Medicines in pregnancy

Published in Medicinewise Living

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When you’re pregnant or breastfeeding, you may need to decide about taking a medicine at some point, whether it’s for a minor headache or a serious condition like asthma. So it’s important you get the right guidance to make the best decision for you and your baby.

NPS Medicines Line, a national telephone-based medicines information service, receives at least 2 calls every day from women or their partners asking if a prescribed, over-the-counter or complementary medicine is safe to take whilst pregnant.

Weigh up the benefits and risks

Deciding whether to take a medicine always involves careful consideration of its potential benefits and risks. But this process is particularly important if you’re pregnant or breastfeeding, and may mean you make a different decision than you would at other times.

Many medicines can be used during pregnancy and breastfeeding, but a small number have the potential to cause considerable harm to your baby. This can depend on the stage of your pregnancy or the age of the baby you’re breastfeeding.

Your baby’s normal development and growth depends on you being well too. So you’ll also need to consider whether leaving your medical condition untreated may be more harmful than taking a medicine. Depending on your circumstances, you may be advised to take a medicine to ensure you stay as healthy as possible for your baby.

Talk to your GP, obstetrician, midwife or specialist about any regular medicines you’re taking as early as possible in your pregnancy, preferably when you’re planning to become pregnant. In many cases you won’t need to change your usual medicines, but your doctor may advise that you adjust the dose or change to another medicine for all or part of your pregnancy.

When not taking a medicine may be more harmful

If you have a condition such as asthma, depression, diabetes, epilepsy, or high blood pressure, you’ll usually be advised to continue treatment throughout your pregnancy, or during certain stages of your pregnancy.

Not treating these conditions adequately may lead to complications for both you and your baby. For example, poorly controlled diabetes increases the chance of miscarriage, stillbirth and some birth defects.

Common illnesses that arise during pregnancy such as severe morning sickness may also cause problems for you and your baby if they’re not treated. Your doctor may advise a medicine to treat the illness and prevent or minimise its effects on you and your baby.

Source reliable information

Finding out if a medicine is safe to use while you’re pregnant or breastfeeding can be tricky.

The best way to start is by getting good quality information from:

  • your doctor, pharmacist or midwife
  • the information on the medicine packaging
  • the consumer medicine information (CMI) leaflet for the medicine
  • NPS Medicines Line on 1300 MEDICINE (1300 633 424).

Sarah Spagnardi, Pharmacist and Manager of the NPS Medicines Line service, says that callers have often found or received conflicting information or advice about medicines in pregnancy.

“There is so much information available about medicines,” she says. “Pregnant women are understandably cautious about any possible effects to their baby, so it’s important that they seek reputable information about the safety of anything they are taking or may want to take”.

Ms Spagnardi notes some of the most common questions NPS Medicines Line receives are:

  • Are anti-depressants safe to take while pregnant?
  • Which is a safe pain killer to take for headache, back pain or muscle pain?
  • I have terrible hay fever this year. Can I take anything for it?
  • I took some cold and flu tablets last night, but I’ve just read that they may be harmful for my baby. Is this true?
  • I get recurrent cold sores, can I continue the treatment I used before I became pregnant?

Getting reliable evidence-based information will assist in making decisions with a GP or specialist, who can take into account your individual needs.

Remember to always find out about over-the-counter medicines bought from a pharmacy, supermarket, or other store, complementary medicines such as herbal and natural remedies, and vitamin and mineral supplements, as these may also cause harm to your baby.

Seek advice if there’s no information

Unfortunately for many medicines, particularly complementary medicines, there is little reliable information about their use during pregnancy and breastfeeding.

In these situations you may need to get more specialised advice, which takes into account your particular situation. Talk to your obstetrician, specialist, or get more information from one of these information lines:

  • New South Wales: MotherSafe Service, 02 9382 6539, or toll-free on 1800 647 848 (outside Sydney)
  • South Australia: Women's and Children's Hospital, 08 8161 7222
  • Victoria: Royal Women's Hospital, 03 8345 3190
  • Western Australia: Women's & Newborn Health Services at King Edward Memorial Hospital, 08 9340 2723
  • Australian Capital Territory: The Canberra Hospital, 02 6244 3333

Treat common pregnancy ailments

Here are treatment tactics for 5 common ailments in pregnancy, including medicines if other approaches don’t work on their own — and which medicines you may need to avoid.

Talk to your doctor or pharmacist first about any of these treatments to ensure they’re right for you and your baby.

Ailment
Lifestyle and home remedies
Medicines
Low back pain
  • Be fit before pregnancy.
  • Do core strengthening exercises during pregnancy.
  • Paracetamol (e.g. Panadol) is the preferred medicine for pain relief during pregnancy.
Avoid using anti-inflammatory medicines for pain relief, such as aspirin (e.g. Disprin), ibuprofen (e.g. Nurofen) and diclofenac (e.g. Voltaren), especially in the last 3 months of your pregnancy (when use can lead to bleeding before and after childbirth, delayed labour and birth, and heart or kidney problems for your unborn baby).

Seek advice before taking regular doses of codeine (e.g. in Panadeine) leading up to delivery, as this may cause your newborn breathing problems or withdrawal effects.

Headache
  • Eat healthily and regularly.
  • Drink plenty, preferably water.
  • Limit caffeine intake.
  • Be physically active.
  • Get enough sleep.
Cognitive behavioural therapy, relaxation exercises and stress management techniques may also help.

Morning sickness
  • Adjust your diet (small, more frequent, high-carbohydrate, low-fat meals/snacks).
  • Get enough sleep (fatigue can make morning sickness worse).
  • Drink plenty of water (use ice chips if needed).
  • Pyridoxine (vitamin B6).
  • Powdered ginger.
Seek advice if these treatments don’t work. Your doctor or pharmacist can suggest another option which may include:
  • an antihistamine medicine like promethazine (e.g. Phenergan),
  • metoclopramide (e.g. Maxolon), or
  • prochlorperazine (e.g. Stemetil).

Heartburn or indigestion
  • Have smaller, more frequent and low-fat meals/snacks.
  • Reduce foods that worsen your symptoms (e.g. spicy foods).
  • Drink fluids between (rather than with) meals.
  • Avoid food for 2 to 3 hours before bedtime or vigorous exercise.
  • Sit up straight when eating and avoid lying down immediately afterwards.

  • Antacid (e.g. Mylanta).
  • H2-antagonist medicine such as ranitidine (e.g. Zantac).
Seek advice if you already take a proton-pump inhibitor medicine such as omeprazole (e.g. Losec): your doctor may need to change how you take it while you’re pregnant or switch you to another type of medicine (at least in your first trimester of pregnancy).



Constipation
  • Drink plenty of fluid.
  • Get enough fibre in your diet.
  • Increase your physical activity.
  • Go to the toilet as soon as you feel the urge.

  • Fibre supplement such as psyllium (e.g. Metamucil).
  • Stool softener laxative such as docusate (e.g. Coloxyl)
  • Osmotic laxative such as lactulose (e.g. Duphalac).
Avoid stimulant laxatives such as bisacodyl (e.g. Bisalax) if possible.

Read our Medicinewise choices pages for tips on finding good quality information about medicines and discussing potential benefits and harms with your doctor.

You can also find more information about vaccinations, managing depression and diabetes during pregnancy.