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Medicines and Herbal Remedies During Pregnancy

Medicines and Herbal Remedies During Pregnancy

If you are pregnant or plan to become pregnant, you probably want to know what medications and herbal remedies are safe to take after you become pregnant. Ideally, it would be best to discuss your current medications with your doctor before you conceive. In any case, as soon as you know you are pregnant, inform your health care providers and discuss what medicines are safe for you to take.

If you are breast-feeding, some medications may pass into the breast milk and cause unwanted effects on your nursing baby, so check with your health care provider about taking medications after the baby is born as well.

Medications Taken For A Medical Condition

If you are taking medication for a condition such as epilepsy, high blood pressure, asthma, or depression, often the benefits of continuing to take the medicine during pregnancy outweigh the risks to the baby. Don't assume you should stop taking the medicine. Always check with your doctor to determine the recommendation for you. You may also be able to switch to another medication that treats your problem with less risk to your developing baby.

Medicines Known to Cause Potential Harm

Some medicines have been shown to cause possible birth defects or other problems in unborn children. For other medicines, there is not good information as to whether they are safe or unsafe during pregnancy. Some of the medications known to cause birth defects are listed below. This list provides examples only -- do NOT assume a medication is safe or unsafe based solely on this chart.

table: Medicines Known to Cause Potential Harm

Drug Used to Treat Possible effect during pregnancy
Accutane (Isotretinoin) Acne Miscarriage; heart, jaw, facial, and brain defects
Androgens Genital abnormalities
Anticoagulants such as warfarin and dicumarol Blood clots Miscarriage, bone, cartilage, eye, and central nervous system defects
Anticonvulsants such as Dilantin, Tridione, Paradione, and Depakote Seizure disorders and irregular heartbeat Intellectual disability; growth and developmental abnormalities; neural tube defects, defects of the hands/face
Antithyroid drugs such as propylthiouracil, iodide, Methimazole Overactive thyroid Thyroid gland defects
Radiation therapy Medical treatment of disorders such as cancer Growth restriction and intellectual disability
Chemotherapy drugs such as methotrexate and aminopterin Cancer and skin disease Miscarriage and birth defects
Etretinate (Tegison) Psoriasis Heart, jaw, and facial defects
Lithium Bipolar disorder Congenital heart defects
Streptomycin Tuberculosis Hearing loss
Tetracycline Infection Underdeveloped tooth enamel; becomes incorporated into fetal bones
Thalidomide Insomnia Malformed limbs and growth problems
Diethylstilbestrol (DES) Menstruation problems, to stop milk production, previously used to prevent preterm labor and miscarriage Abnormalities of cervix and uterus in females, possible infertility in males and females
Organic Mercury Exposure through eating contaminated food Brain disorders
Lead Industries involving lead smelting, paint manufacture and use, printing, ceramics, glass manufacturing, and pottery glazing Problems in development of the fetal central nervous system
From American College of Obstetricians and Gynecologists (ACOG), Planning for Pregnancy, Birth and Beyond (pp. 106-107).

Over-the-Counter Medicines

Aspirin and Ibuprofen: Aspirin should be avoided during pregnancy, unless your health care provider specifically recommends it. Occasionally, women with a history of blood clotting problems, miscarriage, or pre-eclampsia are told to take aspirin while they are pregnant. Otherwise, it’s best not to take aspirin. Be aware that aspirin is in many other over-the-counter medications, such as Pepto Bismol and cold medicines. Ibuprofen is also best avoided during pregnancy, as it can affect the fetus’ kidneys.

Tylenol: Generally, Tylenol (acetaminophen) is considered safe to take during pregnancy in standard doses. Check with your doctor before you take more than a few doses, and discuss the number of days that would be considered safe to take it consecutively.

Medications for Colds, Constipation, and Indigestion: There are some over-the-counter medications and natural remedies that are considered safe for these ailments. Check with your health care provider about which medication is best for you, based on your symptoms and how far along you are in your pregnancy. In general, cold remedies with only one active ingredient are best.

Herbal Medicines During Pregnancy

While herbal medications are commonly thought of as "natural" alternatives to other medicines, they can be just as potent as some prescription medications. Many herbs contain chemicals that will cross the placenta to your baby if taken while you are pregnant. Some herbs have been known to cause premature contractions if taken during pregnancy. Generally, the use of medicinal drugs (including herbal tea) is best avoided altogether, particularly during the first trimester. You should always talk to your health care provider before taking any herb during pregnancy.

Updated: 12/9/2012

Irina Burd, MD, PhD, Maternal Fetal Medicine, Johns Hopkins University, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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