Overview
During pregnancy, your focus may have shifted to your growing baby. But you, too, may need some extra TLC, especially if you get sick. According to the Centers for Disease Control and Prevention, some 9 in 10 women take medication at some point during their pregnancies.
Many over-the-counter (OTC) drugs and prescription medications are classified by the U.S. Food and Drug Administration (FDA) according to risk.
Those falling in categories A, B, or C are generally considered “safe” for use during pregnancy. This is because the benefit of taking the medication outweighs any associated risks demonstrated by studies on animals or humans:
Category Risks
A Controlled studies on pregnant women show no risk to fetus in first trimester or later trimesters.
B Animal studies haven’t shown adverse effects on fetus, but there are no controlled studies on pregnant women.
-OR-
Animal studies have shown adverse effects that weren’t confirmed by studies on women in the first trimester.
C Animal studies have shown adverse effects on fetus.
-AND-
There are either no controlled studies in women or studies on women/animals aren’t available. Drugs in this category are given with caution — only if the benefit justifies the potential risk.
D
Evidence of fetal risk exists with animal or human studies.
Drugs in this category may still be used if benefit outweighs risk; for example, in a life-threatening situation.
X Adverse effects have been confirmed by animal or human studies.
-OR-
Adverse effects have been demonstrated in the public. Risk of taking drug outweighs any benefit. Not prescribed for women who are or may become pregnant.
Pain or headache relief
Acetaminophen (Tylenol; category B) is the drug of choice for pain during pregnancy. It’s widely used with very few documented adverse effects.
Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), on the other hand, should be avoided during pregnancy.
NSAIDs include:
ibuprofen (Advil, Motrin)
ketoprofen (Orudis)
naproxen (Aleve)
If your pain is particularly severe — after a surgery, for example — your doctor may prescribe a short course of opioid pain relievers. When taken as directed, they may not affect fetal development.
That said, opioid use during pregnancy does carry the risk of withdrawal, called neonatal abstinence syndrome (NAS), after delivery.
Cold medicine
Cold medications are not well-studied for use during pregnancy. Some doctors suggest trying to wait until after your 12th week to minimize any potential risks to your baby.
Safe options include:
plain cough syrup, such as Vicks
dextromethorphan (Robitussin; category C) and dextromethorphan-guaifenesin (Robitussin DM; category C) cough syrups
cough expectorant during the day
cough suppressant at night
acetaminophen (Tylenol; category B) to relieve pain and fever
The active ingredient in Sudafed, pseudoephedrine, may elevate blood pressure or affect blood flow from the uterus to the fetus. This drug isn’t classified by the FDA. It may be safe during pregnancy, but speak with your doctor if you have high blood pressure or other concerns.
Doctors often recommend trying home treatments before taking medications:
Get plenty of rest.
Stay hydrated by drinking water and warm liquids, like chicken soup or tea.
Gargle salt water to ease sore throat.
Use saline nose drops to fight stuffiness.
Humidify the air in your room.
Use menthol rub on your chest.
Try nasal strips to open airways.
Suck on cough drops or lozenges.
Heartburn and acid reflux
OTC antacids containing alginic acid, aluminum, magnesium, and calcium are generally safe during pregnancy:
aluminum hydroxide-magnesium hydroxide (Maalox; category B)
calcium carbonate (Tums; category C)
simethicone (Mylanta; category C)
famotidine (Pepcid; category B)
For severe heartburn, your doctor may suggest taking H2 blockers, such as:
ranitidine (Zantac; category B)
cimetidine (Tagamet; category B)
Lifestyle changes may also help take the edge off heartburn:
Wear loose-fitting clothing that doesn’t put pressure on your abdomen.
Try keeping a food diary to help identify certain foods that may trigger your reflux.
Wait three hours to lie down after meals. Avoid late meals right before bedtime.
Sleep with your head elevated at night.
Eat small meals throughout the day.
Speak with your doctor if your heartburn becomes severe. In rare cases, it may be a sign of HELLP syndrome. This is a serious pregnancy complication.
Mild and severe allergies
Mild allergies may respond well to lifestyle measures. If you need some extra help, the following OTC oral antihistamines are generally considered safe:
diphenhydramine (Benadryl; category B)
chlorpheniramine (Chlor-Trimeton; category B)
loratadine (Claritin, Alavert; category B)
cetirizine (Zyrtec; category B)
If your allergies are more severe, your doctor may suggest taking an OTC corticosteroid spray at a low dose along with an oral antihistamine. Options include:
budesonide (Rhinocort Allergy; category C)
fluticasone (Flonase; category C)
mometasone (Nasonex; category C)
You may also try the following lifestyle changes:
Avoid going outdoors or opening windows on high pollen days.
Take off clothing you’ve been wearing outdoors. Rinse off pollen from skin and hair with a quick shower.
Wear a mask while completing outdoor chores or enlist the help of someone else for tasks like mowing.
Rinse nasal passages with saline spray or a neti pot.
Constipation
Stool softeners are generally considered safe during pregnancy. Options include Colace or Surfak.
Laxatives, like Senokot, Dulcolax, or Milk of Magnesia, may also help, but speak with your doctor before trying any of these medications.
Other treatment options for constipation include the following:
Drink more water and fluids. Prune juice is another good choice.
Add more exercise to each day.
Eat more fiber. You can find fiber in fruits and vegetables (with skins, if possible), beans, and whole grains.
Ask your doctor about fiber supplements, like Metamucil.
Nausea and vomiting
Morning sickness is common in the first trimester of pregnancy. Treatment isn’t always needed. Try home remedies, like eating small meals throughout the day or sipping ginger ale, before reaching for medications.
You might try:
vitamin B-6, 25 milligrams by mouth three times a day
doxylamine succinate (Unisom; category B)
dimenhydrinate (Dramamine; category B)
There are medications your doctor may prescribe if you’re experiencing severe nausea and vomiting (hyperemesis gravidarum):
doxylamine succinate-pyridoxine hydrochloride (Diclegis; category A)
ondansetron (Zofran; category B)
Hemorrhoids
Hemorrhoids may develop during pregnancy due to swollen blood vessels or constipation.
Safe treatment options include:
Tucks pads or other witch hazel pads
Preparation H
Anusol
You may want to try other methods first:
Soak the hemorrhoids by filling a tub with warm water. Don’t add soap or bubble bath.
Stand or lie on your side when possible.
Try a ring cushion or hemorrhoid pillow for when you must sit.
Treat constipation by taking stool softeners, drinking more fluids, getting more exercise, and eating more fiber.
Yeast infections
Yeast infections are common in pregnancy. Still, it’s a good idea to contact your doctor for a proper diagnosis before treating it at home.
Safe medications include:
miconazole (Monistat; category C)
clotrimazole (Lotrimin; category C)
butoconazole (Femstat; category C)
Home remedies and natural treatments are generally not recommended for yeast infections during pregnancy.
Skin rashes, cuts, scrapes
Rashes and itchy skin can be treated with OTC hydrocortisone cream during pregnancy. But mention these symptoms to your doctor to rule out conditions like pruritic urticarial papules and plaques of pregnancy (PUPPPs). You doctor may prescribe steroidal creams for certain conditions.
For cuts and scrapes, clean the area well with soap and water. You may then apply an OTC antibiotic ointment, like Neosporin, for added protection.
Difficulty sleeping
Safe medications for insomnia are those in the diphenhydramine (category B) family, including:
Sominex
Nytol
Doxylamine succinate (Unisom; category B) is another possibility that may also be used if you’re experiencing insomnia.
If OTC methods don’t work, your doctor may prescribe the following after weighing the benefits and risks:
sedating tricyclic antidepressants (Amitriptyline, Nortriptyline; category C)
benzodiazepines (Ativan, Klonopin; category D)
Benzodiazepines may be associated with risk of cleft or lip palate. Use in later pregnancy may not carry this risk.
Lifestyle changes you can try include the following:
Schedule sleep for consistent wake and bedtimes.
Get regular exercise.
Limit napping to no more than 30 minutes per day.
Skip caffeine and other stimulants.
Create a nighttime ritual. For example, take a bath, listen to music, or do yoga.
Explore alternative treatments, such as meditation or acupuncture.
Supplement use during pregnancy
Discuss any supplements you take or plan to take during your pregnancy with your doctor.
While prenatal vitamins are recommended to support levels of essential vitamins and minerals, like folate, other supplements may pose risks to your baby. They may also interact with medications you’re already taking.
Note that just because something is labeled “all-natural” doesn’t always mean it’s safe. Supplements are not regulated by the FDA in the same way as prescription drugs. Approach them with caution and discuss using with your doctor before starting any.
Prescription medications you’re already taking
Before pregnancy, you may already be taking prescription medications for thyroid issues, high blood pressure, or other conditions. Speak with your doctor about continuing these medications, especially if you’re already pregnant or plan to become pregnant in the near future.
In many cases, you may safely take your medication during pregnancy. Sometimes you may need to either adjust dosages or switch to another medication that’s considered safer for you and baby.
Alternative therapies
Complementary and alternative therapies may be good options to during pregnancy. Examples include:
acupuncture
acupressure
chiropractic care
massage therapy
Certain complementary and alternative medication methods, especially those involving herbs or supplements, may not be safe, however. In general, alternative therapies aren’t well-studied, so discuss any you plan on trying with your doctor.
Also, do your homework on different practitioners before heading in for a visit. Ensure they have the appropriate licenses to practice on pregnant women.
The takeaway
There are many medications you can safely take during pregnancy. The key is communicating with your healthcare provider.
A great online, evidence-based resource to check is Mother to Baby. It provides fact sheets on different drugs as well as additional information on potential interactions and birth defects.
Even better, most obstetrics offices have a helpline you can call between appointments. Don’t hesitate to dial in with any and all of your questions or concerns.