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Are over-the-counter drugs safe during pregnancy?

It’s common for pregnant women to take at least one over-the-counter medication during their pregnancy, whether it’s a pain reliever or to help manage a cold. While these medications are generally considered safe for unborn babies, Centers for Disease Control and Prevention estimates that less than 10 percent of medications approved by the Food and Drug Administration have enough information to determine their risk for birth defects.

The Food and Drug Administration estimates that 10 percent or more of birth defects occur from medications taken during pregnancy.
As little as 10 percent of the medications approved by the Food and Drug Administration have enough information to determine their risk for birth defects.

“If a medication isn’t necessary, you should avoid taking it,” says Heather Miller, Pharm.D., BCPS, BCACP, CDE, assistant professor at Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy in Round Rock. “A general rule of thumb regarding any medication during pregnancy is to ask your doctor first.”

Some common over-the-counter medications to avoid during pregnancy include:

1. Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs are used to treat inflammation, control pain and reduce fever. Drugs like aspirin (Excedrin, Bayer), naproxen (Aleve) and ibuprofen (Advil, Motrin) are common NSAIDs. Do not take NSAIDs unless prescribed specifically by a doctor.

“If you need to take something to treat these symptoms, acetaminophen (Tylenol) is a better alternative,“ recommends Miller.

She also advises staying away from medications labeled “extra strength,” “maximum strength” or “long acting.”

2. Decongestants

Pseudoephedrine and phenylephrine (Sudafed) work to relieve nasal and sinus congestion caused by allergies or the common cold. While decongestants aren’t specifically harmful, they aren’t necessarily safe either. They may increase heart rate and blood pressure, similar to caffeine, which can be harmful during development. For a safer option, you should avoid allergy triggers and use simple remedies like nasal strips or a humidifier to aid symptoms. If symptoms persist, consult with your doctor before taking decongestants.

3. Medicines that contain alcohol

All forms of alcohol, even in small doses, can cause birth defects. This includes cough and cold medicines that can contain up to 10 percent alcohol per dose. If you find you are experiencing cold or flu-like symptoms while pregnant, look for an alcohol-free cough syrup and stay hydrated.

4. Herbal products

While these products may seem safe because they are natural, there is no guarantee that they are beneficial or effective.

“The problem with natural products is that they don’t go through the same FDA testing procedures that typical over-the-counter medications do,” warns Miller. “There’s no way of knowing if a product works the way it claims on the label.”

In addition, most herbal products haven’t been studied during pregnancy, so the effects are unknown. If you are interested in using natural products during pregnancy, ask your doctor for more information or consult a certified herbalist in your area.

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