Safety of Medications and Other Substances During Pregnancy

Every mother-to-be wants to do what’s best for her unborn baby. However, knowing what’s best when it comes to medication and substance use during pregnancy can be confusing. Read on to find the answers to your common pregnancy-related questions. 

Do I need to stop taking my medications while pregnant?

When deciding to use medications during pregnancy, it is important to review the risks and benefits of the treatment with your healthcare provider first. Note that every pregnant woman has a 3-5% background risk of giving birth to a baby with birth defects. Some medications, but not all, may confer a risk to your baby that is above the background risk. If you are currently taking chronic medications, and are planning on or have already become pregnant, do not stop these medications “cold turkey” as this may do more harm than good. You may be able to continue with your medications safely or you may have to switch to a safer alternative. It is important to remember that uncontrolled chronic conditions can also pose a risk to your baby, so it is important to determine the best option as a team with your healthcare providers.

The following are chronic conditions and the medications that can be used safely during pregnancy to treat them:

Diabetes:

  • Preferred: human insulins, metformin

Depression:

  • Preferred: sertraline, citalopram, escitalopram, fluoxetine, fluvoxamine

Hypertension:

  • Preferred: methyldopa, labetalol, nifedipine

Is it safe to use over the counter medications while pregnant?

The medications you purchased over the counter (OTC) to self-treat headaches, constipation, cough and cold, and other ailments before you were pregnant may not be safe to your unborn baby during pregnancy. It is important that you do not self-treat common minor ailments while you are pregnant without first consulting your pharmacist or other healthcare professional.

The following are common minor ailments and the OTC products most frequently encountered*:

Fever, headaches or other aches and pains:

  • Preferred: Acetaminophen
  • Caution: Aspirin, ibuprofen, and naproxen are okay to use during the first or second trimester only. Avoid during the third trimester.

Cough:

  • Preferred: Dextromethorphan, guaifenesin
  • Avoid: Ethanol-containing products

Constipation:

  • Preferred: Methylcellulose, psyllium, bran, lactulose, polyethylene glycol, glycerin suppositories
  • Avoid: Mineral oil

Insect Repellents:

  • Preferred: Products with <30% DEET
  • Avoid: Oil of citronella

Lice:

  • Preferred: Permethrin 1%, pyrethrins/​piperonyl butoxide
  • Avoid: Dimeticone 50%, isopropyl myristate 50%/​cyclomethicone 50%

*Read and follow the directions for use on the product labels.

Can I still consume caffeine while pregnant? What about alcohol or cannabis use?

Caffeine:

  • It is okay to consume moderate amounts of caffeine during pregnancy. Recommendations: ≤300 mg/day (i.e., approximately two cups per day).

Alcohol:

  • Alcohol is well known for causing Fetal Alcohol Spectrum Disorder (FASD) when consumed during pregnancy. Since there is no known safe amount of alcohol that can be consumed during pregnancy, it should be avoided.

Cannabis:

  • The use of cannabis during pregnancy has been linked to negative consequences at birth and may also interfere with your child’s development later in life. Since there isn’t much research on cannabis thus far, why take the risk? The safest option would be to avoid it during pregnancy.
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