What medications are safe to take during pregnancy?

From the moment you get the happy news—that you’re an expectant parent—your priority is doing what’s best for your child. An important part of keeping a growing baby healthy during pregnancy is learning which medications are safe to take.

Birth defects occur in 3 to 5 out of every 100 pregnancies. This is called the background rate. Drugs considered safe during pregnancy are those that are not believed to increase the risk of birth defects.

It’s important to note: You should not take any medication (even one listed below as safe) without consulting your doctor or pharmacist. Everyone’s health situation is different. If you have any of the health issues below while pregnant, or while you’re trying to become pregnant, a medical professional will be able to recommend the best treatment plan for your specific circumstances.

What anti-nausea medications are safe during pregnancy?

Safe anti-nausea medications during pregnancy include the prescription drug Zofran (ondansetron) and the over-the-counter supplement vitamin B6—among others.

Safe prescription anti-nausea medications

• Diclegis (doxylamine succinate-pyridoxine hydrochloride): Studies of birth defects among pregnant women have found no indication that taking Diclegis increases the risk of birth defects. [Mother to Baby]
• Zofran (ondansetron): A 2018 study found that pregnant women who were prescribed Zofran to treat morning sickness did not show an increased likelihood of having a baby with a birth defect. [Centers for Disease Control]

Safe over-the-counter anti-nausea medications

• Vitamin B6 and Unisom: The combination of the nontoxic supplement vitamin B6 (pyridoxine) and the over-the-counter sleep aid Unisom (doxylamine) sometimes may reduce nausea in pregnant women. [SingleCare]

Anti-nausea medications to avoid

• Pepto-Bismol, Kaopectate, and other medications containing bismuth subsalicylate: Salicylates may cause heart defects in developing fetuses. No studies have demonstrated that they are safe to take during pregnancy. [Drugs.com]

What pain medications are safe during pregnancy?

The safest pain medication during pregnancy is acetaminophen, which is sold over-the-counter as Tylenol (among other brand names). Acetaminophen can also be prescribed by your doctor.

However, recent studies have indicated that acetaminophen use may be linked to certain birth defects. Talk to your doctor to assess the risks and benefits of taking pain medication.

Safe prescription pain medications

• Acetaminophen: If you are dealing with pain during pregnancy, your doctor will likely recommend acetaminophen.

Safe over-the-counter pain medications

• Tylenol: Doctors say it is usually safe to take Tylenol which contains the active ingredient acetaminophen. Use the lowest recommended dosage for short time periods, and be careful about combining Tylenol with cold medications that may also contain acetaminophen. [Kaiser Permanente]

Pain medications to avoid

• NSAIDs including aspirin and ibuprofen: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a category that includes aspirin and ibuprofen. Studies have shown that women who take these drugs are more likely to give birth to babies with heart defects. [CDC]
• Opioid pain medications such as codeine, oxycodone, hydrocodone, and morphine: Taking these medications is associated with severe birth defects affecting the brain, heart, and intestines, as well as withdrawal symptoms in newborns. [CDC]

What anxiety medications are safe during pregnancy?

While there is a small possibility of birth defects associated with the use of SSRIs, the medical community generally considers SSRIs safe during pregnancy. Certain SSRIs, like paroxetine (Paxil), may be more high-risk than others. As always, patients should consult their doctor to make sure their SSRI medications are safe.

Anxiety medications to avoid

• Paxil (paroxetine hydrochloride): Studies have shown an increased risk of congenital heart defects for infants exposed to this antidepressant during the first trimester of pregnancy. [FDA]

What sedatives or sleep aids are safe during pregnancy?

Among over-the-counter drugs, the antihistamine Benadryl (diphenhydramine) is considered low risk for pregnant women and developing babies.

There aren’t any completely safe prescription options. Ambien (zolpidem tartrate) is sometimes prescribed during pregnancy, as it has the least definite association with birth defects. However, there is a risk associated with the use of Ambien in the third trimester of pregnancy.

Safe over-the-counter sedatives and sleep aids

• Benadryl (diphenhydramine): Benadryl is an antihistamine that causes drowsiness. Recent research indicates that antihistamines are not associated with elevated risks for mothers or their babies. [CDC]

Prescription medication sometimes prescribed during pregnancy

• Ambien (zolpidem tartrate): Studies have not shown a clear association between Ambien use and major birth defects. However, use in the third trimester of pregnancy has been associated with respiratory problems in newborns. [FDA]

Sedatives and sleep aids to avoid

• Xanax (alprazolam): Taking Xanax during pregnancy can cause fetal harm including respiratory problems and withdrawal symptoms after birth. [FDA]
• Valium (diazepam): Valium is associated with birth defects and developmental abnormalities. [FDA]

What blood pressure medications are safe during pregnancy?

Safe blood pressure medications during pregnancy include prescription drugs categorized as beta blockers, calcium channel blockers, and diuretics.

Safe prescription blood pressure medications

• Beta blockers such as Lopressor and Toprol-XL (metoprolol), Corgard (nadolol) and Tenormin (atenolol): A recent study ruled out the risk of major first-trimester birth defects associated with beta blockers. However, there may be health risks during delivery, so make sure your doctors know if you are taking these medications. [American College of Cardiology]
• Calcium channel blockers including Norvasc (amlodipine), Cardizem, Tiazac, and others (diltiazem), Adalat CC and Procardia (nifedipine) and Verelan and Calan (verapamil): Multiple studies show no correlation between CCB use and major birth defects. [Canadian Family Physician]
• Diuretics such as Diuril (chlorothiazide), Bumex (bumetanide) and Midamor (amiloride): Studies show that there is no increased risk of birth defects among mothers taking diuretics. [Canadian Family Physician]

Safe over-the-counter blood pressure medications

There are no FDA-approved over-the-counter medications to treat high blood pressure in pregnant women.

Blood pressure medications to avoid

• ACE inhibitors including Vasotec and Epaned (enalapril), Prinivil, Zestril, and Qbrelis (lisinopril), and Altace (ramipril): Have been shown to cause birth defects in all three trimesters of pregnancy. [American Heart Association]
• Angiotensin II receptor blockers (ARBs) including Diovan (valsartan) and Cozaar (losartan): ARBs have been shown to increase the risk of fetal kidney damage or miscarriage. [Obstetrics and Gynecology International]
• Renin inhibitors including Tekturna (aliskiren): Renin inhibitors are associated with severe, catastrophic birth defects. Women taking renin inhibitors should avoid becoming pregnant. [Kaiser Permanente]

What heartburn medications are safe during pregnancy?

Safe heartburn medications for pregnant mothers include the prescription drug metoclopramide, and over-the-counter treatments such as antacids (Tums, Rolaids), proton pump inhibitors (Nexium, Prilosec), and H2 blockers (Zantac).

Safe prescription heartburn medications

• Reglan (metoclopramide): In a review of existing data, there is no evidence that metoclopramide use causes an increased risk of major birth defects, miscarriage, or stillborn births. [Journal of the American Medical Association]

Safe over-the-counter heartburn medications

• Most antacids including Mylanta, Rolaids, Tums: While some studies do indicate a higher risks of birth defects associated with antacid use during the first trimester, there’s limited evidence to show that antacids are harmful to a developing fetus. Birth defects associated with calcium- and magnesium-containing antacids are generally considered rare, especially when taken at the recommended dose.
• Proton pump inhibitors including Prevacid 24HR (lansoprazole), Nexium 24HR (esomeprazole), Prilosec (omeprazole magnesium): Large studies revealed no clear association between PPIs and severe birth defects. [American Journal of Gastroenterology]
• H2 blockers including Zantac (ranitidine): An analysis of studies showed that no significant birth defects are associated with the use of H2 blockers during pregnancy. [Digestive Diseases and Sciences]

Heartburn medications to avoid

• Alka-Seltzer (sodium bicarbonate): Can cause unsafe fluid buildup during pregnancy. [University of Michigan]

What allergy medications are safe during pregnancy?

Over-the-counter antihistamine allergy drugs such as Zyrtec, Clarinex, and Allegra, are thought to be safe for use by pregnant women. Prescription allergy medications should only be taken under the supervision of a doctor.

Safe prescription allergy medications

• Singulair (montelukast): Usage of montelukast during pregnancy for treatment of asthma does not appear to increase the risk of major birth defects. [Therapeutic Advances in Respiratory Disease]
• Allergy shots (immunotherapy): It’s considered safe to continue your allergy shots during pregnancy. Let your healthcare providers know that you’re pregnant and they will carefully monitor your dosage.

Safe over-the-counter allergy medications

• Antihistamines such as Zyrtec Allergy (cetirizine), Clarinex (desloratadine), Allegra Allergy (fexofenadine): Studies indicate that there is no elevated risk of birth defects associated with antihistamine use by pregnant women. [American Family Physician]

Allergy medications to avoid

Many drugs that treat severe allergies come with risks to the fetus. But moms need to stay healthy as well, so the risks may be outweighed by the benefits to the mother’s overall health. Anyone with severe allergies should create a treatment plan with their doctor during pregnancy.

What hemorrhoid medications are safe during pregnancy?

Safe hemorrhoid medications during pregnancy include over-the-counter creams and wipes such as Preparation H.

Safe prescription hemorrhoid medications

Powerful prescription hemorrhoid medications may harbor risks for your developing fetus. Your doctor will help you come up with a treatment plan if your hemorrhoids are severe enough to require prescription medication.

Safe over-the-counter hemorrhoid medications

Over-the-counter creams and wipes such as Preparation H are safe to use for expectant mothers. The active ingredients in these products (anesthetic, corticosteroids, and anti-inflammatory agents) aren’t associated with birth defects or delivery issues. [Canadian Family Physician]

Hemorrhoid medications to avoid

While it’s safe to use over-the-counter hemorrhoid medications as directed, avoid overuse which could thin your skin. [Mayo Clinic]

What cold medications are safe during pregnancy?

Safe cold medications include Mucinex and Robitussin (guaifenesin) to loosen congestion and Tylenol (acetaminophen), for pain. Be careful to avoid cold medications that contain multiple ingredients, as some of these may be unsafe during pregnancy.

Safe prescription cold medications

Any cold that is severe enough to require a trip to the doctor during your pregnancy will require a special treatment plan. Your cold symptoms could indicate a more serious problem, and you and your doctor will need to go over the risks of various medications before deciding on a treatment plan.

Safe over-the-counter cold medications

• Mucinex and Robitussin (guaifenesin): Large-scale studies of pregnant women have shown no indication that these drugs pose risk to the fetus.
• Tylenol (acetaminophen), for pain: Acetaminophen is thought to be the safest pain-relief medication for pregnant women.

Cold medications to avoid

• Alka-Seltzer (sodium bicarbonate): There is some evidence this can cause unsafe fluid buildup during pregnancy. Also, Alka-Seltzer Plus, which is developed for cold and flu symptoms, contains phenylephrine, which may carry an increased risk of birth defects. [University of Michigan]
• Any cold relief medication that includes aspirin or ibuprofen: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a category that includes aspirin and ibuprofen. Studies have shown that women who took these drugs are more likely to give birth to babies with heart defects. [CDC]
• Sudafed (pseudoephedrine) during the first trimester: Some studies have shown an increased risk of birth defects associated with use of pseudoephedrine during the first trimester of pregnancy. [Mother to Baby]

What medications are never safe during pregnancy?

Common medications that you should avoid during pregnancy are aspirin, ibuprofen, opioids, Xanax, and Valium.

• Aspirin and ibuprofen: Part of a class of drugs called NSAIDs, these are associated with a higher risk of heart defects.
• Opioids: Opioid use during pregnancy is associated with severe, catastrophic birth defects.
• Xanax and Valium: These sedatives are both associated with an increased risk of certain birth defects.