When you’re pregnant, your health is not just about you — it’s about your baby too. Every choice you make, from the food you eat to the medicines you take, can impact your baby’s growth and development. That’s why understanding what medications are safe during pregnancy is so important.
From Tylenol to multivitamins, Anna Goswick, MD, a family medicine obstetrician with Banner Health, shares what medications, supplements and vaccines you might encounter during pregnancy. You’ll learn what’s safe, what increases the risk of complications and how to work closely with your health care provider to make the best decisions.
Why medication and supplement safety is important during pregnancy
When you’re pregnant, everything you take – from prescription medications to over-the-counter (OTC) drugs and supplements – has the potential to affect both your health and your baby’s development.
Some medications are considered safe during pregnancy (or after the first trimester). Some medications can cross the placenta and reach your baby, negatively disrupting the growth and development of an embryo or fetus.
“Many drugs have risks when used during pregnancy, which is why it’s so important to work with your health care provider before taking any medications,” Dr. Goswick said. “In the first trimester, when fetal organ development is occurring, the risk of birth defects or developmental issues is especially high. Later in pregnancy, certain medications can also interfere with the growth and function of your baby’s developing organs.”
Prescription medications
Some prescription medications are generally considered safe during pregnancy. Talk to your health care provider before starting or stopping any medicines. They can help you weigh the benefits against any risks for your baby and find safe alternatives for managing pre-existing conditions.
“There are some treatments that can be used effectively and safely to treat pre-existing conditions while minimizing risks,” Dr. Goswick said. “For example, many medications for anxiety and depression (like SSRIs) are safe in pregnancy and continued use often results in improved health outcomes for pregnant people and their newborns.”Other safe prescription medications include insulin for managing diabetes and antibiotics like penicillin and amoxicillin for treating bacterial infections, such as strep throat and urinary tract infections (UTIs).
However, some medications used to control pre-existing conditions, such as high blood pressure, seizure disorders and mood disorders, might pose a risk to you and your baby and may need to be replaced with alternative medicines during pregnancy.
Safe OTC medications
The following OTC medications are generally considered safe in pregnancy, but it's always wise to check with your prenatal provider first:
- Acetaminophen (Tylenol): Tylenol is one of the most common pain relievers and is proven safe during pregnancy. It can help with headaches, back pain and fever. If your symptoms do not improve, be sure to seek further evaluation.
- Saline nasal drops: If you have a stuffy nose due to cold or flu symptoms, saline drops are safe and can provide relief.
- Antacids: Antacids containing calcium and magnesium can safely treat heartburn or indigestion. Always avoid those containing aluminum and high-dose aspirin. “Of note, low-dose aspirin is safe and may be recommended to prevent preeclampsia for pregnant individuals with risk factors,” Dr. Goswick said.
- Bulk-forming fiber (Metamucil, FiberCon): If you’re experiencing constipation, bulk-forming fiber supplements like psyllium and polycarbophil are generally safe during pregnancy and can help with irregularity and constipation.
- Allergy medicines: Antihistamines like loratadine (Claritin) and Cetirizine (Zyrtec) are the best choices for allergy relief during pregnancy. Steroid nasal sprays like Nasonex or Flonase are also safe.
- Cold and flu remedies: If you catch a cold or the flu, avoid products that offer multi-symptom relief and instead try to manage symptoms individually. Some pregnancy-safe cold and flu medicines include diphenhydramine (Benadryl), dextromethorphan (Robitussin) and guaifenesin (Mucinex). For more tips, read “How to Treat a Cold or Flu When You’re Pregnant.”
Avoid these OTC medications
While many OTC medications are safe, some should be avoided because they can increase the risk of complications for your baby. It’s important to read labels carefully and always check with your prenatal provider:
- Ibuprofen (Advil, Motrin): Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause issues like low amniotic fluid and heart complications in the baby, especially after 20 weeks.
- Cold and flu medications with multiple ingredients: Some cold and flu remedies contain several active ingredients that could pose a risk. Decongestants and aspirin should be avoided during pregnancy. Be cautious with combination products and always talk to your provider about safer alternatives.
- Certain cough and allergy medications: Decongestants like pseudoephedrine and phenylephrine can reduce blood flow to the placenta, which may be risky for your baby. Avoid products that use words like extended release, 24-hour or have a D after the brand name. Always check with your prenatal provider before taking these medicines.
Supplements, vitamins and all-natural products
Some herbal supplements or all-natural products can be safe and helpful in pregnancy:
- Prenatal vitamins: These vitamins include important nutrients like folic acid (which helps prevent birth defects) and iron (which prevents anemia). Prenatal vitamins should be taken every day and started as soon as pregnancy is diagnosed.
- Vitamin B6: Safe and known for helping with nausea, vitamin B6 can be taken a few times a day to ease morning sickness. Peppermint and ginger can also help.
- Honey with lemon tea: “This combination is a safe and effective treatment for upper respiratory symptoms, especially cough,” Dr. Goswick said.
However, not all supplements are safe. “Many herbal supplements or all-natural products can cause significant harm and should be avoided,” Dr. Goswick said.
Supplements to be avoided include vitamins A and E and herbal supplements like cohosh, goldenseal, aloe and mugwort. Before taking any supplements, review them with your prenatal provider.
Check out “5 Things to Know About Vitamins Before, During and After Pregnancy.”
Vaccinations
Vaccines can help protect both you and your baby during pregnancy. In some cases, they can prevent serious illness for both of you.
- Flu vaccine: The flu can lead to severe complications during pregnancy. The flu vaccine is safe and recommended to protect you and your baby.
- COVID-19 vaccine: COVID-19 vaccinations are safe before and during pregnancy and beneficial for you and your baby.
- Tdap vaccine: This shot protects against tetanus, diphtheria and pertussis (whooping cough). It’s recommended during the third trimester to protect your baby after birth.
- RSV vaccine: The RSV vaccine is approved for use during pregnancy. It helps protect newborns from respiratory syncytial virus (RSV), a common virus that can cause severe respiratory illness, especially in babies.
- Hepatitis B vaccine: If you’re at risk for hepatitis B, this vaccine is safe during pregnancy and helps protect you and your baby from infection, which can be transmitted during childbirth.
Not all vaccines should be given during pregnancy. Live vaccines, like the MMR (measles, mumps, rubella) vaccine, should be delayed until after delivery. Always check with your provider about any vaccines you’re considering.
Working closely with your health care provider
Your health care provider is your best resource during pregnancy. Always talk to them before taking any new medication, supplement or vaccine.
Here’s how to make sure you’re working effectively with your prenatal provider:
- Discuss all current meds: Whether you’re taking a prescription or OTC medication, tell your provider about all medications, supplements and substances you're using.
- Check before adding anything new: Even something like an herbal remedy can affect your pregnancy. Always check with your provider before trying anything new.
- Be open about your symptoms: If you're dealing with conditions like nausea, heartburn or cold and flu symptoms, ask your provider for safe treatment options.
Takeaway: Put your safety first
Pregnancy comes with lots of changes and knowing what’s safe for both you and your baby can feel overwhelming. The best approach is to be cautious. Always check with your health care provider or a Banner Health specialist before taking anything new, whether a prescription, an OTC drug or a natural supplement.
The health of both you and your baby is the top priority. With the right guidance from your prenatal provider, you can make informed decisions and have peace of mind during your pregnancy journey.
