Doi:10.1016/j.jmwh.2007.03.009

SHARE WITH WOMEN
TAKING MEDICINE DURING PREGNANCY
We hear so much in the news about the dangers of medicines for unborn babies. Because of these concerns, MEDICINE
many women suffer through colds and headaches without any medicine at all. Some medicines are safe to takewhen pregnant, and some are not. This handout answers the most frequently asked questions about takingmedicines during pregnancy.
Which Drugs Are Safe?
The US Food and Drug Administration has a safety class system for all medicines. Medicines are classified by category; they may be category A, B, C, D, or X. These categories refer to what we knowabout the effect a medicine has on a developing baby during pregnancy.
● Category A—Studies have been done with pregnant women. There is no known risk to the growing
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● Category B—Studies have been done with pregnant animals and shown no risk, but there are no
studies in women; OR studies in animals showed some risk, but studies in pregnant women did not findany risk.
● Category C—Studies done with pregnant animals show some risk, but there are no studies in women;
OR no studies have been done in animals or humans, so the risk for a pregnant woman is not known.
Medicines in this category are often prescribed during pregnancy if you need the medicine. Eventhough studies have not been done on the medicines in this class, most of them have been used bypregnant women for years without any problem.
● Category D—Studies have shown this medicine can harm a developing human baby during pregnancy.
However, there are benefits of these drugs for mothers who have a serious illness. This may make themworth taking in spite of the risk. If you need a medicine in this class, your health care provider will talkto you about the pros and cons for both you and your baby.
● Category X—Studies have shown these medicines can harm developing human babies during
pregnancy. There is no benefit to the mother that makes taking these drugs worth the risk.
Unfortunately, most medicines are category C. Not many studies have been done in pregnant women. Wejust don’t know very much for certain about medicines in pregnancy.
What Are the Category X Medicines?
There are a few medicines on the category X list. The most common are: hormones used for birth control,Isotretinoin (Accutane) which is prescribed for acne, some of the drugs used to control hyperlipidemia,warfarin (Coumadin) which is used to help prevent blood clots, misoprostol (Cytotec) which is an ulcermedication, and vaccines for measles, mumps and smallpox.
Are There Some Times in Pregnancy When it is More Dangerous to Take Medicines?
Your baby is developing most rapidly in the first 15 weeks of your pregnancy. This is the time you most want to avoid being exposed to anything that could harm your baby. To be safe, check with your healthcare provider before taking any medicine at any time during your pregnancy.
I’ve Been Taking Medicines That My Health Care Provider Gave Me Before I Got Pregnant. Can I Keep Taking Them?
If you are taking medicine and thinking about getting pregnant, talk with your health care provider. If you aretaking medicine and just found out you are pregnant, tell your health care provider as soon as you know youare pregnant. Some medicines are so important to your health that you will need to keep taking them. Some medicines can be changed to a lower dose or different medicine to cut down on the risk to your baby.
Are Medicines I Can Buy Without A Prescription (Over-the-Counter) Safe to Take During Pregnancy?
Some medicines that you can get over-the-counter are safe to use during pregnancy and some are not recommended. Check with the pharmacist or your health care provider before you take anything. This handout lists the most common over-the-counter medicines that are safe to use during pregnancy.
Journal of Midwifery & Women’s Health • www.jmwh.org
2007 by the American College of Nurse-Midwives 1526-9523/07/$32.00 • doi:10.1016/j.jmwh.2007.03.009 What to Do First
If you Need to Take Medicine
If You Have a Cold
Get plenty of rest. Drink lots of fluids. Wash your hands a lot.
Stuffy nose: chlorpheniramine (Chlor-Trimeton) or Use a saline nasal spray during the day and rub Vicks on your chest and on your throat before you go to bed at night to clear A nasal spray may work well and little drug will get to your Gargle with warm salt water and drink honey with lemon for a sore Use oxymetazoline (like Afrin or Vicks Sinex) or phenylephrine Rub a little Vaseline inside your nose to keep it from chapping.
If you use a medicated nasal spray, stop after 3 days. Using it for a longer time may cause your stuffy nose to get worse! Cough: Guaifenesin and dextromethorphan (like Robitussin DM).
Try to choose a cough syrup with the lowest amount ofalcohol.
Headaches
Drink plenty of water – at least 6 big glasses a day.
Acetaminophen (Tylenol) is best during pregnancy.
Eat small amounts all day long instead of 3 big meals – to avoid Don’t take ibuprofen (Motrin), naproxen (Aleve), or aspirin.
low blood sugar. Get someone to massage your neck andshoulders for you.
Yeast Infections
Use a vaginal cream like clotrimazole (Gyne-Lotrimin) or Allergies
First, use the home remedies listed under “colds”.
Use an antihistamine like Benadryl or loratadine (Claritin). Some antihistamines have alcohol included, so check labels.
Heartburn
Eat 5-6 small meals per day and do not lie down right after
If you need an antacid, take a chewable tablet that has calcium Avoid foods that are acidic (like tomatoes, fruit drinks, spicy foods, Don’t take antacids that have aspirin (Alka-Seltzer, Pepto-
fried foods). Drink or eat something soothing like milk, before Bismol) or soda bicarbonate (baking soda).
you lie down. Try chewing gum after eating.
Constipation
Drink more fluids – at least 6 big glasses of water a day is best.
Stool softeners like (docusate sodium) Metamucil (psyllium) are Eat lots of fruit and vegetables for bulk.
Don’t take mineral oil or Senokot.
Diarrhea
Drink lots of clear liquids.
If you have diarrhea for more than one day, call your health Kaopectate and Imodium are safe in pregnancy.
FOR MORE INFORMATION
Organization of Teratology Information Specialists (OTIS)
Information on the effects of drugs, chemicals, and other exposures on mothers and babies during pregnancy. Fact sheets
can be downloaded from the OTIS Web site or you can call toll-free (866) 626-6947 for
more information.
Motherrisk
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Motherrisk offers information about the effects of medicines during pregnancy and breastfeeding. Fact sheets about manyconcerns during pregnancy can be downloaded from the Motherrisk Web site Eachfact sheet lists which drugs are safe and which are not. You can also call Motherrisk toll-free at (877) 327-4636 (forinformation on alcohol and substance use) or (800) 436-8477 (for questions about morning sickness).
This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction
is subject to JMWH approval. The information and recommendations appearing on this page are appropriate in most instances,
but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JMWH
suggests that you consult your health care provider.
MEDICINE
Volume 52, No. 5, September/October 2007

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