The use of prescription and over the counter (OTC) medications is
common during pregnancy. However, there is
information about the safety of medications
during pregnancy when they are first introduced into the market.
and Drug Administration (FDA)
the FDA Use in Pregnancy Ratings to help patients and their health care providers decide whether
or not the risks of taking a medication outweigh the possible benefits
to the mother and baby. However, most
medicines approved by the Food and Drug Administration are not tested on
pregnant women. The assignment of a new drug to an FDA category may be based
solely on the results of animal tests. Information on the effects of medications in human
pregnancy comes from studies that depend on the recall of the mother ,
prescription databases, teratology services, birth registries, and
Pregnancy Exposure Registries.
It can take years to detect an increase in a specific
outcome associated with the use of a particular medication.
In addition the timing of exposure
and actual dosage are not always clear in these studies.
as Potential Teratogens in Pregnancy
Something that causes a birth
defect to occur at a higher rate than expected is called a teratogen. The
teratogen may be a chemical, a drug, an infection, radiation, or a maternal
condition such as diabetes. It is often difficult to determine
whether a birth defect or other bad outcome was related to a specific factor since there may
be many factors responsible including a mother's
Most teratogens produce their effect during
the sensitive 5th to the 10th week (embryonic period) of development when the major organs are forming .
For example, thalidomide causes limb defects when taken during the the 21st to
the 36th day after conception, and tetracyclines do not produce their effects
until after the first trimester when the skeletal system begins to form bone.
However, some drugs such as alcohol may produce harmful
effects on functional development throughout pregnancy.
some teratogens the effect depends on the amount of the exposure
with less severe birth defects occurring at lower doses. For other teratogens
such as radiation there appears to be a minimum threshold level (5 rads) below
which exposure is not believed to cause birth defects
Suggestions for taking medications when pregnant:
- Use medication only if absolutely
- Avoid taking medications during the
first trimester unless you have been instructed by your doctor to do so.
- Choose a
medication with a proven track record in human pregnancy.
- Use the lowest effective dose.
Avoid combination drugs if possible
- Do not use
over-the counter drugs that might interact with prescription medications.
Modified from: Norwitz ER,Greenberg JA.Rev Obstet Gynec ol.
Consult with your doctor before starting or stopping
ANY medication during
Some OTC Medications Considered Safe for Use During Pregnancy
(See Also Prescription Drugs of Choice During Pregnancy)
(Robitussin DM sugar free ®)
Consult with your doctor if you have severe
or persistent sore throat
Docusate (Colace®, Ducolax ®) Milk of magnesia.Polyethyelene
Loperamide (Imodium A-D ®)
Consult with your doctor if you have high fever, bloody diarrhea, or more
than one dose is necessary
(Gas-X ®, Mylicon ®, Phazyme ®)
Gastroesophageal reflux disease (GERD),
Hayfever, sneezing, runny nose, itchy watery
Chlorpheniramine (Chlor-Trimeton ®,Efidac ®,
Diphenhydramine (Benadryl ®)
Clemastine (Tavist Allergy ®)
Rhinocort Aqua nasal spray
Headache or fever:
(Unisom Sleep Tabs® )
Dimenhydrinate (Dramamine ®)
Pseudoephedrine (Sudafed ®)
-Avoid in first trimester. Consult with your
doctor regarding risk -benefit. Not for
prolonged use.Saline nasal spray (Ocean Mist®)
GingerPyridoxine 25 mg PO
Unisom Sleep Tabs (Doxylamine
Succinate 25 mg) 1/2 tablet TID
Caladryl lotion or cream
Hydrocortisone 1% cream or ointment
Oatmeal bath (Aveeno)
Consult with your doctor if you have
itching for more than a few days
Vaginal yeast infection
Clotrimazole cream (Gyne-Lotrimin®)
Or other topical azole therapy, applied for 7 days