As wonderful as pregnancy can be, there’s no denying the toll it takes on your body. After all, your immune system changes during those nine+ months and works extra hard to protect you and baby. While those changes are incredibly complex and designed to help provide immune responses to baby as they grow, it can also make minor illnesses—like a cold—more common during pregnancy. But when you’re dealing with a cough, cold, allergies or other ailments, which pregnancy-safe medications can you take over-the-counter (OTC), and which should you avoid? And what dosage should you stick to? Below, we asked experts for a list of medications you can take while pregnant, as well as what you need to know beforehand.
In this article: Rules to follow when taking OTC medications during pregnancy What allergy medicine can I take while pregnant? What pregnancy-safe cough medicine can I take? What pregnancy-safe laxatives can I take? What pregnancy-safe heartburn medicine can I take? List of safe OTC medications during pregnancy What OTC medications are not safe to take during pregnancy
Rules to Follow When Taking OTC Medications During Pregnancy
If you’re feeling a little under the weather, you’re likely wondering what medicine you can take while pregnant. While there are many over-the-counter medications that are safe to use during pregnancy, there are also plenty that are not. Before heading to your local pharmacy, you should always check in with your ob-gyn or midwife. Here’s why:
Medicine may affect you differently during pregnancy
Taking medications—whether they’re prescription, OTC, herbal or homeopathic—can be tricky during pregnancy. The biggest reason for this? Even OTC medications you’ve taken previously might affect you (and baby) differently while expecting. “Many over-the-counter medications are safe to use in pregnancy, but there are a few surprising drugs that can lead to problems for baby,” says Ashley Roman , MD, an ob-gyn with NYU Langone in New York City. “Always speak with your doctor prior to taking any medication and always follow the dosage instructions on the package.” Plus, some usually unconcerning symptoms, like headaches, can point to serious pregnancy-related complications in certain cases, Roman adds, so it’s always best to let your doctor know of any aches and symptoms.
Multiple medications may interact
When it comes to pregnancy-safe medications, certain OTC options are generally okay to use as long as you follow the dosage instructions for adults—but that could change if you’re taking multiple medications. “Even medications that are considered safe in pregnancy can become dangerous when they interact with others,” says Roman. “If you’re not sure, always check in with your ob-gyn.” The dosage for a certain OTC medication may also change depending on other medications you’re already taking.
There are liability concerns
While you may not go to your ob-gyn for every ache and pain during pregnancy, they’ll likely be the ones counseling you on what prescription and OTC medications to take, says Daniel F. Roshan , MD, a maternal fetal specialist at Rosh Maternal & Fetal Medicine in New York City. “Other doctors usually avoid giving any medications to pregnant patients in order to avoid liability,” he explains.
Furthermore, pregnant people are often not included in studies due to concerns over potential harm to baby. As a result, there’s a lack of data that makes it hard to know exactly what risks might be associated with OTC medications during pregnancy, says Cynthia Flynn , MD, a Florida-based ob-gyn with JustAnswer. “Any over-the-counter or prescription drug can potentially pose a risk,” says Flynn, especially based on how often the medication is used during pregnancy. The rule of thumb? Always check in with your doctor before taking anything, even if it’s on the list of medications you can take while pregnant.
What Pregnancy-Safe Nausea Medicine Can I Take?
Perhaps the most widely known ailment of pregnancy is morning sickness . Nausea is a common symptom of early pregnancy , and pyridoxine, which is a form of vitamin B-6, is often recommended first to help with the symptoms, says Sherry Ross , MD, an ob-gyn, author, and co-founder of Oneself Intimate Skin Care and the Women’s Health & Wellness School on the MprooV app. “Combining doxylamine and pyridoxine is even more effective for persistent nausea of pregnancy,” she adds. (Doxylamine is also known as Unisom.) Michelle Gebhardt , MD, assistant chair for obstetrics at Kaiser Permanente in Northern California, also cites Emetrol (which uses glucose, fructose and phosphoric acid as main ingredients) and vitamin B6 as pregnancy-safe nausea medicines to try, as well as natural remedies like drinking ginger tea and eating crackers or dry toast.
In your pre-pregnancy life, Pepto-Bismol may have been your go-to nausea remedy, but now that you’re expecting, it’s best to steer clear. The main ingredient in Pepto-Bismol is bismuth subsalicylate, and according to the American Academy of Family Physicians (AAFP), while bismuth on its own is generally safe, it may be harmful when combined with salicylate.
What Cold Medicine Can I Take While Pregnant?
Colds are par for course during pregnancy, especially in the winter months , but treating them can be tricky while expecting. The AAFP notes that most OTC cold medicines are considered safe for short-term use in pregnancy as long as it’s outside of the first trimester. Previous studies have suggested that exposure to certain decongestants, such as pseudoephedrine, phenylephrine and phenylpropanolamine, in early pregnancy may increase the risk of birth defects.
Can you take Sudafed while pregnant?
Many experts believe that Sudafed—and other medications using pseudoephedrine as the main ingredient—should be avoided wherever possible during pregnancy. According to Ross, Sudafed may be used, but only cautiously, as it’s inadequately studied and has been shown to have negative effects in animal studies. Gebhardt recommends trying natural cold remedies first, such as saline nasal drops, drinking fluids, using a humidifier and getting enough rest.
Roman recommends avoiding pseudoephedrine altogether. “It may be associated with birth defects involving baby’s abdominal wall,” Roman says. “Also, decongestants (such as phenylephrine) may affect blood flow to the placenta and should generally be avoided throughout your pregnancy.”
Again, always talk to your doctor before taking an OTC cold medicine during pregnancy. They can guide you on the best treatment based on your specific cold symptoms and pregnancy circumstances.
What Allergy Medicine Can I Take While Pregnant?
According to the American College of Obstetrics and Gynecologists (ACOG) and Centers for Disease Control and Prevention (CDC), studies have found that most antihistamines, which are commonly used to treat allergies , are generally safe to use during pregnancy. These include medications with chlorpheniramine and dexchlorpheniramine, as well as newer antihistamines such as cetirizine and loratadine, as the main ingredient. Some brand name pregnancy-safe allergy medicines that Ross, Gebhardt and Roman say are safe to use for congestion issues include Benadryl , Claritin and Allegra. Zyrtec is also okay to use after 10 weeks of pregnancy, says Roshan.
According to U.S. Pharmacist , you can also use saline nasal decongestants (such as sprays) while pregnant.
What Pregnancy-Safe Cough Medicine Can I Take?
The two main ingredients in many OTC cough (and cold) medicines are dextromethorphan (a cough suppressant) and guaifenesin (an expectorant that loosens up thick mucus). Gebhardt, Ross and Roman all say that these two ingredients should be safe during pregnancy. To ensure it’s truly a safe cough syrup in pregnancy, make sure it doesn’t also contain alcohol, which isn’t safe, says Gebhardt.
Can you take Mucinex while pregnant?
The primary ingredients in Mucinex are dextromethorphan and guaifenesin, both of which are safe for pregnancy.
Can you take Robitussin while pregnant?
Robitussin is also generally safe for pregnancy since the primary ingredients are dextromethorphan and guaifenesin.
What Pregnancy-Safe Laxatives Can I Take?
Constipation is a common concern during pregnancy. Most ob-gyns will recommend dietary modifications or prescribe fiber supplements, like Metamucil and Citrucel, or stool softeners with docusate (a mild laxative), like Colace. All of these are considered safe for pregnancy, Ross says. Additionally, the American Pregnancy Association cites Milk of Magnesia as another mild pregnancy-safe laxative that may offer relief. For anything stronger, always consult with your doctor. “Laxatives, mineral oils and rectal suppositories may stimulate labor, so these should only be used after speaking with your doctor,” Roman says. “Stimulant laxatives, such as Ex-Lax and Senokot, are the hardest on your intestines and should be used with caution during pregnancy.”
What Pregnancy-Safe Heartburn Medicine Can I Take?
Many pregnant people suffer from heartburn during pregnancy . Luckily, antacids such as Tums and Mylanta are usually safe to use and can help with symptoms, Roman says.
Zantac —which uses ranitidine as its main ingredient and was previously considered okay to use during pregnancy—was banned by the FDA in 2019. “The FDA detected low levels of a cancer-causing contaminant in samples of the drug, and manufacturers voluntarily recalled the medicines,” Roman explains. While this sounds scary, it’s important to understand that the science around medicine is always evolving. The best way to protect yourself and baby is to consult with your doctor.
What Headache Medicine Can I Take While Pregnant?
Headaches are unfortunately all too common in pregnancy. If holistic methods like massage, more sleep and applying a warm compress don’t help, see below for more options.
Can you take acetaminophen while pregnant?
Medicine that uses acetaminophen as the main ingredient—like Tylenol —is generally seen as safest for treating general aches and pains, including headaches , Roman says. However, you want to be cautious about what type of Tylenol you take. Gebhardt notes that Tylenol-brand cold medication might not be safe.
It’s also important to be mindful of how much regular Tylenol you’re taking. Previous studies have found that kids with the highest levels of acetaminophen in cord blood samples were more likely to be diagnosed with ADHD or autism spectrum disorder. While this sounds scary, know that many ob-gyns maintain that Tylenol is safe for pregnancy—as long as it’s not being overused. Pregnant people should always follow the dosing instructions on the label and take the lowest effective dose, advises Gebhardt.
Can you take NSAIDs while pregnant?
Nonsteroidal anti-inflammatory drugs—better known as NSAIDS—include ibuprofen (Advil and Motrin), naproxen (Aleve) and aspirin; none of these are safe in pregnancy, particularly not during the third trimester. Studies have found that prenatal use of NSAIDs causes an increased risk of miscarriage . “Certain medications, including nonsteroidal anti-inflammatory drugs such as ibuprofen, can negatively affect the blood flow between mother and baby, causing miscarriages, delayed onset of labor and…other dangerous fetal effects,” says Ross. They may also be associated with “congenital heart defects when taken during the first trimester,” Roman adds. “They’ve also been linked to other heart abnormalities and low amniotic fluid levels when used in the third trimester.” For a pregnancy-safe headache medicine, it’s best to stick to acetaminophen—but use it sparingly.
Can I take Excedrin during pregnancy?
“Combination acetaminophen-aspirin-caffeine (Excedrin) for headache may not be considered safe due to effects that aspirin and caffeine have on the growing fetus as well as the infant,” according to U.S. Pharmacist.
Is aspirin safe during pregnancy?
While Excedrin isn’t preferable during pregnancy, low-dose aspirin is considered safe , and is sometimes recommended for those with a risk of preeclampsia . High doses of aspirin during pregnancy are typically not advised though.
List of Safe OTC Medications During Pregnancy
Below, a list of safe medications during pregnancy:
- Allegra
- Aspirin (low-dose only)
- Benadryl
- Citrucel
- Claritin
- Colace
- Emetrol
- Metamucil
- Milk of Magnesia
- Mucinex
- Mylanta
- Pyridoxine
- Robitussin
- Saline nasal decongestants
- Tums
- Tylenol (with caution)
- Unisom
- Zyrtec (after 10 weeks)
What OTC Medications Are Not Safe to Take During Pregnancy
While there’s a fairly lengthy list of medications you can take while pregnant, there are some OTC medications that should be avoided. These include:
- Aspirin (high-dose)
- Excedrin
- Ibuprofen
- Pepto-Bismol
- Sudafed
- Tylenol that treats multiple cold symptoms
- Zantac
“Before taking any medication, read the ingredient list to make sure it doesn’t contain anything harmful,” Gebhardt says. “There’s a surprising number of over-the-counter medications with alcohol or caffeine.” You can also consult the CDC’s medicine and pregnancy resources for more detailed information.
Along with reading the ingredients, avoid taking multiple medications that can cause drowsiness or sedation, and check with your doctor about what medications are safe to take together. “For example, you would not want to take Benadryl (diphenhydramine) and Unisom (doxylamine) together,” Gebhardt says.
The bottom line? Pregnancy brings a lot of changes to your body, and it can be more challenging to find relief from minor illnesses, aches and pains. But finding relief is possible. “There are situations where the potential benefit of taking medication outweighs any potential risk to baby,” Roman says. “The most important piece of advice regarding medication is to talk with your doctor!”
