Pregnancy and Medications

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While many medications during pregnancy are safe to use, some prescription and over-the-counter (OTC) medications can boost risks of miscarriage and birth defects during pregnancy. That's why it's a good idea to talk to your doctor about which medications you're taking before you get pregnant. However, if you're surprised to find yourself expecting and aren't sure about the connection between medications and pregnancy, and you've have taken OTC or prescription medications since conceiving, don't panic! Talk to your doctor about safe medications during pregnancy. In the vast majority of cases, the baby is absolutely fine, says Jerome Yankowitz, MD, director of maternal-fetal medicine at the University of Iowa College of Medicine and coeditor of Drug Therapy in Pregnancy.

First, talk to your doctor about pregnancy and medications
Of course, it's always smart to avoid taking drugs you don't really need — grabbing a pain reliever at the slightest hint of a headache, for example. And that's doubly true during pregnancy. That said, you shouldn't simply stop taking your prescription medications when you find out you're expecting. Untreated, conditions like diabetes and epilepsy can harm you and baby.

If necessary, your doctor can prescribe safer alternatives to the medications you're taking. Certain drugs are safe during early pregnancy, but not later, and vice versa. In addition, your physician may need to change the dose of certain drugs you're taking during pregnancy. So keep consulting your physician throughout your pregnancy. It's also extremely important that you tell your doctor about any herbal, "natural", or alternative medicines or treatments you're receiving. Taking alternative medicines can affect you and your baby's health during pregnancy.

Over-the-Counter Medications and Pregnancy
Don't assume that OTCs are safe to use without your doctor's okay, simply because you can buy them without a prescription. They're drugs, just like the prescription variety, says Donald R. Mattison, MD, medical director of the March of Dimes Birth Defects Foundation. While you should always double-check with your doctor before taking anything, here's a quick guide to some commonly used, safer, and less safe, OTCs:

Safer OTCs

• Allergy medications: Many, including the nasal spray Nasalcrom, and antihistamines such as Benadryl and Unisom
• Antinausea drugs: Vitamin B6 (up to 100 milligrams daily), and other products, including Dramamine and Unisom
• Constipation remedies: Stool softeners and other products, including Milk of Magnesia, Amphogel, and Maalox
• Flu fighters: The flu vaccine. Caveat: If you're allergic to eggs or chicken, you shouldn't get this vaccine, which may contain egg protein.
• Heartburn remedies: Many antacids, including Amphogel, Gelusil, and Maalox
• Multivitamins: Many brands, as long as they don't include doses of vitamins or minerals far in excess of the Recommended Daily Intake (RDI).
  Caveat: Talk to your doctor about taking prenatal vitamin-mineral supplements, which are specially formulated for pregnant and nursing women.
• Pain relievers: Acetaminophen, or Tylenol
• Yeast Infection remedies: Most vaginal creams, including Monistat and Femizol-M

Less safe OTCs

• Pain relievers: Aspirin at doses higher than 81 milligrams — the amount in "baby" aspirin. Motrin, Advil, and other brands of ibuprofen, as well as other nonsteroidal anti-inflammatory drugs (NSAIDs) including naproxen sodium, and ketoprofen (All should be avoided after the second trimester.)
• Constipation remedies: Mineral oil

Prescription Medications and Pregnancy
Though grabbing an OTC off the shelf is convenient, your doctor may be able to prescribe a drug that does the same job with a greater margin of safety. Many OTC cold remedies, for instance, are combinations of medicines — decongestants, cough suppressants, and antihistamines. If you've got a nasty cough and nothing else, having your doctor prescribe a cough suppressant, and nothing else, is a better bet. That way, you don't end up taking drugs you really don't need, Dr. Yankowitz says.

In general, older prescription drugs are a safer bet than the newest drugs on the market, simply because they've been used longer and we know more about them, he adds. Here's a list of some of the most commonly used drugs with cleaner, and not so clean, track records during pregnancy:

Safer prescription drugs

• Antibiotics: Several major classes, including penicillin, cephalosporin, erythromycin, clindamycin
• Asthma medications: Most inhaled medications, including inhaled steroids
• Antacids: Many, including Zantac and Carafate
• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and Zoloft; and tricyclic antidepressants, such as imipramine, sold as Tofranil, and amitriptyline, sold as Elavil
• High blood pressure drugs: Several, including Aldomet, Normodyne, and Trandate

Less safe prescription drugs

• Antibiotics: Tetracycline and doxycycline (avoid after the first trimester), streptomycin and kanamycin
• Antiseizure drugs: Carbamazepine, sold as Tegretol or Carbatrol, and valproic acid
• Migraine medications: Ergotamine drugs such as Ergomar and Bellamine

Unsafe prescription drugs

• Acne medications: Accutane and other oral vitamin A compounds
• Arthritis drugs: Arthrotec
• Blood thinners: Warfarin, sold as Coumadin
• High blood pressure medications: ACE inhibitors such as Lotensin, Accupril, Monopril (Avoid after the first trimester.)
• Ulcer medications: Misoprostol, sold as Cytotec

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

Content courtesy of American Baby.