Written and medically reviewed by Dorcas Morak, Pharm.D
Pregnancy changes how your body absorbs, metabolizes, and clears medications, which means a drug that worked well before pregnancy may need a second look now. The good news is that many common conditions—from headaches to infections and chronic health conditions—can still be treated safely during pregnancy. Understanding which medications are generally considered safe, which should be avoided, and when to talk with your healthcare provider can help you make informed decisions throughout your pregnancy.
How Does Pregnancy Affect the Way Medications Work?
Pregnancy increases blood volume, alters liver and kidney function, and changes how quickly medications are absorbed and cleared from the body. These changes can affect how much medication you need and how easily a medication crosses the placenta to reach your developing baby. Because every pregnancy is different, your healthcare provider may adjust your treatment plan as your pregnancy progresses.
Which Pain Relievers Are Safe During Pregnancy?
Acetaminophen (Tylenol) is generally considered the preferred over-the-counter option for treating pain and fever during pregnancy when used at the lowest effective dose for the shortest amount of time.
Always check with your healthcare provider before taking any medication during pregnancy, even over-the-counter products.
Why Should NSAIDs Be Avoided During Pregnancy?
The FDA recommends avoiding nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil, Motrin) and naproxen (Aleve), beginning at 20 weeks of pregnancy unless specifically directed by your healthcare provider. These medications may reduce amniotic fluid levels and, later in pregnancy, may affect the baby's heart or kidney development.
Which Cold and Allergy Medications Are Safe During Pregnancy?
Some allergy medications, such as loratadine (Claritin) and cetirizine (Zyrtec), are commonly recommended during pregnancy when needed.
Certain decongestants, including pseudoephedrine (Sudafed), are generally avoided during the first trimester and may not be appropriate for women with high blood pressure. Before taking any cold, cough, or allergy medication, ask your healthcare provider or pharmacist whether it's appropriate during pregnancy.
Which Antibiotics Are Safe During Pregnancy?
Many antibiotics can be used safely during pregnancy when needed. Penicillins, such as amoxicillin, and cephalosporins, such as cephalexin (Keflex), are commonly prescribed for bacterial infections.
Some antibiotics, including doxycycline and certain fluoroquinolones, are generally avoided because they may affect fetal development. Your healthcare provider will choose the safest antibiotic based on the type of infection and your stage of pregnancy.
Which Medications Should Be Avoided During Pregnancy?
Certain medications are known to increase the risk of birth defects or pregnancy complications and should generally be avoided unless specifically recommended by your healthcare provider.
These include:
- Isotretinoin (Accutane) and certain prescription acne medications
- ACE inhibitors and ARBs, such as lisinopril and losartan, used to treat high blood pressure
- Certain live vaccines during pregnancy
If you're planning a pregnancy or discover you're pregnant while taking one of these medications, contact your healthcare provider promptly. Never stop taking a prescription medication without medical guidance.
Can You Continue Chronic Medications During Pregnancy?
Many chronic health conditions should continue to be treated during pregnancy because uncontrolled illness may pose greater risks than the medication itself.
For example:
- Insulin and sometimes metformin (Glucophage) are commonly used to manage diabetes.
- Levothyroxine (Synthroid, Euthyrox) is usually continued for hypothyroidism, although the dose may need adjustment.
- Many asthma medications are also continued to help keep both mother and baby healthy.
Your healthcare provider will carefully balance the benefits and risks of each medication.
Are Antidepressants and Anti-Anxiety Medications Safe During Pregnancy?
For some women, continuing treatment for depression or anxiety during pregnancy is the safest option. Certain SSRIs, including sertraline (Zoloft), are commonly continued when the benefits outweigh the potential risks.
Treatment decisions should always be individualized and made with your obstetrician and mental health provider. Stopping these medications suddenly can sometimes be more harmful than continuing treatment.
Are Herbal Supplements and Vitamins Always Safe During Pregnancy?
Not necessarily. "Natural" doesn't always mean safe during pregnancy. Some herbal supplements may not have been well studied or could increase the risk of complications.
Prenatal vitamins are an important part of a healthy pregnancy because they provide nutrients such as folic acid and iron, which support your baby's development. However, even vitamins can be harmful if taken in excessive amounts. Always discuss supplements, herbal products, and vitamins with your healthcare provider before taking them.
Should You Tell Every Healthcare Provider That You're Pregnant?
Yes. Be sure to tell every healthcare provider you see—including your dentist, pharmacist, urgent care clinician, and any specialists—that you're pregnant or planning to become pregnant. This helps ensure any medications or treatments they recommend are appropriate for you and your baby.
What Questions Should You Ask Your Doctor Before Starting or Stopping a Medication?
Before starting, stopping, or changing any medication during pregnancy, consider asking:
- Is this medication considered safe during pregnancy?
- Is there a safer alternative?
- Does my dose need to change during pregnancy?
- What side effects should I watch for?
- Should I avoid this medication while breastfeeding later?
Having these conversations can help you feel more confident about your treatment plan.
Should You Ever Stop a Medication on Your Own?
No. Stopping certain medications abruptly—especially those used to treat seizures, high blood pressure, thyroid disease, diabetes, or mental health conditions—can sometimes be more dangerous than continuing them.
Always speak with your healthcare provider before making any changes to your medications during pregnancy.
How Can You Save on Pregnancy-Safe Prescription Medications?
Pregnancy-related prescriptions, including prenatal vitamins, antibiotics, thyroid medications, and insulin, can become an ongoing expense throughout pregnancy.
The RxLess® Assurance Plan helps you compare real-time prescription prices and access free digital coupons at more than 70,000 pharmacies nationwide. Simply download the free RxLess® app from the Apple App Store or Google Play to automatically become a member of the RxLess® Assurance Plan and compare prices on eligible prescription medications before heading to the pharmacy.
