Because researchers don’t conduct drug safety experiments on pregnant patients, we can never guarantee the safety of any medicine in pregnancy. For the most part, we advise avoiding any medications that may be unnecessary, even more so in the first trimester when the fetus is still developing new tissues and organs.

However, many medications are used commonly during pregnancy and are not thought to pose any problems; and many more medicines may have some risks but are necessary to treat serious medical problems that pose even bigger risks if left untreated.

Medicines to avoid during pregnancy:

The truth is, there are only a few medications that we know for sure you should avoid during pregnancy. These include:

• ACE-inhibitors or angiotensin receptor blockers (ARBs) such as lisinopril, enalapril, ramipril, captopril, benazepril, irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), and valsartan (Diovan). These medications don’t cause harm in the first trimester but should be stopped when you become pregnant. Talk to your doctor about a blood pressure medicine that would be safe for you.
• Some seizure medications, such as carbamazepine, phenytoin, and valproic acid. There are safer alternatives to treat seizure disorders and your doctor can help you transition to a safer medicine.
• This medicine is used to treat bipolar disease and usually it can be replaced with a safer medication.
• Some antibiotics including streptomycin, kanamycin, tetracycline and fluoroquinolones, such as ciprofloxacin or levofloxacin, should not be used.
• The blood thinner warfarin should almost always be avoided.
• This medicine is used for many things, including rheumatoid arthritis, but should not be used in pregnancy.

There are many, many other medications that should be avoided during pregnancy and you should ask your doctor about your medicines and supplements at your first visit.

Medicines safe for pregnancy:

Most over-the-counter medications are safe to use for common pregnancy complaints. Here are some common medicines and remedies that you should feel comfortable using for different problems:

• Headaches: Tylenol (acetaminophen)
• Nausea: vitamin B6 (at least 25 mg two times per day); Unisom SleepTabs (doxylamine) (half a tablet during the day or a whole tablet at night), Benadryl (diphenhydramine).
• Heartburn: Mylanta, Maalox, TUMS, Rolaids, and other drugs such as Zantac or Pepcid
• Diarrhea: Kaopectate or Imodium (don’t treat for the first 24-48 hours).
• Constipation: MiraLAX, Milk of Magnesia, Fibercon, Metamucil, Citrucel
• Leg cramps: hydration, calcium supplements
• Cold symptoms: Tylenol
• Nasal congestion: humidifiers, saline drops, Sudafed (as long as you don’t have high blood pressure), Afrin, nasal spray, Benadryl
• Sore throat: Cepacol or similar products, lozenges, etc.
• Vaginal yeast infection: Monistat 3 or 7
• Gas: Gas-X, Mylicon
• Insect bites, rashes: Benadryl cream, Calamine
• Insomnia or difficulty falling sleeping: Unisom SleepTabs, Benadryl, Tylenol PM