From the Guidelines
During pregnancy, it's safest to take acetaminophen (Tylenol) for pain and fever, as it is the most widely used medicine during pregnancy with a large survey reporting 40-65% of pregnant women using it at some time during their pregnancy 1. When considering medication use during pregnancy, it's crucial to prioritize the safety of both the mother and the fetus.
- Generally considered safe options include:
- Acetaminophen (Tylenol) for pain and fever, as supported by a study published in the American Journal of Obstetrics and Gynecology 1
- Certain antacids like Tums for heartburn
- Some antihistamines such as diphenhydramine (Benadryl) or loratadine (Claritin) for allergies
- Fiber supplements and stool softeners like docusate sodium for constipation
- For chronic conditions, medications like methyldopa or labetalol for hypertension, insulin for diabetes, and levothyroxine for thyroid disorders are often continued under healthcare provider supervision, as noted in the 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy 1
- However, many medications including most NSAIDs (like ibuprofen), certain antibiotics, some antidepressants, and statins should be avoided due to potential risks to the fetus.
- It is essential to consult a healthcare provider before taking any medication during pregnancy, including over-the-counter drugs and herbal supplements, to assess the specific situation and recommend the safest options for both the mother and the baby 1.
From the FDA Drug Label
If pregnant or breast-feeding, ask a health professional before use. The FDA drug label does not answer the question.
From the Research
Medications Safe to Take During Pregnancy
- Acetaminophen, chlorpheniramine, kaolin and pectin preparations, and most antacids have a good safety record 2
- Histamine H2-receptor blockers, pseudoephedrine, and atropine/diphenoxylate should be used with caution 2
- Doxylamine-pyridoxine is commonly prescribed for nausea and vomiting of pregnancy, but its safety is still being debated 3, 4
- Pyridoxine monotherapy has stronger support for safety than the combination of doxylamine-pyridoxine during pregnancy 3
Biologic Agents During Pregnancy
- Most biologic agents are safe to use in pregnancy, but treatment options should be individualized to each patient's disease activity and response to medication 5
- Hydroxychloroquine, sulfasalazine, azathioprine, cyclosporine A, and low-dose aspirin are considered safe 5
- Glucocorticoids may increase the risk of gestational diabetes and gestational hypertension/preeclampsia 5
- Methotrexate, mycophenolate, and leflunomide are contraindicated during pregnancy 5
Safety of Specific Medications
- Doxylamine succinate-pyridoxine hydrochloride delayed-release combination (Diclegis) is safe and well tolerated by pregnant women when used in the recommended dose 6
- The combination of doxylamine and pyridoxine should be first-tier in the hierarchical approach to pharmacological treatment of nausea and vomiting of pregnancy 4