When you’re pregnant, you’re sharing a blood supply with your baby. That means the baby is affected by the foods you eat, the beverages you drink, and even the air you breathe. The baby is also affected by the medicines you take.
Babies process many medicines differently than adults. Their livers and kidneys are not fully formed, meaning some medicines are difficult or impossible for them to process. Many medications may be perfectly safe for adults but can have harmful effects on a developing brain. Just because a medicine is sold over-the-counter or approved by the FDA doesn’t mean it’s safe for a fetus.
So, what medicines are dangerous during pregnancy?
Who decides if medications are safe for pregnant women?
First, how do we know what medicines are dangerous during pregnancy? The Food and Drug Administration (FDA) reviews clinical studies and other data to approve medications for various uses. The FDA will review clinical studies and other evidence to determine whether a pharmaceutical company can fairly market a drug as being safe for use during pregnancy.
In order to be considered safe for use during pregnancy, the FDA requires that a drug be tested on two different types of animals to learn how the drug affects mother and baby during pregnancy. Testing on two types of animals rather than one is believed to give a better estimate of potential human reactions to the drug. Testing on a single type of animal leaves the door open for issues that only affect that animal or issues that don’t affect that animal but do affect others.
Even with testing on two different types of animals, determining the safety of a drug during pregnancy is risky. There simply isn’t enough information in most cases to determine how a given drug affects pregnancy.
While it’s very difficult to determine what drugs are safe for pregnancy, it’s much easier to determine what drugs aren’t safe. Drugs that cause negative effects during animal testing are ruled unsafe for pregnancy. Drugs that go to market and end up causing side effects will also be ruled (and relabeled) unsafe for pregnancy.
Unfortunately, it’s often safest to simply avoid taking medication while pregnant.
Common Medications NOT Safe for Pregnancy
Over-the-counter medications are safe for adults and we often take them casually. If we have a headache or a stomachache, we head for the medicine cabinet. However, safe for adults does not mean safe for fetuses.
Many of the medicines we take casually for minor ailments are dangerous for a developing fetus. These include:
- aspirin: used as a pain reliever in drugs such as Bayer Aspirin and Excedrin;
- ibuprofen: used as a pain reliever in drugs such as Advil and Motrin;
- naproxen: used as a pain reliever in drugs such as Aleve;
- phenylrephrine and pseudoephedrine: used as a decongestant in drugs such as Claritin-D, Advil Cold & Sinus, Sudafed, and other cold medicines;
- chlorpheniramine: used as a decongestant in drugs such as Dristan Cold, Alka-Seltzer Plus Cold Relief, and Advil Allergy & Congestion relief;
- bismuth subsalicylate: used to relief indigestion in drugs such as Pepto Bismol and Kaopectate.
How can I find out if a medicine is safe?
If you’re wondering about whether a medication is safe to take during pregnancy, the best place to start is with the medication’s label.
Some drugs will have explicit warnings that they are not safe for pregnant women. Those are easy to avoid. Others may include a warning that their effects have not been tested on pregnant women. Those drugs should also be avoided. Some drugs will have specific labels stating that they are safe for use during pregnancy.
When in doubt, ask a pharmacist or your doctor. It’s better to take nothing at all than to risk the health and safety of your baby.
Taking a look at the label and doing some research online can help you with over-the-counter drugs for a headache or some nausea, but that’s not the only type of drug you may need while you’re pregnant. Maybe you have asthma and need to take a daily inhaler. Maybe you have epilepsy and need to take medications to control your seizure risk. Maybe you suffer from severe depression and need to take mood stabilizers. Maybe you’ve had blood clots and need to take blood thinners.
If you take prescription medications, you’ll need to work with your doctor to determine the best course of action for you and your child. You can talk to your doctor about the risks, if any, associated with the medications you usually take compared with the benefits of taking those medications.
In some cases, you may be able to find a pregnancy-safe alternative medication. In other cases, there won’t be a pregnancy-safe alternative and you’ll need to work with your doctor to decide how to manage your medication during pregnancy.
See also: Does Zofran Cause Birth Defects?
People take herbal supplements for a variety of reasons, from keeping joints healthy to making hair grow faster. Herbal supplements are not regulated by the FDA and the plants and other compounds in them have not been evaluated for safety in pregnant women. Herbs and plants may have a variety of active compounds in them — those herbs and plants are often used as a basis for other types of medication. Those active compounds can affect both you and your growing little one.
In addition to the potential effects of the ingredients in herbal supplements, many herbal supplements suffer from purity problems. Because these supplements are unregulated, their ingredients may vary from what is listed on the bottle. At best, you may get something harmless. At worst, you may end up consuming something truly dangerous.
In general, herbal supplements are too risky for pregnancy. If you take herbal supplements, speak to your doctor about the supplements you take. Many have prescription or over-the-counter alternatives that are tested and regulated, so you know what you’re taking.
Better Safe Than Sorry
At the end of the day, we just don’t have very good data on how most medications and supplements affect pregnant women and developing fetuses. Where possible, the safest option is to avoid taking anything. When medication is necessary, work closely with your doctor to keep the risk to you and your developing baby to a minimum.
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