Open any prescription or over-the-counter drug insert and read the fine print (squinting may be required). Virtually all will spell out the reasons why a pregnant person shouldn't take the medication — or at least advise you to call your health care provider before doing so.

But many expectant moms take at least one prescribed drug and more than one over-the-counter medication during pregnancy. So how do you sort through the fine print to know which medications can be used safely during pregnancy?

The list below can help you understand which medications are commonly taken during pregnancy, as well as those considered off-limits. But your best bet is always to talk to your doctor before starting a new medication during pregnancy or continuing to take one you were on before you conceived. 

Which medications can you take during pregnancy?

Unfortunately, medications in pregnancy cannot be definitely considered "safe" or “unsafe.”[1]

No drug — whether prescription, over-the-counter or herbal — can be considered 100% safe during pregnancy. This is because it depends so much on timing of exposure, the dose of the medication, and the indication for which the medication is being used. 

What’s more, the Centers for Disease Control and Prevention (CDC) notes that because pregnant women usually aren’t used in studies, most medications approved since 1980 don’t have sufficient information to determine whether they’re safe to use during pregnancy.[2]

Fortunately, only a few drugs are known to be harmful to a developing fetus. Many others can be taken safely during pregnancy and are commonly used; some are even necessary.

The Food & Drug Administration's (FDA) prescription drug labeling system offers detailed summaries of a drug's effects on pregnancy, lactation and "reproductive potential" (i.e. men and women who might get pregnant or are trying to conceive). 

These labels can help moms-to-be and nursing moms better understand the effects of a drug they're taking after a doctor prescribes it:

  • The "pregnancy" section outlines the likelihood and seriousness of developmental abnormalities from exposure to a drug; when it should be prescribed; side effects; clinical trial data; directions for use during labor and delivery; and alternative treatments, if applicable.
  • The "lactation" section includes how much of the drug is secreted in breast milk; an estimate of how much an infant will consume as a result of mom taking the drug; data on the effects of a baby's exposure to the drug; and how to minimize an infant's exposure.
  • The "reproductive potential" section explains any effects the drug might have on contraception; pregnancy testing and infertility while and after you're taking it; and additional precautions to take.

Always check in with your doctor or midwife before using medication to get the green light along with dosing and brand recommendations. “It’s really important to talk to your doctor about medications if you are trying to get pregnant or are currently pregnant,” says Jennifer L. Wu, M.D., a board-certified OB/GYN with her own private practice, Women's Health of Manhattan, in New York City, and member of the What to Expect Medical Review Board. That’s especially true during the first trimester, she says, when “the organs are forming and a fetus is the most vulnerable to drugs."

Commonly used medications in pregnancy

These medications should be safe to take when you're pregnant, though always check with your practitioner first.

Other medications to manage chronic illnesses such as asthma or diabetes are often okay to continue during pregnancy — but it depends on the medication and your situation, so always be sure to check with your doctor first.

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It is really important to talk to your doctor about medications if you are trying to get pregnant or are currently pregnant, especially during the first trimester.

Dr. Jennifer L. Wu, an OB/GYN in New York City and member of the What to Expect Medical Review Board

Medications you may be able to take during pregnancy

In certain cases your practitioner may okay some medications for specific health conditions with close supervision:

  • Antibiotics: Certain antibiotics may be fine to take for bacterial infections if your doctor prescribes them, though others won't be allowed.
  • Antidepressants: Treating depression is very important in pregnancy. Most antidepressants can be used when you're expecting, such as certain selective serotonin reuptake inhibitors (SSRIs), though there are others that should be discussed with your psychiatrist and OB/GYN and considered on a case-by-case basis — the research is ongoing and ever-changing. Your doctor will weigh their use against the risk of untreated (or undertreated) depression, which can have many adverse effects on a developing fetus.[10]
  • Antidiarrheal treatment: Kaopectate is sometimes used in limited amounts and for a limited period of time, but ask your practitioner first to be sure (most will advise waiting until after the first trimester; note that Pepto-Bismol and other salicylates should probably not be used during pregnancy).
  • Aspirin: This will likely be off-limits, especially during the third trimester, since it increases the risk for potential problems in newborns as well as complications like excessive bleeding during delivery. Some studies, however, suggest that very low dosages (baby aspirin) may help to prevent preeclampsia in certain circumstances. Other research indicates that low-dose aspirin in combination with the blood-thinning medication heparin may reduce the incidence of recurrent miscarriage in some women. In both cases, only your doctor can let you know if these drugs are safe for you and under what circumstances.[11]
  • Ibuprofen (Advil or Motrin): It generally shouldn't be used during pregnancy (though there are some exceptions) — especially during the first and third trimesters, when it can have the same blood-thinning effects as aspirin. Use it only if it's specifically recommended by a physician who knows you're pregnant.[12]

Medications you should definitely avoid during pregnancy

Make sure to avoid the following drugs when you're expecting:

Can you take antibiotics during pregnancy?

Antibiotics can be a literal lifesaver when they're used to treat a bacterial infection. If your doctor prescribes you an antibiotic during pregnancy, it's generally because the infection it's treating is more dangerous than any potential side effects of taking the drug. If your doctor prescribes you an antibiotic, it will generally be in the penicillin or erythromycin family.

That said, antibiotics can also be overused when they're not necessary, leading to antibiotic-resistant infections. A few things to remember:

  • Antibiotics only treat bacterial infections, which means they don't work for viral infections (like the cold and flu).
  • Many antibiotics are considered safe to use during pregnancy. So if your practitioner prescribes an antibiotic for a UTI, don't hesitate to take it.
  • Every infection needs a specific type of antibiotic and dose. That means you should always get a new prescription and throw away any leftovers.
  • Take antibiotics exactly as your doctor prescribes; this helps ensure they have the opportunity to do their full job. Never purposely skip a dose or finish taking your meds early just because your symptoms start to subside.
  • Only take antibiotics prescribed for you by a doctor who knows you're pregnant.
  • Talk to your doctor about taking a probiotic supplement to replenish the good bacteria in your body. Try to take the probiotic and the antibiotic a few hours apart, if possible.
  • One antibiotic you should definitely avoid: tetracycline, which is often used to treat acne and can cause minor birth defects and possibly calcification of a baby's bones and teeth (causing baby and permanent teeth to gray, and reducing the growth of some bones — though bone issue seems to return to normal after stopping the drug).[17]

Some research suggests that certain — and importantly, not all — antibiotics may be linked to a higher risk of miscarriage and birth defects.[18] This risk, however, is very low, and the illnesses the pregnant moms were being treated for could have been the cause for the miscarriages rather than the drugs themselves.

Remember that while it's not wise to take antibiotics when they're not warranted (e.g. when you have a viral infection like the cold), they can be essential — even lifesaving — for your health and your baby's. If your doctor prescribes antibiotics and you're concerned, ask about the potential risks and benefits.

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KEY TAKEAWAYS

No medications can be definitely considered "safe" or “unsafe" during pregnancy. But many meds are commonly taken by moms-to-be and should be safe to take while pregnant, such as acetaminophen, antacids, cough medications and nasal sprays.

Other medications may be safe, but you should check in with your doctor to make sure. For example, some antibiotics, antidepressants and antidiarrheal treatments may be recommended during pregnancy.

There are other medications you should definitely avoid, since research has suggested they may not be safe for your growing baby. That includes ACE inhibitors, decongestants, isotretinoin (also known as Accutane) and methotrexate.

Always check in with your doctor before taking medications during pregnancy, even if you're pretty sure that something you're considering is safe. Together, you and your provider can weigh the pros and cons of different medications, and they may suggest an alternative that's a better fit for you.

How to safely take your medicine during pregnancy

You've heard it before, but it bears repeating: Never take any medication, supplement or herbal remedy without checking with your health care provider first. A few more tips to keep in mind:

  • Make sure all your doctors are informed. Always tell any doctor you visit that you're expecting, and be sure to tell them about any other medications (antibiotics, etc.) that you've been prescribed.
  • Talk to your practitioner about meds you already take. Some medications are metabolized differently during pregnancy, so be sure to ask your doctor whether you need to switch up the dosage because you're expecting. And if you take a drug to control a chronic condition, you may need to make other adjustments. For example, if you take medication to help with morning sickness, you may want to take it at night instead so there's less of a chance you'll throw it up. Or, if you have to take a medication on an empty stomach (first thing in the morning), talk to your doctor about taking an anti-nausea suppository first.
  • Optimize it. Ask your practitioner about ways you can optimize benefits and minimize risks for both you and your baby. For instance, you might want to take cold medications at night to help you sleep. Or you may be able to take a lower dose for a shorter amount of time and still get the intended/required effects.
  • Get all the details. Make sure you understand how often to take the medication, how to properly store it and if you should avoid any other medications, foods or beverages. (Your doctor as well as your pharmacist can help).
  • Know how your medication should look. Check it and read the label to confirm what you're getting is what your doctor prescribed. If you're not sure (say, because you get a generic instead of the brand-name drug), talk to your pharmacist or physician.
  • Double check all labels. Many OTC medications contain multiple active ingredients, some of which may be okay for pregnancy and others that may not. In addition, if you need to take more than one med to treat multiple symptoms or conditions, you want to be careful not to accidentally get a double dose of the same ingredient (acetaminophen, for example).
  • Read the patient information sheet. This can help you to understand how the medicine works along with any risks and possible side effects. Talk to your doctor about any potential side effects to look out for and report to them.
  • Take as directed. Don't alter the dose, skip doses or stop taking a medication you’ve been prescribed before speaking to your doctor.
  • Don't share. Never use medicines that don't belong to you (or offer yours to others).

If you have questions about how or when to take a medication, always talk to your practitioner first.

Figuring out what's safe and what's not safe to take during pregnancy can be difficult. Fortunately, you don't have to go it alone.


FAQs

In short, ask your doctor. Phenylephrine, which is the main ingredient in medications like DayQuil, Sudafed and Claritin-D, is taken over-the-counter to treat a stuffy nose. Though research is limited, some studies found a slightly higher chance for babies with minor differences in the eyes or ears among moms who took phenylephrine during pregnancy, although these are not considered to be birth defects and other studies have not found an increased risk for birth defects. 

Some experts have also suggested that because phenylephrine causes the blood vessels to constrict, it might theoretically reduce blood flow to the placenta if taken during pregnancy.

Your OB/GYN can advise you on whether it makes sense for you to take DayQuil or a similar medication during pregnancy; some doctors give the green light in limited amounts in the second or third trimesters, for example.

 

Though you should check with your OB/GYN, most doctors will probably recommend you avoid ibuprofen during pregnancy and instead take acetaminophen (Tylenol) to treat pain or a fever. Some studies have suggested that taking ibuprofen may increase risk of miscarriage or certain birth defects, though more research is needed. Other reports have found that NSAIDs such as ibuprofen may increase your risk of other pregnancy-related problems after week 20 of pregnancy.

 

Diphenhydramine is the main ingredient in Benadryl, which you can get over-the-counter to treat allergy symptoms, itchy skin and motion sickness. “Benadryl is a pregnancy category class B drug and is considered safe in pregnancy, even in the first trimester,” says Dr. Wu. “Benadryl is often used for allergic reactions, some of which can be life threatening to the mother.”