Is it safe to take Advil (Ibuprofen) during the first trimester of pregnancy?

From the Guidelines

It is not safe to take Advil (Ibuprofen) during the first trimester of pregnancy, and instead, paracetamol should be used as the first-line medication for acute treatment. According to the most recent and highest quality study, NSAIDs, such as ibuprofen, can only be used during the second trimester due to the potential harm to the fetus 1. The use of NSAIDs during the first trimester has been associated with an increased risk of miscarriage and potential interference with fetal development.

Key Considerations

• NSAIDs, including ibuprofen, are not recommended during the first trimester of pregnancy due to the potential risks to the fetus 1
• Paracetamol is considered the safer option for pain relief during pregnancy, and should be used as the first-line medication for acute treatment 1
• If pain relief is needed during pregnancy, it's best to consult with a healthcare provider to determine the safest and most effective treatment option

Potential Risks

• Increased risk of miscarriage when using NSAIDs in early pregnancy
• Potential interference with fetal development and problems with the baby's heart and blood vessels
• Premature closure of the ductus arteriosus (a blood vessel in the developing baby's heart) in the third trimester

Recommendations

• Use paracetamol as the first-line medication for acute treatment during pregnancy
• Consult with a healthcare provider before taking any medication during pregnancy
• Use the lowest effective dose of paracetamol for the shortest duration necessary 1

From the FDA Drug Label

Use of NSAIDs, including ibuprofen tablets, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment Data from observational studies regarding other potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive Ibuprofen tablets should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus

The use of ibuprofen during the first trimester of pregnancy is not recommended unless the potential benefit justifies the potential risk to the fetus. Key considerations include:

• The potential for premature closure of the fetal ductus arteriosus
• Fetal renal dysfunction leading to oligohydramnios
• Inconclusive data regarding other potential embryofetal risks It is essential to weigh the potential benefits against the potential risks and consider alternative treatments. 2

From the Research

Safety of Ibuprofen During Pregnancy

• Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is generally not recommended during pregnancy, especially during organogenesis and in the third trimester 3.
• However, some studies suggest that ibuprofen may be used during the first trimester, but with caution and for a short period 4.
• It is considered the NSAID of choice for mild to moderate pain in pregnancy, but is contraindicated after 28 weeks of gestation due to the increasing risk of premature closure of the ductus arteriosus and impairment of fetal kidney function 5.
• The use of NSAIDs, including ibuprofen, during the second trimester is considered reasonably safe, but may be associated with fetal risks such as cryptorchism 6.

Recommendations for Pain Management During Pregnancy

• Paracetamol is the agent of choice for mild to moderate pain in any stage of pregnancy 5, 7.
• Ibuprofen and other NSAIDs can be administered carefully in the event of pain, depending on the trimester, but special care is required in the last trimester 7.
• Non-pharmacological treatment concepts, such as transcutaneous electrical nerve stimulation (TENS therapy), kinesio tapes, and acupuncture, are also available for pain management during pregnancy 7.