5 Over-The-Counter Medications Are Safe To Use During Pregnancy
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- Written by Sean Newton, B.S., Former Health & Fitness Writer
Medically reviewed by
Gopal Ramakrishnan, Ph.D.
Pregnancy can be really uncomfortable. Expectant moms might experience heartburn, nausea, rashes, pains, and that’s just the start. The source of the discomfort is often a minor issue, something you would take an over-the-counter medication like Tylenol for in any other situation. You have to wonder though, is that safe for the baby?
Over-the-counter (OTC) medications work by interacting with the chemistry of our bodies, easing pain, reducing inflammation, and so forth. However, when a baby is developing, changing our body chemistry can pose a risk to the developing fetus.
Prescription medications are always monitored by a doctor. During pregnancy, a doctor will usually want to monitor OTC drugs as well. However, many OTC drugs are safe both for you and your baby.
What Over-The-Counter Medications Are Safe to Use During Pregnancy?
Unfortunately, there isn’t a simple way to tell a safe OTC medication from an unsafe one. Some over-the-counter medications may be safe to take during pregnancy, but others should be avoided. Telling them apart may require some research. Some examples of safe medications include:
- Acetaminophen
- Pyridoxine or Nestrex
- Maalox
- Neosporin
Expecting moms have to take greater care in a number of ways. One of the more important ones is monitoring the drugs you’re taking. Due to the changes a mother’s body is undergoing to get ready for birth, her body chemistry is often very sensitive. The same thing is even more true for a developing baby.
As a result, otherwise safe OTC medications have been identified as causing birth defects. Even safe medications should most wisely be used in moderation.
How Do You Know if a Drug is Safe?
Just a few years ago, the Federal Drug Administration released new labeling guidelines[1] for prescription drugs, offering more detailed information to healthcare providers. However, those changes did not extend to OTC drug labels[2]. Most of those simply say pregnant women should consult a doctor.
Before you talk to your doctor, you may want to do your own research regarding which drugs are safe[3]. If you have questions about a specific drug or ingredient, there are a number of resources that can help.
The Food and Drug Administration (FDA) offers an index of drug information[4], which gives basic information including side effects. The Centers for Disease Control also have a program[5] aimed at educating people about medications.
Most of us can’t identify OTC drugs by medical name, so sometimes those resources can be difficult to use. To make things a little easier, here is a list of most-likely safe drugs, broken down by illness.
5 Type Over-The-Counter Medications During Pregnancy
Nausea and Vomiting
A lot of expectant moms struggle with some serious nausea and vomiting. Morning sickness hits pregnant women to different degrees, but it’s never really fun. You can ease the nausea with OTC drugs, but it is a good idea to be cautious. Morning sickness shows up most often in the first trimester, when the baby’s development is especially fragile.
A few safe OTC anti-nausea options include:
- Doxylamine and pyridoxine – sold as Diclectin
- Pyridoxine on its own – sold as Nestrex
- Emetrol – Contains added sugar, so best avoided by diabetics
- Vitamin B6
Cough and Cold
As if the common cold wasn’t bad enough, getting sick when you’re pregnant can be particularly miserable. Luckily, many decongestants and cough medicines are safe to take during pregnancy. As we’ve mentioned, the first trimester of development is particularly important. Some drugs that are safe otherwise during pregnancy should be avoided in early pregnancy.
It should be safe for pregnant women to take:
- Most cough syrup brands – though not all are safe in the 1st trimester
- Many decongestants, such as Actifed, Flonase, and Nasocort
- Acetaminophen – Tylenol
Most of the decongestants on that list contain some form of antihistamine, which is also usually safe.
Cold medications often come in extra strength or multi-symptom form. Usually, that’s great as one pill is easier to swallow than several. When you’re pregnant some of the drugs added to treat multiple symptoms may pose a fetal risk, however, having the potential to harm your developing baby. Extra strength options may include too large a dose of an otherwise safe drug.
In the past, drugs that had pseudoephedrine as an ingredient were generally considered safe. New research has shed some doubt on that conclusion, though. When in doubt, check with your doctor.
Heartburn
For heartburn, antacids like calcium carbonate are generally considered safe. There was initially some concern about drugs like Prilosec, called proton pump inhibitors. Follow up research suggests they are safe during pregnancy, however.
Other safe OTC drugs for heartburn in pregnancy include:
- Gaviscon
- Maalox
- Mylanta
- Riopan
Pain Relief
Headaches, body aches, cramps, and sore muscles are all part of the wonderful miracle of childbirth. Easing those aches and pains are a big part of making pregnant women more comfortable.
When we have an ache, we usually reach for an OTC pain reliever. Most of those should be avoided in pregnancy. Nonsteroidal anti-inflammatory drugs, better known as NSAIDs, have been linked to birth defects, including cleft palate and cardiac defects.
The safest OTC drug for pain is acetaminophen[6], better known as Tylenol.
First Aid
Topical ointments, like antibiotics or antifungals, appear to be completely safe for pregnant women. Common brands like Neosporin or Bacitracin can be used without worry.
Alternative Treatments During Pregnancy
Unfortunately, many common OTC drugs are not safe during pregnancy. Their use can result in birth defects, developmental problems later in life, or worse. OTC treatments kept in most bathroom cabinets without worry such as Pepto-Bismol or Mucinex can pose a serious fetal and neonatal risk.
However, pregnant women have always faced the same sorts of problems. Methods of easing pain and discomfort were developed that still work and which are safe for pregnant women.
Not all alternative treatments[7] are equal. You should be cautious with herbal supplements, for example, as they can have the same sorts of effects an OTC drug can. Others are like OTC drugs in that they may be safe in some circumstances, but should be avoided during pregnancy.
Do Alternative Treatments Work?
Doctors are hesitant to recommend alternative treatments in many cases. In many cases, the treatments have not been tested scientifically. Without that sort of information a doctor can’t give you informed advice. As a result, they may decline to give an opinion or advise against you using alternative treatments.
However, many treatments can be used without any danger. Others have had some scientific study and can be recommended with more confidence. As always, your healthcare provider is the best source of information.
Alternative Treatments To Consider
Many alternative treatments are gentle and non-invasive. They can offer some pain relief to the mom without endangering the baby at all. Who doesn’t like a good massage?
As with other varieties of treatments, be sure to seek out knowledgeable professionals. There may be some massage therapists in your area that specialize in massage for pregnant women, for example.
Some safe alternative therapies to consider include:
Though it’s not really considered an alternative treatment, improving your health generally can also help. Moderate amounts of low impact exercise is great for both a pregnant mom and new baby. It increases blood flow, can help lower blood pressure, and has a whole range of other benefits.
- Breathing exercises
- Relaxation techniques
- Massage
- Aromatherapy
- Meditation
- Acupuncture[8] and acupressure
Some herbal treatments can be helpful and are safe to use. Ginger is very effective for reducing nausea and is safe. Echinacea is also safe for pregnant patients to use.
Alternative Treatments to Avoid
There are some alternative treatments you would be better off avoiding. At the top of the list are many herbal supplements. They can mess with your body chemistry just like any other drug.
Herbal supplements that should be avoided include: Arbor vitae, beth root, black cohosh, blue cohosh, cascara, chaste berry tree, chinese angelica, cinchona, cotton root bark, feverfew, pennyroyal oil, rue, sage, sebba, St. John’s Wort, tansy, wormwood, and yarrow.
The list continues and includes many more herbal supplements. Many of them are abortifacients, meaning that could lead to a premature end to the pregnancy. Others are ‘uterine stimulants’, meaning that they can cause contractions in the uterus. Contractions of that sort are known to bring on preterm labor.
Most expecting parents have their doctor on speed dial. Even so, not every problem will need a full on exam and the doctor might be reluctant to prescribe a new drug. When that’s the case, milder treatments like OTC drugs and alternative treatments can offer relief from comfort while still being largely safe.
+ 8 sources
Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here
- Center for Drug Evaluation and Research (2021). PLLR Labeleing Final Rule. [online] U.S. Food and Drug Administration. Available at: https://www.fda.gov/drugs/labeling-information-drug-products/pregnancy-and-lactation-labeling-drugs-final-rule [Accessed 21 May 2021].
- Center for Drug Evaluation and Research (2020). OTC Drug Facts Label. [online] U.S. Food and Drug Administration. Available at: https://www.fda.gov/drugs/information-consumers-and-patients-drugs/otc-drug-facts-label [Accessed 21 May 2021].
- Servey, J.T. and Chang, J.G. (2021). Over-the-Counter Medications in Pregnancy. American Family Physician, [online] 90(8), pp.548–555. Available at: https://www.aafp.org/afp/2014/1015/p548.html?fbclid=IwAR3yURsFteKrdM_WTG0yqLtXugQ1cbOrGe4S9LW7Wv_eoSL8BykX9eTYSHE#afp20141015p548-b46 [Accessed 21 May 2021].
- Center for Drug Evaluation and Research (2020). Index to Drug-Specific Information. [online] U.S. Food and Drug Administration. Available at: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/index-drug-specific-information [Accessed 21 May 2021].
- Anon, (2021). Medication Safety Program. [online] Available at: https://www.cdc.gov/medicationsafety/index.html [Accessed 21 May 2021].
- Bandoli, G., Palmsten, K. and Chambers, C. (2019). Acetaminophen use in pregnancy: Examining prevalence, timing, and indication of use in a prospective birth cohort. Paediatric and Perinatal Epidemiology, [online] 34(3), pp.237–246. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1111/ppe.12595 [Accessed 21 May 2021].
- Cleveland Clinic. (2019). Pregnancy and Alternative Therapies. [online] Available at: https://my.clevelandclinic.org/health/drugs/9595-pregnancy-using-alternative-therapies [Accessed 21 May 2021].
- Park, J., Sohn, Y., White, A.R. and Lee, H. (2014). The Safety of Acupuncture during Pregnancy: A Systematic Review. Acupuncture in Medicine, [online] 32(3), pp.257–266. Available at: https://journals.sagepub.com/doi/abs/10.1136/acupmed-2013-010480 [Accessed 21 May 2021].
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Medically reviewed by:
