Medication Safety During Pregnancy: What’s Safe and What to Avoid

Finding clear answers on which medications are safe during pregnancy can be challenging. OU Health experts provide evidence-based guidance to help expectant mothers make informed decisions.

Why Medication Safety Matters

OU Health follows medication safety guidelines from trusted organizations, including the American College of Obstetricians and Gynecologists (ACOG), the U.S. Food and Drug Administration (FDA) and the CDC. Physicians and pharmacists review each patient’s health, current research and national standards before prescribing medication. This team-based approach ensures care that is safe, effective and compassionate.

Understanding Medication Risks During Pregnancy

When it comes to medications during pregnancy, remember that correlation is not causation. A condition that appears after a mother takes medication does not necessarily mean the drug caused it.

“It’s important to rely on the most reliable, up-to-date evidence,” said Dr. Stephanie DeLeon, M.D., associate chief medical officer for Children’s Services and section chief of pediatric hospital medicine at the University of Oklahoma College of Medicine. “That’s far more trustworthy than sensational headlines or trending stories. The relationship between a patient and their doctor is incredibly important, and that’s where women can turn for accurate information.”

Safe and Unsafe Medications During Pregnancy

Always talk to your OB-GYN before taking any medication, even something as common as a pain reliever or allergy pill. Here’s a look at common categories:

Fever, Pain and Headache

Safe:

• Acetaminophen (Tylenol) – Generally considered safe when used as directed.Recommended by ACOG and the Society of Obstetricians and Gynaecologists of Canada (SOGC) as first-line treatment.

Avoid:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)
• Aspirin (unless prescribed for specific conditions like preeclampsia) – These NSAIDs may cause fetal heart issues and other complications.

Cold, Flu and Congestion

Safe:

• Acetaminophen – For fever and aches
• Guaifenesin (Mucinex) – For chest congestion
• Dextromethorphan (Robitussin DM) – For cough
• Saline nasal spray or Neti pot – For congestion
• Pseudoephedrine (Sudafed) – Safe after 12 weeks; avoid if you have high blood pressure.

Avoid:

• Phenylephrine (in some cold medications) – May not be safe in early pregnancy
• NSAIDs – Common in multi-symptom cold medications

Nausea and Vomiting

Safe:

• Vitamin B6 – 25 mg up to three times a day
• Doxylamine (Unisom) – Often used with B6
• Ginger chews or tea
• Dimenhydrinate (Dramamine) – For motion sickness

Heartburn, Indigestion and Gas

Safe:

• Calcium carbonate (Tums, Rolaids)
• Famotidine (Pepcid)
• Simethicone (Gas-X, Mylicon)
• Omeprazole (Prilosec) – Use with caution under guidance

Avoid:

• Bismuth subsalicylate (Pepto-Bismol) – Contains aspirin-like ingredients

Constipation and Diarrhea

Safe:

• Docusate sodium (Colace) – Stool softener
• Polyethylene glycol (Miralax) – Gentle laxative
• Fiber supplements (Metamucil, Citrucel)
• Loperamide (Imodium) – For diarrhea lasting over 24 hours

Allergies and Asthma

Safe:

• Diphenhydramine (Benadryl)
• Cetirizine (Zyrtec)
• Loratadine (Claritin)
• Fluticasone (Flonase) – Nasal spray
• Albuterol (Ventolin) – For asthma

Sore Throat and Cough Drops

Safe:

• Benzocaine lozenges (Cepacol, Chloraseptic)
• Menthol drops (Halls, Ricola, Vicks)
• Warm salt-water gargles

Skin Issues, Rashes and Hemorrhoids

Safe:

• Hydrocortisone cream
• Calamine lotion
• Witch hazel pads (Tucks)
• Topical hemorrhoidal treatment (Preparation H)
• Oatmeal baths (Aveeno)

Yeast Infections

Safe:

• Miconazole (Monistat) – 1-, 3- or 7-day treatments
• Clotrimazole cream or suppositories

Sleep Help

Safe:

• Diphenhydramine (Benadryl)
• Doxylamine (Unisom)
• Tylenol PM – Combines acetaminophen and diphenhydramine

Important Notes

• Many medications have different combinations. For example, Mucinex has multiple formulas with extra ingredients that may be unsafe. Always check with your doctor.
• Always ask your OB provider before starting or stopping any medication.
• Do not take herbal supplements unless your doctor says they are safe.
• Take the smallest amount of medicine you need for the shortest time necessary.

Why Choose OU Health for Pregnancy Care

It’s important to have a doctor you trust — someone who knows your medical history and can guide decisions about starting or stopping medications. Every patient is different, so your doctor may have specific recommendations for you.

OU Health physicians provide safe medication lists in a comprehensive guidebook for newly pregnant patients.

“We are the only academic health center in the state,” said Dr. DeLeon. “Because our physicians participate in advanced research and train the next generation of doctors, providing high-quality, evidence-based care to Oklahomans is a core part of what we do.”

Whether you’re navigating a routine pregnancy or a more complex health issue, OU Health offers expert care backed by the latest research. Talk to your healthcare provider about your options and explore OU Health’s Women’s Health Services, Pregnancy and Childbirth Services Care and Pharmacy Services.