Medicines and Drug Use During Pregnancy

Medicines

While pregnant and when trying to get pregnant, avoid using any medicines or dietary supplements unless your health professional prescribes or recommends them. Nonprescription medicines are generally not well studied for use during pregnancy. However, some medicines have been widely used with no ill effects and are therefore thought to be safe. For example, acetaminophen (such as Tylenol) is safe at recommended doses to relieve fever or treat pain.

If you are pregnant or trying to conceive, follow these guidelines about medicine use, and be sure to check with your health professional before taking anything:

• Avoid medicine use before the second trimester if at all possible. The first trimester is the most high-risk period for taking medicine. This is when early cellular division, placenta growth, and organ development are taking place.
• Some cold and allergy medicines are thought to be safe during pregnancy. But many health professionals discourage their use unless absolutely necessary. If your symptoms are severe, talk to your health professional about the right cold or allergy treatment for you.
• Some complementary and alternative medicines, such as herbs or vitamin and mineral supplements, are safe during pregnancy. Many are not, and some supplements are dangerous when taken in too high a dose.
• Acetaminophen (such as Tylenol) is considered safe for pain or fever relief during pregnancy. But too much Tylenol can damage your liver. And its safety profile is based on wide use, rather than a lot of medical research. Check with your health professional before using it.

There are a lot of medicines that are not safe to use when you're pregnant. Common medicines to avoid include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen. Do not use an NSAID when trying to get pregnant and during pregnancy.
• The antidepressants Paxil and Paxil CR (paroxetine). The U.S. Food and Drug Administration (FDA) has issued a warning on paroxetine and birth defects. One study has shown that women who took Paxil during their first 12 weeks of pregnancy had a slightly higher chance of having a baby with birth defects.
• The acne medicine called isotretinoin (such as Sotret). This medicine causes birth defects.
• The heart medicines called ACE inhibitors (such as lisinopril, also known as Prinivil, Zestoretic, and Zestril). This type of medicine causes birth defects.

Information about medicine safety during pregnancy sometimes changes with new research, so be sure to check with your health professional before taking something that you've heard was safe in the past.

Drug use

Use of cocaine or methamphetamine during pregnancy can cause fetal harm or death resulting from:

• Placenta abruptio, which is the separation of the placenta from the uterus before a baby is delivered.
• Early (preterm) labor and premature birth.
• Fetal drug exposure.

Injected drugs are linked to an increased risk of infections, such as hepatitis or human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

Credits

By	Healthwise Staff
Primary Medical Reviewer	Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer	Kirtly Jones, MD - Obstetrics and Gynecology
Last Revised	July 23, 2012