Even medications that seem harmless, such as vitamins and herbal remedies, may not be tested for safety in pregnant women. According to the Centers for Disease Control and Prevention (CDC) less than 10% of FDA approved medications have been tested for safety in pregnancy, since pregnant women are not often included in drug safety trials for ethical reasons. Some medications are not recommended for pregnant women and others may only be safe in certain stages of pregnancy.
To reduce the risk of birth defects due to medications, all drugs including prescription, over-the-counter, illicit drugs, herbal supplements and vitamins should be taken only when the benefit outweighs the risk. Since pregnancy may not be detected for several days or weeks, women who are trying to get pregnant should avoid taking medications unless approved by an obstetrician.
The FDA ranks medication safety by letter using information about the specific drug and what is known about it when used in pregnant women or animals. Medications with a ranking of A are considered the safest. The higher the letter value, the more cautious you should be about taking that medication. Below are some examples of common medications and their ranking:
Category A drugs:
- Levothyroxine (thyroid hormone medication)
- Folic acid
Category B drugs:
- Acetaminophen (Tylenol) – this is the most widely recommended medication for pain relief during pregnancy and can typically be taken during all three trimesters
- Chlorpheniramine (ChlorTrimeton) – antihistamine of choice during pregnancy
Category C drugs:
- Oxymetazoline nasal spray – nasal decongestant of choice in pregnancy, limit use to no more than 3 days
- Guaifenesin (Robitussin) – Avoid in first trimester, but may take in second and third trimester
Depending on your stage of pregnancy and need for treatment, your obstetrician may recommend other medications that are deemed appropriate considering your symptoms. Pregnant women should never take any medication, even those listed as safe during pregnancy, without first consulting their OBGYN.
Instead of relying on OTC medications or prescription meds for the treatment of self-limiting conditions such as the common cold, women may opt to try certain non-medication alternatives for symptom relief. These include:
- Increasing fluid intake to maintain hydration
- Vaporizers or humidifiers
- Nasal irrigation
- Saline nasal spray
Before taking any medication or supplement, it is important to consider the effect it could have on your unborn child. The less exposure your baby has to medications while in the womb, the lower the risk. If you need medication for an existing health condition, talk with your obstetrician about the best, safest option available.