How Safe Are OTC Meds During Pregnancy?

Medically reviewed in August 2021

Women naturally worry about taking any over-the-counter (OTC) medications during pregnancy for fear of harming their baby. But there’s an exception to every rule. One medication that has been considered safe is acetaminophen (Tylenol), commonly used by pregnant women to relieve fever, body aches, pain and sore throat. Now a recent study raises questions even about that. 

The study, which focused on pregnancy complications and diseases in children, involved over 64,000 Danish mothers and their children. UCLA researchers followed the women’s OTC drug use during pregnancy and six months after birth. They then used Danish medical databases to see which children had been diagnosed with ADHD or prescribed ADHD medications. What they found was up to a 40% higher risk of behavioral problems and ADHD in kids before the age of seven when the mothers-to-be took acetaminophen. The researchers noted that the strongest effects were seen in women who took acetaminophen for six weeks or more, and even higher for women who took it for 20 weeks or more during pregnancy. But because the study didn’t establish a conclusive cause-and-effect, experts not involved in the study said that follow-up research was needed to support the findings. The report also noted that taking acetaminophen once or twice during pregnancy was unlikely to cause harm.

Related: What are the signs of ADHD in children?

But before we put acetaminophen on the banned list, remember that maternal fever itself carries risks.

With all this conflicting information, what should you know about the use of OTC meds during pregnancy?

  • It is well accepted that suppressing fever at term is important for the health of the late-term fetus and newborn. Acetaminophen is still your best option. Do check with your doctor before taking any other pain medications, especially non-steroidal anti-inflammatory drugs (NSAIDS) like aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve). NSAIDS may harm your baby, especially in the last trimester, or cause problems during labor.
  • What can you take for constipation? Start by adding more water and soluble fiber to your diet. Soluble fibers are found in oats, citrus fruits, apples, barley, psyllium, flax seeds and legumes. If that doesn’t work then try a supplement, such as fiber pills (FiberCon is one example) or fiber powders (such as Metamucil). Laxatives can cause intestinal cramping that is hard to distinguish from premature labor, which is one of several reasons to be careful here. 
  • What about allergies? You have some great options for treating allergy symptoms. Claritin (loratadine) is considered safe, as are saline nasal sprays.
  • How can you find relief from a cough that just won’t stop? Experts recommend Robitussin or Mucinex. But they also advise pregnant women to stay away from decongestants containing pseudoephedrine or phenylephrine (Sudafed PE, Dimetapp as examples).
  • Last but not least, diarrhea? The only good news if you are pregnant and have diarrhea (cruel), is that most OTC options are safe, including loperamide (Imodium), Kaopectate II, Maalox and Pepto.

Hopefully you won’t come down with any of these otherwise run-of-the-mill ailments while you’re pregnant. But if you do, use caution with the OTC meds you take, and always check with your doctor first.

Related: 20 Must-Know Facts About Pregnancy

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