Questions Pregnant Women Ask About OTC Medicines

J. Kyle Mathews, M.D.

Backaches, indigestion and nausea are just a few of the symptoms women typically experience during pregnancy. Many women also have seasonal allergies that flare up during pregnancy. And then, of course, there is the common cold and its ailments, like congestion, coughing and aches, that many pregnant women will catch.

As an obstetrician and gynecologist, I’m in charge of the well-being of both the mother and her child. So when it comes to treating symptoms like these, I talk to all of my pregnant patients about how they can safely find relief, including the use of over-the-counter medicines.

Here are some common questions my patients ask me about using over-the-counter, or OTC, medicines.

Is it safe for me to take OTC medicines while I am pregnant?

First and foremost, talk to your doctor or another healthcare professional before taking any OTC medicines. Your doctor is in the best position to help you decide whether taking an OTC medicine is right for you. Your doctor can also suggest other remedies to treat symptoms if OTC medicines are not an option. Also, make sure your doctor knows any prescription medicines, dietary supplements and herbs you are taking.

Most doctors in general agree that it’s best to avoid taking any medicine during your first trimester. This is when your baby’s facial features, spinal cord, brain and other internal organs begin to form so it’s best to take extra caution with what goes into your body. However, you don’t need to suffer through symptoms either. If you feel that an OTC medicine can help, talk to your doctor about it.

Is it OK for me to take pain relievers?

Whether it’s to ease back pain from your growing belly or to treat a throbbing headache, many women will talk to their doctor about turning to pain relievers during their pregnancies. Many of my colleagues and I generally consider OTC medicines containing the active ingredient acetaminophen safe for short-term pain relief throughout pregnancy, including the first trimester. To minimize any adverse side effects, patients are advised to start with the minimum possible dose—or one pill– and to take only what is needed for symptom relief.

Do not use aspirin during pregnancy as it can potentially cause harm  in the unborn child or during delivery. Also avoid using other NSAIDs (nonsteroidal anti-inflammatory drugs), especially during the third trimester. They may cause problems in your unborn child or complications during delivery. NSAID active ingredients include ibuprofen and naproxen.

What can I take to relieve heartburn and indigestion?

Almost all of my patients complain of indigestion during some point in their pregnancies. Antacids, which neutralize stomach acid, are generally safe to take during pregnancy and can be taken as needed to relieve heartburn, but patients should always consult a doctor first, especially if during the first trimester.

If your symptoms are persistent, talk to your doctor about taking an H2 blocker, which are the next step up from antacids. H2 blockers, which block stomach acid production, take about 30 to 90 minutes to take effect and can provide relief for up to 24 hours.

In addition, eating smaller meals more frequently can help prevent indigestion. To avoid nighttime heartburn, don’t eat a large meal within three hours of going to bed.

Is there anything I can do to alleviate nausea or morning sickness?

Nausea is very common, especially during the first trimester. The best treatment for nausea is to eat small meals and snacks throughout the day, eat slowly and stick to a bland diet.

If you experience morning sickness, try eating a few crackers before getting out of bed. Also, having a small snack that contains protein before bed, such as yogurt or a peanut butter sandwich, may help prevent morning sickness.

If these home remedies don’t help, talk to your doctor. In some women, excess stomach acid may cause or contribute to nausea; taking an antacid or acid blocker as a preventive measure may eliminate or reduce nausea.

What can I take to help with constipation?

Constipation is common during pregnancy. It can be caused by the extra iron in prenatal vitamins, hormone changes and pressure the growing uterus places on the colon (large intestine). It can also be caused by not drinking enough fluids; this causes the stool to harden in the large intestine, making it more difficult and painful to go to the bathroom.

The first thing you should do to prevent and treat constipation is to drink more water. Eating more fruits and vegetables will help increase your fluid intake and up the amount of fiber in your diet which will help keep you running smoothly.

Even when you’re farther along in your pregnancy and need to urinate more frequently, don’t cut back on the amount of water you drink. It may be annoying to go to the bathroom so often, but drinking lots of water will help keep you and your baby healthy and help prevent constipation.

If those measures don’t work, a stool softener may help. In fact, some prenatal vitamins include a stool softener, but talk to your doctor before taking any stool softeners.

If I catch a cold, what medicine can I take?

You should always talk to your doctor before taking any OTC cold or cough medicine. Some medicines contain alcohol or other ingredients such as aspirin, NSAIDs or phenylephedrine that aren’t safe for your baby.

I often advise my patients to drink plenty of fluids and make sure they receive extra rest when they feel cold symptoms coming on. Humidifiers and saline nasal sprays also provide ways to help relieve congestion. If your cold symptoms do not go away within seven to ten days or you feel you need to take an over-the-counter medicine to feel better, talk to your doctor. If you do take something, treat symptoms individually rather than taking multi-symptom treatments to avoid taking medicines you don’t need.

What can I take to help with seasonal allergies?

Being pregnant can be a wonderful experience but it also brings a bit of suffering to expectant moms. If patients suffer from severe allergies and need relief, they should always talk to their doctor first. He or she may point to the American College of Asthma, Allergy and Immunology (ACAAI) guidelines which note that antihistamines may useful during pregnancy to treat symptoms of hay fever and other types of allergies. ACAAI also says that chlorpheniramine and diphenhydramine have been used safely for many years during pregnancy, but be careful — they may cause drowsiness. Loratadine and cetirizine are two newer, less sedating, antihistamines that are also safe to use during this time.

Although they are minimally absorbed in the blood stream, avoid taking decongestant nasal sprays for more than three days as they can cause a “rebound” effect, making your symptoms worse.

Should I take a prenatal vitamin?

Women who are pregnant or thinking about becoming pregnant should take a daily vitamin that contains at least 400 micrograms (mcg, or µg) of folic acid. Folic acid reduces the chance that the baby will develop neural tube defects like spina bifida, where the brain doesn’t form properly.

It’s also a good idea to take extra iron and calcium during pregnancy. Look for supplements that contain 17 milligrams (mg) of iron and 200-300 mg of calcium.

Prenatal vitamins can be a good way to get the extra vitamins and minerals you need during pregnancy in a single pill, but you can also take these supplements separately, if you prefer.

Remember, you don’t necessarily have to suffer through your symptoms just because you’re pregnant. But be sure to talk to your doctor before taking any OTC medicines. It’s the best way to make sure that both you and your baby stay healthy. If you have any doubts about whether something is safe to take during pregnancy, ask your doctor.

Meet Our Experts

J. Kyle Mathews, M.D.

Dr. J. Kyle Mathews is a board-certified physician in obstetrics and gynecology in private practice in Plano, T.X.