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Medication Strategies During Pregnancy

When you're pregnant, you want to do everything you can to protect your baby. If you have a cold, a headache, or heartburn, is it safe to take an over-the-counter (OTC) remedy?

No one can say for sure that a medication is safe to use while you're pregnant. But, avoiding medicines may not be a good idea, either. It may be wiser to treat an illness than ignore it.

Doctor knows best

When you find out you're pregnant, it's important to talk with your doctor or midwife about whether to stop or continue medications you're taking. You and your health care provider should discuss the risks and benefits of the medications and decide what's best for you and your baby.

Planning ahead is even better. If you're planning to get pregnant, talk with your health care provider about medications that are safe during pregnancy and which you should avoid.

Read labels

Medications sold in the United States are regulated by the U.S. Food and Drug Administration (FDA). The FDA also ranks them on how safe they are during pregnancy. Warnings for pregnant women may be on the packaging. But some products haven't been thoroughly evaluated for risks during pregnancy because it would be unethical to do so. Even without a warning, risks may exist. This is also true for herbal products and dietary supplements, which aren't regulated by the FDA.

If your health care provider says it's OK to take an OTC medication, follow his or her instructions about how much to take and how often.

OTC drugs to avoid

Many pregnant women take medication, including OTC remedies. Ask your health care provider about the following, which are usually off-limits:

  • Aspirin. This nonsteroidal anti-inflammatory drug (NSAID) has been associated with a higher risk of bleeding, low-birth-weight babies and problems during delivery. It also may cause problems when trying to conceive.

  • Ibuprofen, ketoprofen, indomethacin and naproxen. These NSAIDs usually aren't recommended in the third trimester. They've been linked with a higher risk of some fetal heart problems. They may cause problems with conception and may raise the risk for miscarriage.

  • Guaifenesin. Avoid this common ingredient in cough medicine during the first trimester. One study showed that it may increase the risk for neural tube defects, such as spina bifida, although other studies failed to confirm this.

  • Nizatidine. This medicine for heartburn and gastroesophageal reflux disease has been linked to problems with pregnancies in animals. More studies relating to pregnant women are needed.

Don't assume you need to suffer through symptoms because you're expecting a baby. Ask your provider about ways to get relief.

What about maintenance medications?

Pregnancy poses special challenges if you have a chronic condition such as asthma, diabetes, or high blood pressure. Managing medications may be one of them. It's smart to see your provider before conceiving so you can plan ahead.

In some cases, sticking with your current treatment regimen may be the best idea. For example, controlling your blood glucose levels if you have diabetes may reduce your risk of miscarriage. And, keeping asthma or high blood pressure in check during pregnancy can help prevent problems with the baby. Other drug therapies may need to be fine-tuned. Perhaps a lower dose of the medication or another drug is an option.

Whatever you do, don't stop taking medicine on your own. Discuss your medication and your pregnancy with your obstetrician first. Your doctor will help you weigh any risks and benefits. If medication helps you stay healthy, it may be the best choice for you and your baby.