy they are taken. These can be divided - more or less - into three groups: (the medications shown are examples only and should not be considered complete listings)

Minor/Theoretical Concerns

Some definite risk of harm

Serious risk of harm

Discontinue or don't take if pregnant, but minimal cause for concern

Use in pregnancy only if truly necessary

Not to be taken during pregnancy for any reason

Aspirin (salicylates)*

Birth control pills**

Motrin®, Advil®, Medipren® (ibuprofen)

Orudis® (ketoprofen)

Anaprox®, Aleve® (naproxen)

Caffeine

Anti-cancer drugs

Anti-coagulants

Anti-epilepsy drugs

Anti-thyroid drugs

Ephedrine

Immune suppressants

Lithium

Steroids

Accutane® (isotretinoin)

clomiphene

estrogen, birth control pills

tetracyclines

thalidomide

* Read the package label! Many things contain aspirin including Alka-Seltzer®, Doan's Pills®, and Pepto-Bismol®.

** if taken unintentionally early in pregnancy

It goes without saying that alcohol, tobacco, marijuana, cocaine, and other recreational drugs should not be used at any time during pregnancy. Even though pregnant women do use these substances to some degree and not all of them suffer complications, some do and there is therefore no justification for taking unnecessary risks. Why depend on good luck when good judgment can be used?

On the other hand, there are many medications that have been around for a long time, or with which there is some experience, that are believed to be safe during pregnancy. Also, there are a few things that are certainly safe to take in pregnancy:

No evidence of harm in pregnancy, so probably safe

Safe to take during pregnancy

Use if necessary

Use if directed, necessary, or desired

Asthma inhalers

Benadryl® (diphenhydramine)

Gynelotrimin® or Mycelex® (clotrimazole-containing vaginal yeast creams)

Penicillins and some other antibiotics

Robitussin® cough syrups

Sudafed® (pseudoephedrine)

Tylenol® (acetaminophen)

Calcium supplements including Tums®

Emetrol (for nausea - CHERRY tastes best)

Equalactin® (for diarrhea and constipation)

Iron supplements

Kaopectate® (original formulation)

Nutrasweet® (aspartame)

Prenatal vitamins

Limited information suggests that some other medications including anti-depressants (Prozac® and Zoloft®), some anti-hypertensives, and even oral anti-diabetes drugs are safe to take in pregnancy if there is good reason to use them.

There is simply not enough information available about most herbal products and other "nutritional/dietary supplements," even though they are usually advertised as "all natural" and therefore "safe." Some are definitely dangerous, such as chaparral, pennyroyal, and ma huang and other ephedrine-containing products. With others, even though they may have been used safely in the past on an occasional, short-term basis as folk remedies, their regular use in pills, capsules, creams, and teas has simply not been studied. With these products, the unfortunate fact of the matter is that if you use them you are being your own guinea pig. In pregnancy it is best to avoid them.