Overview

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 sometimes you have to take medicine to treat a health problem, such as high blood pressure or asthma.

Before prescribing any medicine, your doctor or midwife will look at whether the risk of taking medicine is higher than the risk of not treating your illness. If you or your baby would face worse problems without treatment, then your doctor or midwife will prescribe medicine or recommend an over-the-counter one. He or she will also look at which medicine to give you. For example, some antibiotics are safe for pregnant women, and some are not.

What medicines can you 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, 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. Talk to your doctor or midwife before you take any medicines.

In general, doctors say it is usually safe to take:

• Acetaminophen (such as Tylenol) for fever and pain.
• Penicillin and some other antibiotics.
• HIV medicines.
• Some allergy medicines.
• Some over-the-counter cold medicines.
• Some medicines for high blood pressure.
• Most asthma medicines.
• Some medicines for depression.
• Some medicines for heart burn.

If you are planning a pregnancy, talk to your doctor or midwife about any medicines you are taking, including over-the-counter ones. Some of them may be safe during pregnancy. But others may not be safe. Your doctor or midwife may have you stop taking a medicine or may switch you to another one. Some medicines that aren't safe in the first trimester may be safe to use later in the pregnancy.

What medicines should you avoid during pregnancy?

Some medicines are known to increase the chance of birth defects or other problems. But sometimes, stopping a medicine (such as one that controls seizures) has greater risk to the mother and the baby than continuing to take the medicine. Talk to your doctor about any medicines you take if you are thinking about having a baby or if you are pregnant.

Some of the over-the-counter medicines that increase the chances of birth defects are:

• Bismuth subsalicylate (such as Pepto-Bismol).
• Phenylephrine or pseudoephedrine, which are decongestants. Avoid medicines with these ingredients during the first trimester.
• Cough and cold medicines that contain guaifenesin. Avoid medicines with this ingredient during the first trimester.
• Pain medicines like aspirin and ibuprofen (such as Advil and Motrin) and naproxen (such as Aleve). The risk of birth defects with these medicines is low.

Some of the prescription medicines that increase the chances of birth defects are:

• The acne medicine isotretinoin (such as Accutane). 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, which lower blood pressure.
• Some medicines to control seizures, such as valproic acid.
• Some antibiotics, such as doxycycline and tetracycline.
• Methotrexate, which is sometimes used to treat arthritis.
• Warfarin (such as Coumadin), which helps prevent blood clots.
• Lithium, which is used to treat bipolar depression.
• Alprazolam (such as Xanax), diazepam (such as Valium), and some other medicines used to treat anxiety.
• Paroxetine (such as Paxil), which is used to treat depression and other conditions.

Is it okay to take natural health products?

Talk to your doctor or midwife about any natural health products that you have been taking. Don't take any natural health products unless you talk with your doctor or midwife first.

Folic acid is especially important before and in the first few weeks of pregnancy, because it prevents some birth defects. Take 400 mcg of folic acid every day for at least 2 to 3 months before trying to get pregnant and while you are pregnant.^{footnote 1} Some women need higher doses. Talk with your health professional about how much folic acid you need.

You can get folic acid in an over-the-counter multivitamin or in a multivitamin that your doctor or midwife prescribes. Follow your doctor's advice about how to get higher amounts of folic acid. Don't just take more multivitamins. You could get too much of the other substances that are in the multivitamin.

In some cases doctors and midwives prescribe extra iron.