No medication is completely risk-free for pregnant people. However, there are cases where not taking a medication can cause you more harm than taking it.
During your pregnancy, your doctor will prescribe medications that are as safe as possible for you and your baby while still effectively treating your condition.
Several common pregnancy symptoms, such as nausea and heartburn, might prompt you to seek care using prescription or over-the-counter (OTC) medications. You might also have symptoms not directly related to your pregnancy, such as allergy or cold symptoms, that require medicine.
Some medications may be safe to take during pregnancy to provide relief from these symptoms. However, always consult your primary care doctor or OB-GYN to confirm these medications are safe for you before taking them, even if they are available without a prescription.
Allergies
Some medications that may be safe to use to manage allergies during pregnancy include:
- Loratidine (Claritin, Alavert)
- Cetirizine (Zyrtec, Aller-Tec)
- Chlorpheniramine (Chlor-Trimeton, Aller-Chlor)
- Fexofenadine (Allegra)
- Fluticasone propionate (Flonase Allergy Relief)
- Budesonide (Rhinocort)
Headaches and Pain Relief
Some medications that have been found to be safe in relieving headaches, migraines, or pain during pregnancy include:
- Acetaminophen (Tylenol): This is the preferred OTC pain reliever for pain relief during any trimester.
- Ibuprofen (Advil) and naproxen (Aleve): These should only be used in the second trimester for headaches that do not respond to acetaminophen. Avoid use at all in the third trimester.
- Sumatriptan: May pose some risk to the baby. Make sure to talk to your doctor before taking sumatriptan during pregnancy. Avoid combination sumatriptan tablets containing naproxen.
Cold and Flu Symptoms
Several OTC cold and flu medications may be used safely in pregnancy. However, most are only considered safe when used for a short term and are not safe for people in their first trimester.
Some cold and flu medications that may be considered safe during pregnancy include:
- Acetaminophen (Tylenol)
- Chlorpheniramine (Chlor-Trimeton)
- Loratadine (Claritin)
- Certrizine (Zyrtec)
- Topical menthol rubs (Vicks)
- Diphenhydramine (Benadryl)
Heartburn
Heartburn tends to be worse during the third trimester. Some medications you can use safely within the recommended dose to manage heartburn during pregnancy include:
- Antacids containing aluminum, calcium, or magnesium (first-line treatment in pregnancy).
- Sucralfates
- Histamine receptor antagonist (H2RAs) such as cimetidine and ranitidine. H2RAs are commonly used in pregnant people who do not respond to antacids.
- Proton pump inhibitors such as esomeprazole and omeprazole. This type of medication is often reserved for people who do not respond to antacids or H2RAs.
Diarrhea
In most cases, diarrhea will often disappear on its own within a couple of days. Healthcare providers recommend the use of oral rehydration and diet change for pregnant people with diarrhea.
However, if the diarrhea doesn’t clear up, your doctor may recommend medications to help. Some medications that may be safe for pregnant people with diarrhea include:
- Kaolin preparations
- Pectin preparations
- Loperamide (the lowest possible dose for people with severe diarrhea)
Constipation
Lifestyle changes like increasing fluid intake, eating more fiber, and getting light exercise are often the first-line treatment to manage constipation in pregnancy. However, if these fail, your healthcare provider can recommend medications to help improve bowel movement.
Some medications that may be safe for managing constipation in pregnancy include:
- Bulk-forming laxatives, such as Psyllium (Metamucil), Calcium polycarbophil (FiberCon), and Methylcellulose (Citrucel). These medications are not well absorbed by the body, so they are generally safe.
- Polyethylene glycol solution
Yeast Infections
Yeast infections are common during pregnancy. Healthcare providers recommend the use of vaginal creams and suppositories only to treat yeast infections in pregnancy. Some treatments for yeast infections that may be safe in pregnant people include:
- Vaginal creams or suppositories that contain miconazole or clotrimazole
- Nystatin creams
Nausea and Vomiting
Experts recommend pyridoxine (a form of vitamin B) as the first choice for managing nausea and vomiting during pregnancy.
Other safe options may include:
- Doxylamine succinate (Decapryn, Doxy-Sleep-Aid, Unisom)
- Diphenhydramine (Benadryl, Hydramine)
- Meclizine (Antivert, Bonine)
- Chlorpheniramine (Chlor-Trimeton)
- Ondansetron (Zofran). This is reserved for when other medications do not work.
Some medications have been linked to birth defects or may harm the baby, especially during the first three months of pregnancy. This is why it’s important not to use any medication without discussing the risks and benefits with your primary care doctor and OB-GYN.
Here are some medications you may want to avoid during pregnancy:
Allergies:
- Pseudoephedrine
- Triamcinolone (Nasacort allergy)
- Oxymetazoline (Afrin)
Headaches and pain:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil), naproxen (Aleve), and diclofenac (Cataflam). Ibuprofen and naproxen may be safe for use in the second trimester, but should be avoided in the first and third trimesters.
- Ergotamine
Heartburn:
- Sodium bicarbonate
- Bismuth subsalicylate or any Bismuth-containing compounds
Cold and flu symptoms (avoid these in the first trimester):
- Phenylephrine (Preparation H, Sudafed PE)
- Pseudoephedrine (Sudafed)
- Guaifenesin (Mucinex)
Heartburn:
- Antacids containing sodium bicarbonate
- Calcium-containing antacids (greater than 1,000 milligrams elemental calcium per day)
- Vonoprazan
Diarrhea:
- Diphenoxylate-atropine (Lomotil)
- Bismuth subsalicylate (Pepto-Bismol)
Constipation:
- Mineral oil
- Stimulant laxatives such as bisacodyl (Dulcolax) and senna (Senokot, Ex-Lax)
- Products containing bismuth and castor oil
Yeast Infections:
Other medications that you may want to avoid during pregnancy, as they have a high risk of harm to a fetus, include:
- Systemic retinoids
- Valproic acid
- High amounts of vitamin A (significantly more than 25,000 IU retinol per day)
- Tetracycline antibiotics, including doxycycline (Doryx) and minocycline (Minocin)
- Thalidomide
It is not uncommon to use one or two medications to manage some pregnancy symptoms. However, you must take these medications with caution.
Before using any medication, talk to your doctor. They will assess the risk of health problems such as birth defects, premature birth, or pregnancy loss. They will also offer you options to help manage your condition.
In most cases, they might suggest lifestyle and dietary changes as a first option to manage your symptoms. If you do require medication, they will place you on the medicine least likely to cause you or your baby harm.
If you do not find relief from OTC medications, your doctor can recommend safe alternatives.
It’s important not to assume a drug is safe in pregnancy just because it’s available over-the-counter. Always consult your doctor before taking any medication.
It is often preferable to avoid medications during pregnancy, especially in the first trimester when the fetus is developing.
Several natural remedies may help relieve common pregnancy ailments and other symptoms. Trying these as a first step can help you avoid or minimize medication use:
Allergies
- Do a nasal rinse to soothe irritated nasal passages
- Use HEPA air filters to reduce allergens in your home
- Take a shower after spending time outside to remove pollen and other allergens
Headaches and pain
- Apply a warm compress around your eyes and nose
- For a tension headache, place a cold compress, a damp towel, or an ice pack at the base of your neck
- Get a light shoulder and neck massage to help relieve tension headaches
- Take a short nap
- Talking to your doctor about safe relaxation exercises that can help relieve headaches or migraines
Cold and flu
- Get plenty of rest
- Drink warm liquids
- Use a humidifier
- Eat chicken soup or any other nutrient-dense foods to support your immune system
- Gargle salt water for sore throat symptoms. Honey and lemon may also help
Heartburn
- Elevate the head of your bed by about 10-15 centimeters
- Try chewing gum, as it can help clear acid buildup in the esophagus
- Add ginger tea for its soothing effects. Ginger is safe in the first trimester. However, consult your doctor if it’s okay for you to have ginger tea
- Sit up after eating
- Walk more, if possible
Diarrhea
- Drink plenty of water to avoid dehydration
- Try the BRAT diet (Bananas, Rice, Applesauce, and Toast)
Constipation
- Eat more fiber, aiming for about 25-30 grams of dietary fiber each day
- Try prune juice or stewed prunes
- Move more, if possible
Yeast infections
- Drink yogurt that contains live culture of bacteria, especially Lactobacillus acidophilus
- Wear loose and breathable underwear
Nausea and vomiting
- Eat bland foods
- Consider the BRATT diet (bananas, rice, applesauce, toast, and tea)
- Add ginger to your meal
No medication is 100% safe in pregnancy. Always consult a doctor to determine which medication is best for you and your baby.
If possible, consider natural ways to manage your symptoms. If this doesn’t work, talk to a healthcare provider. Sometimes, taking medication to manage your symptoms may be the best thing you can do.
