Drugs and medicines in pregnancy

Some medicines can harm your growing baby, and this can include certain standard over-the-counter painkillers, such as ibuprofen (Nurofen for example). 

Because many medicines may be unsafe during pregnancy, it’s always best to ask your doctor, midwife, pharmacist or dentist before you take anything.

This page covers prescribed or over-the-counter drugs and medicines. For information on 'recreational' drugs, such as cannabis, cocaine and heroine, click here.

If you were taking any particular medicine before your pregnancy, you should also ask your doctor whether this is still OK to take now you’re pregnant (or planning to get pregnant). For many medicines, there may not be evidence or research to be able to give a definite answer as to whether it is safe to take or not, so you and your doctor will need to discuss the risks and benefits of taking the medicine.

It is usually safer to take your regular medicine than to let a condition such as asthma, diabetes or high blood pressure go untreated. This is also true of treatment for mental health problems. Your doctor may be able to prescribe a different drug that’s known to be safe to use during pregnancy. If possible you should talk about this when you’re planning to get pregnant but if you are already pregnant discuss it as soon as possible.

All medication should be taken as instructed on the pack or as prescribed by a doctor or midwife. Do not go over the prescribed dose.

What medicines can I take in pregnancy?

There are some medicines listed here that are safe for taking for common conditions.

Coughs and colds

Cough and cold remedies often contain a mixture of ingredients so always check what is in them. 

You can take:

• hot honey and lemon drink
• paracetamol – but always stick to the recommended dose on the packet.
• dextromethorphan, which is found in many cough syrups.
• simple linctus (a syrupy liquid) or lozenges containing honey or glycerol to coat your throat if it is sore
• steam inhalations for a blocked, stuffy nose.

Constipation

The first step to help with constipation is to try to increase the amount of water or fluids that you are drinking. Aim for about eight glasses (200ml) a day. Having plenty of fibre such as fruit and vegetables in your dietcan help. Aim for at least five portions a day. If this doesn’t help you can also try these medicines:

• Lactulose - a sugar substance softens the stool so it is easier to pass
• Senna or cascara - laxatives that stimulate your bowel to empty
• a bulk-forming laxative that contains ispaghula (such as Fybogel), methylcellulose, bran or sterculia. Taken with plenty of water, this increases volume of your bowel contents so your gut muscles work better

Read more about constipation here

Hayfever and allergies

Avoid products containing antihistamines, such as brompheniramine, meclozine, diphenhydramine, doxylamine, cetirizine and loratadine, as there is not enough information about their safety. The same is true of nasal decongestants, with ingredients such as pseudoephedrine, phenylephrine, xylometazoline and oxymetazoline.

You can use:

• sodium cromoglicate nasal spray or eye drops.
• nasal sprays containing corticosteroids such as beclometasone, although you should only use these for a short time.
• Chlorphenamine (such as Piriton) (limit use, especially in third trimester)
• steam inhalations for a blocked, stuffy nose.

Heartburn and indigestion

If dietary changes such as avoiding fizzy drinks, spicy and acidic foods do not help then there are medications that can help. Medicines containing aspirin (such as Alka-Seltzer) should also be avoided during pregnancy. Aspirin may be listed on a label as salicylate or acetylsalicylic acid.

• antacids – apart from sodium bicarbonate, which you should avoid
• alginates, such as Gaviscon
• ranitidine and omeprazole.

Read more about heartburn here

Pain, such as headache or backache

Headaches are common in pregnancy and can be caused by dehydration so try drinking more water before taking the following.
You can take:

• paracetamol – but always stick to the recommended dose on the packet.
• codeine and dihydrocodeine can be prescribed when necessary however should only be taken for short periods of time to treat pain in pregnancy. If you use them a lot, particularly at the end of your pregnancy, they may cause withdrawal symptoms or breathing problems in your baby.

What medications should I avoid in pregnancy?

Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs)

These can interfere with blood clotting. In the last few weeks of pregnancy they could also cause a problem with the baby’s heart and lungs. Used late in pregnancy, ibuprofen may interfere with labour or cause you to have less amniotic fluid (waters) around the baby. This is called oligohydramnios. A small dose of aspirin is sometimes prescribed in pregnancy (by your obstetrician). This is considered to be safe.

Isotretinon (Roaccutane), Co-cyprindiol

This is used to treat chronic acne and psoriasis but may cause malformations while the baby’s organs are forming. Topical medications (gels and creams) are thought to be safe to use such as benzoyl peroxide and antibiotic creams however vitamin A gel or cream should be avoided.

Sodium valproate (Epilim)

This is used to prevent epileptic seizures. However, during pregnancy it may cause problems with the development of the baby’s spine, heart and face, as well as with brain development. If you are taking sodium valproate and find out you are pregnant it is important to talk to your doctor as soon as possible rather than stopping the medication immediately. If a doctor advises you to continue taking sodium valproate during your pregnancy, you should also be prescribed a higher dose of folic acid of 5mg to take until at least the end of the first trimester. There is limited evidence about other antiepileptic drugs such as carbamazepine, lamotrigine, levetiracetam and phenytoin.

Anti-migraine drugs, such as ergotamine and methysergide

These medicines are used to head off migraine attacks but raise the risk of miscarriage and stillbirth. There is limited evidence about the safety of triptans.

Anticoagulant drugs that you take by mouth

These are used to thin your blood when treating heart disease or if you are at increased risk for stroke or blood clots. Warfarin is a common example. Taken during early pregnancy, they may cause problems with facial and mental development. Later on, they raise the risk of uncontrolled bleeding.

Anti-depressants and other mental health medicines

It’s important that you do not stop taking medicines that are prescribed for your mental health without discussing it with your doctor. You can read more about mental health medication and pregnancy here.

Aromatherapy

Aromatherapy oils may be 'natural', but they are still strong chemicals, and some are not recommended for use in pregnancy. Not all alternative remedies are safe for pregnant women, so always check first.

If you go to a qualified practitioner, they’ll be trained to advise you on what’s best. Contact the Institute of Complementary and Natural Medicine to find a practitioner in your area.

For information on 'recreational' drugs, such as cannabis, cocaine and heroine, click here.