The moment a woman finds out she is pregnant, worries and questions immediately flood her mind. Among the questions of
“how are we going to raise this child,” “afford the expenses” and “what to name him/her;” there is the question of “is what I am doing safe for my baby?” When it comes to medication choices when you are pregnant there is no straight forward answer. Over time, doctors have monitored pregnant women and medication use so we now have a better understanding as to what medications are considered safe to use during pregnancy. Controversy remains however, as these medication safety studies are difficult to conduct.
As a pharmacy student I have always been taught when a pregnant woman approaches you regarding medication recommendations we are to tell the patient, “check with your doctor before starting any new medications.” However, at 7:00 pm on a Friday evening, that may not be possible. This is where pharmacists are able to accommodate by making suggestions on what to do until you are able to talk to your doctor. It is important you communicate with your doctor on all the medications you take, including over-the-counter medications the doctor may not always remember to ask you about. It is your responsibility to make sure your doctor is up to date on all the current medications you are taking at every prenatal appointment. There are medications that can be harmful to your baby if taken during pregnancy but this should not lead you to avoid treating symptoms you experience while pregnant. It is important to stay healthy and treat your body appropriately, if you are not healthy your baby is not healthy.
To help diminish some of the anxiety that comes with medication choices during pregnancy, here are some common ailments that can be treated safely with over-the-counter medications.
Tylenol (acetaminophen), when used at appropriate therapeutic doses, is the go-to medication to use for pain in all trimesters of pregnancy. However, it is also found in many over-the-counter medications that you may not even realize. Tylenol can lead to damaging effects on the liver, so it is important not to exceed maximum daily dose of 3000 mg per day. All other over-the-counter pain medications should not be used unless directed by your doctor.
The symptoms of allergies can be decreased with the use of antihistamines. First generation antihistamines like Benadryl (diphenhydramine) can be used safely, as well as second generation antihistamines like Claritin (loratidine), Zyrtec (cetirizine) and Allegra (fexofenadine). Benadryl, and all older first generation antihistamines, have the common side effect of drowsiness (a desirable effect when treating insomnia) which should be considered before taking the medication when you need to remain alert.
A common ailment many women experience during pregnancy is hemorrhoids. This can be treated with over-the-counter wipes such as Preparation H or Tucks. Wipes must contain witch hazel or pramoxine only. You should not use any combinations that contain the letters HC which stands for hydrocortisone, a steroid that can affect development of the fetus.
Cold symptoms often include pain and fever which can be treated with Tylenol (acetaminophen). For cough there is dextromethorphan, a cough suppressant, or Robitussin DM (guaifenesin/dextromethorphan), a combination of an expectorant and cough suppressant that can be used to treat cough and cold symptoms. Cough drops can also be used to diminish cough and soothe a sore throat. Saline nasal spray or a humidifier can be used to alleviate nasal congestion. One thing to be aware of when choosing cold medicine is the formulation you take does not contain alcohol. Also avoid cough/cold products that contain decongestants such as pseudoephedrine, phenylephrine, and oxymetazoline. Nasal sprays should additionally be avoided as these medications have been found to constrict the blood vessels in the placenta, decreasing blood flow and development of the fetus.
This limited list of the appropriate medications should be used as a guide to help direct you on what to take until you are able to talk to your doctor to get their professional opinion on the best treatment for your symptoms.
Make sure to check in next week to learn about common gastrointestinal issues pregnant women can treat with over-the-counter remedies in the second part of “Dos and Don’ts of Medication during Pregnancy.”