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OTC Medicines and Pregnancy

If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

Over-the-counter (OTC) medicines are medicines that you can buy without a prescription from your health care provider. Many OTC medicines haven’t been well studied for safety in pregnant people. Talk to your healthcare provider or pharmacist before taking any OTC medicine, vitamin, or supplement. If you’re pregnant, there is a risk of them affecting your baby. If you’re breastfeeding, there is a risk of them getting into your breast milk. They can be passed on to your baby this way.

Path to improved health

All people who are pregnant, trying to get pregnant, or breastfeeding should take a prenatal vitamin each day. The following are some basic guidelines for taking other OTC medicines.  If you’re pregnant or trying to get pregnant:

  • Don’t take OTC medicines without talking to your healthcare provider or pharmacist first. This includes medicines to treat cough, cold, diarrhea, constipation, or nausea.  Avoid taking OTC medicines during your first trimester (first 12-13 weeks of pregnancy). This is when the risk to your baby is highest.
  • In general, avoid taking aspirin unless your healthcare provider tells you to take it.
  • Acetaminophen (brand name: Tylenol) is generally considered safe for short-term pain relief during pregnancy.
  • Avoid taking NSAIDs (non-steroidal anti-inflammatory drugs), especially during the third trimester. They can cause heart defects in your baby. NSAIDs include ibuprofen (brand names: Advil, Motrin) and naproxen (brand name: Aleve).
  • Avoid combination medicines that treat many different symptoms at once. This will help you minimize the number of medicines your baby is exposed to. If your health care provider says it’s safe, use 1 medicine to treat 1 symptom. For example, you might use acetaminophen for a headache. But don’t use acetaminophen combined with other active ingredients, such as decongestants or antihistamines.

If you are breastfeeding

  • Take oral medicines after you breastfeed or before your baby’s longest sleep period. This will give the medicine a chance to leave your system before you feed your baby again.
  • Acetaminophen and NSAIDs are safe for pain relief.
  • Avoid using aspirin because it can cause rashes and bleeding problems in nursing babies.
  • Limit long-term use of antihistamines. Just like other medicines you take, antihistamines will pass into your breast milk. They may cause side effects in nursing babies, such as drowsiness, irritability, crying, and sleep disturbances. Antihistamines may also decrease the amount of milk you produce. If you’re not sure whether an OTC medicine contains antihistamines, ask your family health care provider or pharmacist.
  • Watch your baby for any signs of side effects. These signs can include a rash, trouble breathing, or other symptoms that your baby didn’t have before you took the medicine.
  • Keep all medicines out of the sight and reach of your baby and any other children.

Things to consider

Conception occurs about 2 weeks after your last period. That means you may not know you’re pregnant until you’re more than 3 or 4 weeks along. Your baby is most vulnerable 2 to 8 weeks after conception. This is when your baby’s facial features and organs begin to form. Any medicines you take can affect your baby. So can anything you eat, drink, smoke, or are exposed to. This is why you should avoid these things if you’re trying to become pregnant.

If you’re taking medicine regularly because of a health problem, talk with your healthcare provider before you try to get pregnant. There may be other ways to treat your condition rather than taking medicine.

This information provides a general overview and may not apply to everyone. Talk to your healthcare provider to find out if this information applies to you and to get more information on this subject.

Contributed by familydoctor.org editorial staff.

Copyright (c) by the American Academy of Family Physicians

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, January 2025.

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