What over-the-counter and prescription drugs in pregnancy are not safe or safe to take during pregnancy?

Drugs in pregnancy is very tricky and your health professional will advise you of what you should or shouldn't be taking. In the US guidance is sort from The Food and Drug Administration (FDA) which has a system to rate drugs in terms of their safety during pregnancy.

This system rates both over-the-counter (OTC) drugs you can buy in a pharmacy/drug or discount stores, and drugs your health care provider prescribes. The drugs in pregnancy that are used have been fully established for safety, but most medicines in general have not been studied in pregnant women due to the risk of damage they potentially may cause to a developing foetus.

Always talk with your health care professional if you have questions or concerns.

The FDA system ranks drugs as:

Category A - drugs in pregnancy that have been tested for safety during pregnancy and that have been found to be safe includes folic acid, vitamin B6, and thyroid medicine in moderation, or in prescribed doses.

Category B - drugs in pregnancy that have been used a lot during pregnancy and do not appear to cause major birth defects or other problems. This includes drugs such as some antibiotics, acetaminophen (Tylenol), aspartame (artificial sweetener), famotidine (Pepcid), prednisone (cortisone), insulin (for diabetes), and ibuprofin (Advil, Motrin) before the third trimester. Pregnant women should not take ibuprofen during the last three months of pregnancy.

Category C - drugs in pregnancy that are more likely to cause problems for the mother or the foetus and this includes drugs for which safety studies have not been finished. The majority of these drugs do not have safety studies in progress. These drugs often come with a warning that they should be used only if the benefits of taking them outweigh the risks. This is something a woman would need to carefully discuss with her doctor. These drugs include prochlorperzaine (Compazine), Sudafed, fluconazole (Diflucan), and ciprofloxacin (Cipro). Some antidepressants are also included in this group.

Category D - drugs that have clear health risks for the foetus, include alcohol, lithium (used to treat manic depression), phenytoin (Dilantin), and most chemotherapy drugs to treat cancer. In some cases, chemotherapy drugs are given during pregnancy.

Category X - drugs that have been shown to cause birth defects and should never be taken during pregnancy. This includes drugs to treat skin conditions like cystic acne (Accutane) and psoriasis (Tegison or Soriatane); a sedative; thalidomide.

Aspirin and other drugs containing salicylate are not recommended during pregnancy, especially during the last three months. In rare cases, a woman's health care provider may want her to use these type of drugs under close watch.

Acetylsalicylate, a common ingredient in many OTC painkillers, may make a pregnancy last longer and may cause severe bleeding before and after delivery.Should I avoid taking any medicine while I am pregnant?

Whether or not you should continue taking drugs in pregnancy is a serious question. But, if you stop taking medicine that you need, this could harm both you and your baby. An example of this is if you have an infection called toxoplasmosis, which you can get from handling cat feces or eating infected meat. It can cause problems with the brain, eyes, heart, and other organs of a growing foetus. This infection requires treatment with antibiotics.

For pregnant women living with HIV, the Centers for Disease Control and Prevention (CDC) recommends the drug zidovudine (AZT). Studies have found that HIV positive women who take AZT during pregnancy decrease by two-thirds the risk of passing HIV to their babies. If a diabetic woman does not take her medicine during pregnancy, she increases her risk for miscarriage and stillbirth. If asthma and/or high blood pressure are not controlled during pregnancy, problems with the foetus may result. Talk with your health care provider about whether the benefits of taking a medication outweigh the risk for you and your baby.

What about taking natural medications, or herbal remedies, when you are pregnant?

While some herbal remedies say they will help with pregnancy, there have been no clinical studies to figure out if these claims are true. Or the data regarding the safety is limited. Although, there have been studies to look at how safe and effective herbal remedies are. Echinacea, Gingko biloba, and St. John's Wort have been popular herbs, to name a few.

Do not take any herbal products without talking to your health care provider first. These products may contain agents that could harm you and the growing foetus, and cause problems with your pregnancy.

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