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OTC medications during pregnancy: everything you need to know

Many of us take for granted the ability to safely use medications for common aches, pains, and other symptoms. Ibuprofen seems harmless and is commonly used by adults. However, it carries significant risks when used during pregnancy except in very specific circumstances. This is a perfect example of why ensuring the pregnancy safety of each over-the-counter medication you take is very important.

What are OTC medications?

Over-the-counter medications, or OTC medications, are those that you can buy at your local pharmacy or convenience store without a prescription. A huge number of OTC medications are available to treat a wide variety of ailments and afflictions, including headaches, heartburn, fever, cold symptoms and more. OTC medications are those that generally carry less risk of misuse, abuse, and/or unintentional harm than prescription medication. However, this can impart a false sense of security that they are risk-free. They still need to be used following the label instructions and under safe circumstances.

How can medications be dangerous during pregnancy?

Most medications you take enter your bloodstream to do their job. Many are small enough or have other properties that allow them to cross through the barrier in the placenta that separates your blood from your baby’s blood. This is how Baby can be exposed to the medication you take directly. Other medications can change the blood flow going to the placenta and have an indirect effect on Baby by restricting blood flow., And some medications can cause your uterus to contract which could lead to preterm birth. The effects of medications can range from growth restriction of Baby to major congenital (started in the womb) defects and varying levels of impact on Baby’s development.

How will I know if a medication is safe to take?

Your healthcare provider will be your most valuable resource throughout pregnancy, from conception to delivery. They have the benefit of knowing your personal health history that may impact the safety of medications for you during pregnancy. They also have the expertise to help you weigh the risks and benefits of medications so you can make an informed decision whether or not to use them. Some medications may also have more or less risk at different points in your pregnancy. Some have the highest risk in the first trimester but are safer later on, and others are the most dangerous later in pregnancy. Your provider can help determine the safest option for you based on all of these factors.

You can also talk to your pharmacist about which OTC meds are safe in pregnancy.

The bottom line

This can be a frustrating topic because most medications have not been studied in pregnancy. There are ethical limitations because babies cannot consent to potential life-altering experiments like adults can. So most safety information we have on medications is from seeing how they affect pregnant people and their babies over long periods of time. This still isn’t a fool-proof way to determine if a medication is safe for you to use. So checking with your healthcare team is always the safest bet. OTC medications can be very helpful for managing some pregnancy symptoms, and some are very safe – you just have to make sure you pick the right ones!

Read more
  • J Servey, J Chang. “Over-the-Counter Medications in Pregnancy.” American Family Physician. 90(8):548-555. Web. 10/15/2014.
  • Sumit Kar, Ajay Krishnan, K. Preetha, Atul Mohankar. “A review of antihistamines used during pregnancy.” Journal of Pharmacology & Pharmacotherapeutics. 3(2): 105-108. Web. April-June 2012.
  • “Can I take ibuprofen when I’m pregnant?” NHS. NHS Choices, 4/4/2014. Web.
  • “Drug Use in Pregnancy; a Point to Ponder!”, National Center for Biotechonology Information, NCBI, Feb 2009,
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