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Over the counter (OTC) Medications Considered Safe for Use During Pregnancy

The use of prescription and over the counter (OTC) medications is common during pregnancy. However, there is often little reliable information about the safety of medications during pregnancy when they are first introduced into the market.

The Food and Drug Administration (FDA) created 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.

Medications 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 underlying illness.

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. 
 

Use Our Developmental Stage Calculator
To find out how far along you were in pregnancy when
you were exposed to an agent.

For 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 indicated.
  • 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. 2009;2(3):135-6


 

Consult with your doctor before starting or stopping
ANY medication during pregnancy.


Some OTC Medications Considered Safe for Use During Pregnancy
(See Also Prescription Drugs of Choice During Pregnancy)

Condition

Medication

Cough
  • Dextromethrophan (Robitussin DM sugar free ®) -Cough suppressant
  • Cough drops
    Consult with your doctor if you have
    severe or persistent sore throat
  • Constipation
  • Metamucil® , Citrucel®,
  • Docusate (Colace®, Ducolax ®)
  • Milk of magnesia.
  • Polyethyelene glycol (Miralax®)
  • Diarrhea
  • Loperamide (Imodium A-D ®)
    Consult with your doctor if you have high fever, bloody diarrhea,  or more than one dose is necessary
  • Gas
  • Simethicone (Gas-X ®, Mylicon ®, Phazyme ®)
  • Gastroesophageal reflux disease (GERD),
  • Ranitidine (Zantac®)
  • Cimetidine (Tagamet®)
  • Hayfever, sneezing, runny nose, itchy watery eyes
  • Chlorpheniramine (Chlor-Trimeton ®,Efidac ®, 
        Teldrin ®)
  • Diphenhydramine  (Benadryl ®) Clemastine (Tavist  Allergy ®)
  • Rhinocort Aqua nasal spray
  • Headache or fever:
  • Acetaminophen (APAP,Paracetamol,Panadol, Tylenol®)
  • Heartburn
  • TUMs®
  • Hemorrhoids
  • Tucks®
  • Preparation H®
  • Anusol®
  • Insomnia
  • Doxylamine (Unisom Sleep Tabs® )
  • Motion sickness
  • Dimenhydrinate (Dramamine ®)
  • Nasal congestion
  • Pseudoephedrine (Sudafed ®)
        -Avoid in first trimester. Consult with your
        doctor regarding risk -benefit. Not for
         prolonged use.
  • Saline nasal spray (Ocean Mist®)
  • Nausea
  • Ginger
  • Pyridoxine 25 mg PO TID WITH

  •        Unisom Sleep Tabs (Doxylamine Succinate 25 mg) 1/2 tablet TID
    Rash
  • 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
  • Printable Table

    SEE ALSO:
    Medications and Diagnostic Agents in Pregnancy

    Created: Mark A Curran, M.D.,F.A.C.O.G.
    Update: 1/10/2013

     


     

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