What you should know about taking medicine while pregnant

By Joni Sweet | Updated on Mar. 31, 2021 Medically reviewed by Laura K. Grubb, MD, MPH

Pregnancy can feel like a big list of don’ts. Don’t eat soft cheese—or deli meats. Don’t take cold medicine. And while going drug free for nine months sounds ideal, the reality is nine out of 10 women in the U.S. take medication at some point during their pregnancies.

Finding pregnancy-safe medications isn’t always easy—especially if you regularly take medication for your mental health or a pre-existing condition. It’s an important, must-have conversation with your healthcare provider as soon as you find out you’re expecting.

Are there pregnancy-safe medications?

“Everything in life is about the risk-benefit ratio,” says Felice Gersh, MD, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness. “If the woman has a certain infection or a life-threatening disease, there may be a pharmaceutical she absolutely needs. You have to make compromises sometimes.”

In other words, the ability for a certain drug (such as blood pressure medication) to keep a mom-to-be healthy throughout her pregnancy may outweigh the small risk it poses to the developing fetus. This evaluation is considered by you and your doctor on a case-by-case basis, and it’s important to understand all potential risks involved.

When it comes to how a drug may affect a fetus, timing is a huge component. “In general, the first trimester is the highest risk because that’s the time when the fetus is most vulnerable,” says Ceppie Merry, Ph.D., a clinical pharmacologist and writer for Healthy But Smart. “The growing fetus has an immature kidney and liver system, and it can’t handle drugs the same way adults can. You need to be careful throughout every trimester, though, and even in what’s called the ‘fourth trimester,’ as some drugs can be passed through breast milk.”

The types of drugs you take also make a huge difference in the protection of the fetus. Some prescriptions—and specific brands of prescriptions—pose bigger risks than others. For example, valproic acid (Depakote) has shown a high risk of causing physical birth defects and cognitive/behavioral health issues in babies in the womb compared with other anti-seizure medication. While selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression, may increase the baby’s risk of neonatal adaptation syndrome, the impact of stopping the medication during pregnancy on the mental health of the mother may make it difficult for her to get good prenatal care. Again, it goes back to the risk-benefit analysis between you and your doctor.

Which medications are safe to take during pregnancy?

If you’re looking for a pregnancy safe medications list, your healthcare provider is the most accurate source of information. However, there are some that most providers agree are safe to take in moderation:

For pain: Tylenol (acetaminophen)
For constipation: Metamucil, Colace, Citracel, Milk of Magnesia, Dulcolax
For indigestion or heartburn: Tums, Maalox, Mylanta, Pepcid
For infections: Penicillin
For yeast infections: Monistat, Gynelotrimin
For allergies or a cold: Benadryl, Sudafed, Afrin nasal spray, Claritin, Robitussin DM, Vicks Formula 44, Halls cough drops
For the flu: Tamiflu

Here are some frequently asked questions we asked medical experts to weigh in on:

Are over-the-counter medications and supplements safe?

Ultimately, everything you put into your body can have an impact on your fetus; even over-the-counter medications and natural supplements—the latter of which are not FDA regulated for safety and effectiveness—can potentially cause birth defects or other health problems for the child later in life. For example, high doses of aspirin during the first trimester could cause congenital defects and miscarriage. Pepto Bismol (bismuth subsalicylate) should also be avoided during pregnancy because chronic exposure to the active ingredient salicylate may be toxic to your baby.

Does that mean you have to endure common discomforts like a headache or an upset stomach when you’re carrying a baby? Not necessarily.

“The field of complementary and alternative medicine can really help you while you’re pregnant,” Dr. Merry explains. “Certain forms of healing, like relaxation, hypnosis and acupuncture, will have no impact on your baby.”

Dr. Gersh also suggests a few natural remedies for common pregnancy ailments: Heartburn may be relieved by avoiding triggering foods such as citrus fruit, tomato, and onion. A cup of ginger tea can settle certain digestive issues. A head and neck massage can relieve physical and emotional tension. And when you have anxiety, listening to a guided meditation can help you relax.

All that being said, every pregnancy is unique. If you’re feeling less than your best—for any reason—it’s best to talk to your doctor to explore which medicine is right for your pregnancy.