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Pregnancy Medications Pregnancy Medications

Medications and Pregnancy


Some medications are not safe to take during pregnancy. Even medication and drugs prescribed to you by your health care provider before you became pregnant might be harmful to both you and the growing fetus during pregnancy.

Pregnancy and Medications

It can be hard to plan exactly when you will get pregnant, in order to avoid taking any medicine. Most of the time, medicine a pregnant woman is taking does not enter the fetus. But sometimes it can, causing damage or birth defects. The risk of damage being done to a fetus is the greatest in the first few weeks of pregnancy, when major organs are developing. But researchers also do not know if taking medicines during pregnancy also will have negative effects on the baby later.

The following has been adapted from websites listed at the bottom of the page.

Many drugs that you can buy over-the-counter (OTC) in drug and discount stores, and drugs your health care provider prescribes are thought to be safe to take during pregnancy, although there are no medicines that are proven to be absolutely safe when you are pregnant. Many of these products tell you on the label if they are thought to be safe during pregnancy. If you are not sure you can take an OTC product, ask your health care provider.

Some drugs are not safe to take during pregnancy. Even drugs prescribed to you by your health care provider before you became pregnant might be harmful to both you and the growing fetus during pregnancy. Make sure all of your health care providers know you are pregnant, and never take any drugs during pregnancy unless they tell you to.

Also, keep in mind that other things like caffeine, vitamins, and herbal teas and remedies can affect the growing fetus. Talk with your health care provider about cutting down on caffeine and the type of vitamins you need to take. Never use any herbal product without talking to your health care provider first.

What over-the-counter and prescription drugs are not safe to take during pregnancy?

The Food and Drug Administration (FDA) has a system to rate drugs in terms of their safety during pregnancy. This system rates both over-the-counter (OTC) drugs you can buy in a drug or discount store, and drugs your health care provider prescribes. But most medicines have not been studied in pregnant women to see if they cause damage to the growing fetus. Always talk with your health care provider if you have questions or concerns.

The FDA system ranks drugs as:

  • Category A - drugs that have been tested for safety during pregnancy and have been found to be safe. This includes drugs such as folic acid, vitamin B6, and thyroid medicine in moderation, or in prescribed doses.
  • Category B - drugs that have been used a lot during pregnancy and do not appear to cause major birth defects or other problems. This includes drugs such as some antibiotics, acetaminophen (Tylenol), aspartame (artificial sweetener), famotidine (Pepcid), prednisone (cortisone), insulin (for diabetes), and ibuprofin (Advil, Motrin) before the third trimester. Pregnant women should not take ibuprofen during the last three months of pregnancy.
  • Category C - drugs that are more likely to cause problems for the mother or fetus. Also includes drugs for which safety studies have not been finished. The majority of these drugs do not have safety studies in progress. These drugs often come with a warning that they should be used only if the benefits of taking them outweigh the risks. This is something a woman would need to carefully discuss with her doctor. These drugs include prochlorperzaine (Compazine), Sudafed, fluconazole (Diflucan), and ciprofloxacin (Cipro). Some antidepressants are also included in this group.
  • Category D - drugs that have clear health risks for the fetus and include alcohol, lithium (used to treat manic depression), phenytoin (Dilantin), and most chemotherapy drugs to treat cancer. In some cases, chemotherapy drugs are given during pregnancy.
  • Category X - drugs that have been shown to cause birth defects and should never be taken during pregnancy. This includes drugs to treat skin conditions like cystic acne (Accutane) and psoriasis (Tegison or Soriatane); a sedative (thalidomide); and a drug to prevent miscarriage used up until 1971 in the U.S. and 1983 in Europe (diethylstilbestrol or DES).

Aspirin and other drugs containing salicylate are not recommended during pregnancy, especially during the last three months. In rare cases, a woman's health care provider may want her to use these type of drugs under close watch. Acetylsalicylate, a common ingredient in many OTC painkillers, may make a pregnancy last longer and may cause severe bleeding before and after delivery.

Should I avoid taking any medicine while I am pregnant?

Whether or not you should continue taking medicine during pregnancy is a serious question. But, if you stop taking medicine that you need, this could harm both you and your baby. An example of this is if you have an infection called toxoplasmosis, which you can get from handling cat feces or eating infected meat. It can cause problems with the brain, eyes, heart, and other organs of a growing fetus. This infection requires treatment with antibiotics.

For pregnant women living with HIV, the Centers for Disease Control and Prevention (CDC) recommends the drug zidovudine (AZT). Studies have found that HIV positive women who take AZT during pregnancy decrease by two-thirds the risk of passing HIV to their babies. If a diabetic woman does not take her medicine during pregnancy, she increases her risk for miscarriage and stillbirth. If asthma and/or high blood pressure are not controlled during pregnancy, problems with the fetus may result. Talk with your health care provider about whether the benefits of taking a medication outweigh the risk for you and your baby.

What about taking natural medications, or herbal remedies, when you are pregnant?

While some herbal remedies say they will help with pregnancy, there have been no studies to figure out if these claims are true. Likewise, there have been very few studies to look at how safe and effective herbal remedies are. Echinacea, Gingko biloba, and St. John's Wort have been popular herbs, to name a few. Do not take any herbal products without talking to your health care provider first. These products may contain agents that could harm you and the growing fetus, and cause problems with your pregnancy. For more information on herbal remedies see "Herbs and vitamins during pregnancy" and "Herbs and vitamins to avoid during pregnancy".

Where can I find more about pregnancy and medications?

For additional information please visit the links Drugs and Pregnancy, as well as Pregnancy Risks and Pregnancy and Smoking.  Also please visit the websites:

American College of Obstetricians and Gynecologists (ACOG) Resource Center

Center for the Evaluation of Risks to Human Reproduction (CERHR). This agency, part of the National Institutes of Health, provides the latest information about potentially hazardous effects of chemicals on human reproduction and development.

March of Dimes Birth Defects Foundation. A national voluntary health agency whose mission is to improve the health of babies by preventing birth defects and infant mortality. Founded in 1938, the March of Dimes funds programs of research, community services, education, and advocacy to save babies.

Motherisk Program. A clinical, research and teaching program, affiliated with the University of Toronto, dedicated to antenatal drug, chemical, and disease risk counseling. Motherisk provides on-on-one counseling for pregnant women. Created in 1985, Motherisk provides evidence-based information and guidance about the safety or risk to the developing fetus or infant, of maternal exposure to drugs, chemicals, diseases, radiation and environmental agents.

National Center on Birth Defects and Developmental Disabilities (NCBDDD). Information about use of medications during pregnancy and while breastfeeding. NCBDDD is part of the Centers for Disease Control and Prevention.

National Institute of Child Health and Human Development

National Women's Health Information Center (NWHIC). This government health information and referral center for women helps expectant mothers learn what they need to do to promote a healthy pregnancy.

Organization of Teratology Information Services (OTIS). OTIS provides medical consultation about prenatal exposures to drugs, medications, and chemicals. OTIS has Centers throughout the U.S. and in Canada that provide these consultations and also conduct studies on the effect that drugs, medications, chemicals and other exposures may have on the fetus. The Website publishes fact sheets on various exposures of concern.

Physicians' Desk Reference (PDRhealth.com). For more than 50 years, doctors have relied upon the Physicians' Desk Reference for the latest, most accurate drug information. The drug information on PDRhealth is written in lay terms and is based on the FDA-approved drug information found in the PDR. It gives consumers plain-English explanations for the safe and effective use of prescription and nonprescription drugs—explanations that are consistent with the information professionals are referencing in the PDR. Use this section to read about a drug your doctor may have prescribed to check for side effects, drug interactions, and other important information. To search for a particular item, you can select from the list: Prescription Drugs A-Z, OTC Drugs A-Z, Herbal Medicines A-Z, and Nutritional Supplements A-Z.

Safe Motherhood Initiative. The Safe Motherhood Initiative, launched in 1987, is a global effort that aims to reduce deaths and illnesses among women and infants. Physicians' Desk Reference

U.S. Food and Drug Administration

National Institutes of Health. Prescription and over-the-counter medication information as well as information on Herbs and Supplements: Browse by first letter of herb or supplement

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Additional Information

4woman: Pregnancy and medications
American Pregnancy: Abusing prescription drugs
U.S. Food and Drug Administration: Medicines while pregnant
PDR health: Prescription medications, herbs, and supplements

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