Overview

Medicines you can take during pregnancy

It can be hard to know if a medicine is safe for your baby. Most medicines are not studied in pregnant women. That's because researchers worry about how the medicines might affect the baby. But some medicines have been taken for so long by so many women that doctors have a good idea of how safe they are.

In general, doctors say it is usually safe to take the following.

Prescription medicines

• Some medicines for high blood pressure
• Most medicines for asthma
• Some medicines for depression
• Penicillin and some other antibiotics
• Medicines for HIV

Over-the-counter medicines

• Acetaminophen (such as Tylenol) for fever and pain
• Some allergy medicines, including loratadine (such as Claritin) and diphenhydramine (such as Benadryl)
• Some over-the-counter cold medicines

Talk to your doctor or midwife about any medicines you take. This includes over-the-counter medicines and natural health products.

Deciding about medicines during pregnancy

Doctors usually tell women to avoid medicines during pregnancy, if possible, especially during the first 3 months. That is when a baby's organs form.

But what if you take medicine for a health problem, such as high blood pressure or asthma? Your doctor or midwife will look at the risks. A medicine may have risks, but not treating your illness could be risky too. If you or your baby would face worse problems without treatment, then your doctor or midwife may keep you on your current medicine or switch you to another one. Some medicines that aren't safe in the first trimester may be safe to use later in the pregnancy.

Medicines you need to avoid during pregnancy

Some medicines are known to increase the chance of birth defects or other problems. But sometimes there's more risk for the mother and the baby if the mother stops taking a medicine (such as one that controls seizures) than if the mother keeps taking it. You can work with your doctor or midwife to make the safest medicine choices.

Some medicines that increase the risk of birth defects are:

• The acne medicine isotretinoin. This medicine is very likely to cause birth defects. It should not be taken by women who are pregnant or who may become pregnant.
• ACE inhibitors, such as benazepril and lisinopril. These medicines are used to treat high blood pressure and some heart conditions.
• Some medicines to control seizures, such as valproic acid.
• Methotrexate. It is sometimes used to treat arthritis.
• Warfarin (such as Coumadin). It helps prevent blood clots.
• Lithium. It is used to treat bipolar depression.
• Alprazolam (such as Xanax), diazepam (such as Valium), and some other medicines used to treat anxiety.
• Over-the-counter pain medicines like ibuprofen (such as Advil and Motrin) and naproxen (such as Aleve). The risk of birth defects with these medicines is low, but acetaminophen (such as Tylenol) is a safer choice.

Folic acid

Folic acid is a B vitamin. Taking it before and during early pregnancy reduces the risk that your baby will have a neural tube defect or other birth defects. Experts recommend that everyone who is pregnant take a daily multivitamin with folic acid.

• During pregnancy, you should get at least 400 mcg DFE (0.4 mg) of folic acid.^{footnote 1} You can get it from fortified foods (such as cereals) and supplements. ^{footnote 1}
• If you are pregnant with twins or more, talk to your doctor about how much folic acid you need daily.

You may need even more folic acid if you have a family history of neural tube defects, had a baby with this defect, or take medicines for seizures. Experts recommend 4000–5000 mcg DFE (4–5 mg) of folic acid a day.^{footnote 1}

If you need extra folic acid, work with your doctor. Don't try to do it on your own by taking more multivitamins. You could get too much of the other substances that are in the multivitamin.