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Pregnancy-safe medications: What's OK to take

[6 MIN READ]

In this article:

  • It’s important to watch what medications you take during pregnancy, but fear not: There are safe options for just about anything that ails you.

  • For pain relief, you can take acetaminophen, but avoid ibuprofen, aspirin and naproxen.

  • It’s important to talk to your obstetrician before you start taking any medications on a regular basis.

Pregnancy-safe medications: What you can (and can’t) take

Pregnancy can be a joyful time in a woman’s life — but it can also be filled with anxiety. It can be overwhelming to keep track of all the foods, medications and activities you should avoid. Here, a Providence obstetrician and gynecologist provides an easy-to-skim guide to which medications you should and shouldn’t take when you’re expecting.

Why medication safety matters during pregnancy

Many (but not all) substances taken during pregnancy will reach the fetus via the placenta, which means they can affect your baby at the same time they are affecting you.

Of the substances that do reach the fetus through the placenta, scientists have been able to confirm some that are safe for the developing baby, and some that pose a health risk. For most substances, however, the level of risk or safety is still unknown.

The Food and Drug Administration (FDA) classifies the known safety level of drugs for pregnant women using the following lettering system:

  • Class A: Controlled human studies have demonstrated no risks to the fetus.
  • Class B: Presumed safe, based on animal studies; no well-controlled human studies are available.
  • Class C: Safety is uncertain; data from human studies does not exist, and animal studies have shown some question of risk to the fetus. Pregnant women may take these medicines if they clearly need them.
  • Class D: Evidence suggests the possibility of the medication causing birth defects or other problems, but a pregnant woman still might need to take it for her own medical needs.
  • Class X: Proven risks to the fetus outweigh any possible benefits to the mother.

In general, if obstetricians can’t say with certainty that a substance is safe for developing babies, they advise pregnant women to avoid taking it, if possible. In each case, however, they weigh the risk to the fetus against the benefits to the mother.

Safe medications for common pregnancy symptoms

While you’re pregnant, you can’t avoid the normal illnesses of life — and the unique symptoms that accompany pregnancy. Here is a rundown of the medications you can take for the following conditions:

Cold and flu relief

According to Jennifer Phy, D.O., an obstetrician and gynecologist who treats patients in Lubbock, Texas, cold medications that are generally considered safe in pregnancy are:

  • Dextromethorphan (Robitussin or Delsym) for cough
  • Cetirizine hydrochloride (Zyrtec) for runny nose
  • Acetaminophen (Tylenol) for headache
  • Saline nasal spray for nasal congestion 

Pain and headache management

“Tylenol is generally regarded as safe in pregnancy,” says Dr. Phy. “However, ibuprofen or aspirin are not typically recommended in pregnancy. This is because of the risks of premature closure of a blood vessel that is important in fetal circulation, potential birth defects, reduced amniotic fluid or risk of premature delivery. At times, low-dose aspirin is recommended in pregnancy, so patients should discuss the risks and benefits with their health care provider.” 

Stomach issues (heartburn, nausea, diarrhea)

For heartburn, you can try antacids like Tums and Maalox. Other safe medications include H2 receptor blockers like Pepcid. If these other medications don’t work, you may be able to try proton pump inhibitors (PPIs) like Prevacid and Prilosec.

For morning sickness and general nausea, start with vitamin B6, either by itself or in combination with doxylamine, which is found in Unisom.  

For diarrhea, you can take loperamide (Immodium) after the first trimester. However, you should not take it for more than 24 hours.

Allergy relief

If you suffer from seasonal allergies, you definitely need relief. In general, most over-the-counter (OTC) allergy medications are safe to take during pregnancy, including Zyrtec, Benadryl, Allegra, Claritin and Flonase.  

Medications to avoid during pregnancy

There are a number of medication classes that you should avoid during pregnancy. As stated above, you should not take ibuprofen, aspirin and naproxen (Aleve), especially after you are 20 weeks pregnant. Other medications to steer clear of include:

  • ACE inhibitors angiotensin II receptor blockers – These high blood pressure medications can cause kidney failure and other issues with the fetus.
  • Isotretinoin – Used to treat acne, this medication can cause severe birth defects.
  • Warfarin – This is a blood thinner that can cause birth defects.
  • Antibiotics like quinolones, tetracyclines and sulfonamides – These medications can harm the fetus.
  • Benzodiazepines – These medications are used for anxiety and seizures, and may cause withdrawal symptoms in a newborn.
  • Opioids – Continued opioid use for pain management can cause neonatal abstinence syndrome.
  • High doses of vitamin A – This can cause birth defects.
  • Thalidomide – This can also cause multiple birth defects.
  • Codeine – This pain relief medication can cause neonatal respiratory depression.
  • Valproic acid – This medication, which is used to treat seizures, can cause birth defects. 

Safe remedies beyond medications

Whenever possible, try to use natural remedies rather than medications. For example, if you’re dealing with constipation (and many pregnant women are), try to drink more fluids and eat more fiber, such as oat bran, fruits, vegetables and beans. Check out our guide to healthy hydration

In addition to using OTC medications for allergies, you can also try nasal rinses and essential oils like eucalyptus and lavender. Also, try to stay inside as much as possible when pollen counts are especially high.

If you have a cold, drink lots of water, use honey to soothe a sore throat, and give yourself plenty of time to rest. 

Talk to a doctor before taking any medication

Ultimately, however, your doctor has the final word on what medications you should be taking, how often and at what point during your pregnancy. They can help you weigh risks versus benefits and monitor how you’re feeling. That’s why it’s essential that you keep up with your regular obstetrician visits. Schedule an appointment today!

Contributing caregiver

Jennifer Phy, D.O., is an obstetrician and gynecologist who treats patients in Lubbock, Texas.

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Related resources

What to know when preparing for pregnancy

How midwives help parents have healthy deliveries 

There is hope for pregnant people battling substance abuse

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions. 

About the Author

While it's your birth, bringing babies into this world is our passion. The Providence Maternity Team is committed to giving expectant and new moms with tips, advice, and hacks to help ease the inherent stress and uncertainty that accompanies being a parent.