The issue of over the counter, or OTC, medications and pregnancy is a challenging one. According to research by the US Centers for Disease Control (CDC) one of the problems with determining safety and effectiveness of medications during pregnancy or when women breastfeed their children, is that these groups are routinely not tested in studies conducted by the Food and Drug Administration (FDA). Most studies on OTC medications and pregnancy are inferred from tests on pregnant animals or arise as a result of women using OTC meds and then having problems. The first method is not always the best predictor for human reactions. The second means that if problems with OTC medications and pregnancy arise, the only help is usually to remove the drug from the safe list, which may not mitigate damage to children whose mothers used a formerly “safe” medication while pregnant.
Despite that, there are many women who will need to take a medication during pregnancy, and what must be weighed first, is whether the need for the medication outweighs any potential risk, and also if the medication falls into what is considered a low-risk category. It should be observed that medications determined low-risk can change, and it’s always a good idea to ask your doctor to approve any OTC medications you might take. Studies can change current lists; you only need to look as far as medications like Tylenol® (acetaminophen) to see that warnings about the drug have extended to include being sure people take no more than the recommended dose because of the potential for liver damage.
A short list of OTC medications that are generally accepted as safe during pregnancy would include the following meds:
- Most chewable antacids like Maalox, Rolaids and Tums
- Simethicone, in medications like Gas-X
- Cough medicines that contain dextromethorphan or guaifenesin, or both, but not alcohol, pseudoephedrine or phenylephrine
- Fiber supplements like psyllium husk and methylcellulose
- Antihistamines like loratadine, diphenhydramine and chlorpheniramine
- Topical antibiotics for small cuts
An important thing to remember with OTC medications and pregnancy is to read labels carefully. Read for contraindications against taking the medication if you are pregnant. Similar to the safe list applicable for OTC medications and pregnancy is the list of drugs you absolutely should avoid unless these medications are doctor recommended and they pose some benefit worthy of the risk. For instance, you should avoid any medications that contain alcohol, aspirin, ibuprofen, naproxen sodium, pseudoephedrine, and phenylephrine. Essentially, if you read an ingredient on an OTC drug that is not on your “low risk” list, ask your doctor before taking this medication.
You should also be aware that most herbal preparations, medications and tinctures are contraindicated during pregnancy. Speak to your doctor if you plan to take any herbs, and ask him or her for information regarding their safety. Most herbs you would eat in food are likely safe in small doses, but highly concentrated amounts of them may occur in herbal preparations, which may not be safe. Treat an herbal preparation as you would an OTC medication and get medical advice before using it.