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A List of Over-The-Counter Medications You Can Take While Pregnant

Colds, coughs or congestion are never fun, but they're even worse when you're expecting. Here are the pregnancy-safe medications you can take to feel better fas...
ByNehal Aggarwal, Editor|Updated October 25, 2023
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pregnant woman holding glass of water and two white pills
Image: ShotPrime Studio | Shutterstock

As wonderful as pregnancy can be, there’s no denying the toll it takes on your body. After all, your immune system changes during those nine+ months and works extra hard to protect both you and baby. While those changes are incredibly complex and designed to help provide immune responses to baby as they grow, it can also make minor illnesses—like a cold—more common during pregnancy. But when you’re dealing with a cough, cold, allergies or other ailments, which pregnancy-safe medications can you take over-the-counter (OTC), and which should you avoid? And what dosage should you stick to? Below, we asked the experts for a list of medications you can take while pregnant, as well as what you need to know beforehand.

Rules to Follow When Taking OTC Pregnancy-Safe Medications

If you’re feeling a little under the weather, you’re likely wondering what medicine you can take while pregnant. While there are many over-the-counter medications that are safe to use during pregnancy, there are also plenty that are not. Before heading to your local pharmacy, you should always check in with your ob-gyn or midwife. Here’s why:

Medicine may affect you differently during pregnancy

Taking medications—whether they’re prescription, OTC, herbal or homeopathic—can be tricky during pregnancy. The biggest reason for this? Even OTC medications you’ve taken previously might affect you (and baby) differently while expecting. “Many over-the-counter medications are safe to use in pregnancy, but there are a few surprising drugs that can lead to problems for baby,” says Ashley Roman, MD, an ob-gyn with NYU Langone in New York City. “Always speak with your doctor prior to taking any medication and always follow the dosage instructions on the package.” Plus, some usually unconcerning symptoms, like headaches, can point to serious pregnancy-related complications in certain cases, Roman adds, so it’s always best to let your doctor know of any aches and symptoms.

Multiple medications may interact

When it comes to pregnancy-safe medications, certain OTC options are generally okay to use as long as you follow the dosage instructions for adults—but that could change if you’re taking multiple medications. “Even medications that are considered safe in pregnancy can become dangerous when they interact with others,” says Roman. “If you’re not sure, always check in with your ob-gyn.” The dosage for a certain OTC medication may also change depending on other medications you’re already taking.

There are liability concerns

While you may not go to your ob-gyn for every ache and pain during pregnancy, they’ll likely be the ones counseling you on what prescription and OTC medications to take, says Daniel F. Roshan, MD, a maternal fetal specialist at Rosh Maternal & Fetal Medicine in New York City. “Other doctors usually avoid giving any medications to pregnant patients in order to avoid liability,” he explains.

Furthermore, pregnant people are often not included in studies due to concerns over potential harm to baby. As a result, there’s a lack of data that makes it hard to know exactly what risks might be associated with OTC medications during pregnancy, says Cynthia Flynn, MD, a Florida-based ob-gyn with JustAnswer. “Any over-the-counter or prescription drug can potentially pose a risk,” says Flynn, especially based on how often the medication is used during pregnancy. The rule of thumb? Always check in with your doctor before taking anything, even if it’s on the list of medications you can take while pregnant.

What OTC Painkillers Are Safe During Pregnancy?

Pain in places like your back, legs, abdomen and even vagina are unfortunately part of the pregnancy package. Luckily, you can generally turn to certain OTC painkillers for relief.

Can you take acetaminophen while pregnant?

Medicine that uses acetaminophen as the main ingredient—like Tylenol—is generally seen as safest for treating general aches and pains, including headaches, Roman says. However, you want to be cautious about what type of Tylenol you take. “While Tylenol can be safe, Tylenol treating multiple cold symptoms typically is not,” says Michelle Gebhardt, MD, assistant chair for obstetrics at Kaiser Permanente in Northern California.

It’s also important to be mindful of how much Tylenol you’re taking. Previous studies have found that kids with the highest levels of acetaminophen in cord blood samples were more likely to be diagnosed with ADHD or autism spectrum disorder. While this sounds scary, know that many ob-gyns maintain that Tylenol is a safe painkiller in pregnancy—as long as it’s not being overused. Pregnant people should always follow the dosing instructions on the label and take the lowest effective dose, says Gebhardt.

Can you take NSAIDs while pregnant?

Nonsteroidal anti-inflammatory drugs—better known as NSAIDS—include ibuprofen (Advil and Motrin), naproxen (Aleve) and aspirin. However, none of these are safe painkillers in pregnancy. Studies have found that prenatal use of NSAIDs causes an increased risk of miscarriage. “Certain medications, including nonsteroidal anti-inflammatory drugs such as ibuprofen, can negatively affect the blood flow between mother and baby, causing miscarriages, delayed onset of labor and…other dangerous fetal effects,” says Sherry Ross, MD, an ob-gyn and women’s health expert. They may also be associated with “congenital heart defects when taken during the first trimester,” Roman adds. “They’ve also been linked to other heart abnormalities and low amniotic fluid levels when used in the third trimester.” For a pregnancy-safe painkiller, it’s best to stick to acetaminophen.

What OTC Heartburn Medicine Can I Take During Pregnancy?

Many pregnant people suffer from heartburn during pregnancy. Luckily, antacids such as Tums and Mylanta are usually safe to use and can help with symptoms, Roman says. If milder antacids aren’t doing the trick, you might want to talk to your ob-gyn about taking famotidine, also known as Pepcid, for pregnancy. “It crosses the placenta but doesn’t appear to be associated with any pregnancy complications,” Roman says.

Zantac—which uses ranitidine as its main ingredient and was previously considered okay to use during pregnancy—was banned by the FDA in 2019. “The FDA detected low levels of a cancer-causing contaminant in samples of the drug, and manufacturers voluntarily recalled the medicines,” Roman explains. While this sounds scary, it’s important to understand that the science around medicine is always evolving. The best way to protect yourself and baby is to consult with your doctor.

What OTC Pregnancy-Safe Nausea Medicine Can I Take?

Perhaps the most widely known ailment of pregnancy is morning sickness. According to Ross, nausea is a common symptom of early pregnancy, and pyridoxine, which is a form of vitamin B-6, is often recommended first to help with the symptoms. “Combining doxylamine and pyridoxine, also known as Unisom, is even more effective for persistent nausea of pregnancy,” she adds. Gebhardt also cites Emetrol (which uses glucose, fructose and phosphoric acid as main ingredients) and vitamin B6 as pregnancy-safe nausea medicines to try, as well as natural remedies like drinking ginger tea and eating crackers or dry toast.

In your pre-pregnancy life, Pepto-Bismol may have been your go-to nausea remedy, but now that you’re expecting, it’s best to steer clear. The main ingredient in Pepto-Bismol is bismuth subsalicylate, and according to the American Academy of Family Physicians (AAFP), while bismuth on its own is generally safe, it may be harmful when combined with salicylate.

What OTC Pregnancy-Safe Cold Medicine Can I Take?

Colds are par for course during pregnancy, especially in the winter months, but treating them can be tricky while expecting. The AAFP notes that most OTC cold medicines are considered safe for short-term use in pregnancy as long as it’s outside of the first trimester. Previous studies have suggested that exposure to certain decongestants, such as pseudoephedrine, phenylephrine and phenylpropanolamine, in early pregnancy may increase the risk of birth defects.

Can you take Robitussin while pregnant?

Wondering if you can take Robitussin DM while pregnant? Gebhardt, Ross and Roman say OTC medications with dextromethorphan (a cough suppressant) and guaifenesin (an expectorant that loosens up thick mucus) should be safe during pregnancy. These are the two main ingredients in many OTC cold medicines and cough syrups, such as Robitussin, Mucinex and others. To ensure it’s truly a safe cough syrup in pregnancy, make sure it doesn’t also contain alcohol, which is not safe, says Gebhardt.

Can you take Sudafed while pregnant?

Many experts believe that Sudafed—and other medications using pseudoephedrine as the main ingredient—should be avoided wherever possible during pregnancy. According to Ross, Sudafed may be used, but only cautiously, as it’s inadequately studied and has been shown to have negative effects in animal studies. Gebhardt recommends trying natural cold remedies first, such as saline nasal drops, drinking fluids, using a humidifier and getting enough rest.

Roman recommends avoiding pseudoephedrine altogether. “It may be associated with birth defects involving baby’s abdominal wall,” Roman says. “Also, decongestants (such as phenylephrine) may affect blood flow to the placenta and should generally be avoided throughout your pregnancy.”

Again, always talk to your doctor before taking an OTC cold medicine during pregnancy. They can guide you on the best treatment based on your specific cold symptoms and pregnancy circumstances.

What OTC Allergy Medicines Are Safe For Pregnancy?

According to the American College of Obstetrics and Gynecologists (ACOG) and Centers for Disease Control and Prevention (CDC), studies have found that most antihistamines, which are commonly used to treat allergies, are generally safe to use during pregnancy. These include medications with chlorpheniramine and dexchlorpheniramine, as well as newer antihistamines such as cetirizine and loratadine, as the main ingredient. Hydroxyzine is fairly safe as well, but it’s generally not recommended for use in early pregnancy. Plus, there are some concerns that chronic use of it may lead to withdrawal symptoms in baby after birth. Some brand name pregnancy-safe allergy medicines that Ross, Gebhardt and Roman say are safe to use for congestion issues include Benadryl, Claritin and Allegra. Zyrtec is also okay to use after 10 weeks of pregnancy, says Roshan.

What OTC Pregnancy-Safe Laxatives Can I Take?

Constipation is a common concern during pregnancy. Most ob-gyns will recommend dietary modifications or prescribe fiber supplements, like Metamucil and Citrucel, or stool softeners with docusate (a mild laxative), like Colace. All of these are considered safe for pregnancy, Flynn, Roman and Ross say. Additionally, the American Pregnancy Association cites Milk of Magnesia as another mild pregnancy-safe laxative that may offer relief. For anything stronger, always consult with your doctor. “Laxatives, mineral oils and rectal suppositories may stimulate labor, so these should only be used after speaking with your doctor,” Roman says. “Stimulant laxatives, such as Ex-Lax and Senokot, are the hardest on your intestines and should be used with caution during pregnancy.”

OTC Medications to Avoid During Pregnancy

While there’s a fairly lengthy list of medications you can take while pregnant, there are some OTC medications that should be avoided, including Zantac, Pepto-Bismol, ibuprofen, aspirin, Sudafed and more. Gebhardt also says to steer clear of Tylenol that treats multiple cold symptoms and Excedrin, which contains caffeine. “Before taking any medication, read the ingredient list to make sure it doesn’t contain anything harmful,” Gebhardt says. “There’s a surprising number of over the counter medications with alcohol or caffeine.”

Along with reading the ingredients, avoid taking multiple medications that can cause drowsiness or sedation, and check with your doctor about what medications are safe to take together. “For example, you would not want to take Benadryl (diphenhydramine) and Unisom (doxylamine) together,” Gebhardt says.

The bottom line? Pregnancy brings a lot of changes to your body, and it can be more challenging to find relief from minor illnesses, aches and pains. But finding relief is possible. “There are situations where the potential benefit of taking medication outweighs any potential risk to baby,” Roman says. “The most important piece of advice regarding medication is to talk with your doctor!”

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Sources

Cynthia Flynn, MD, is a board-certified ob-gyn based in Florida with over 20 years of experience. She is also an expert with the online platform JustAnswer. She received her degree from the Michigan State University College of Human Medicine.

Michelle Gebhardt, MD, is the assistant chair for obstetrics at Kaiser Permanente in Northern California, where she has been on staff since 2012. She obtained her undergraduate and medical degrees from UC Davis and completed her residency in obstetrics and gynecology at Kaiser Permanente in Santa Clara.

Ashley Roman, MD, is an ob-gyn and maternal-fetal health specialist at NYU Langone Obstetrics & Gynecology Associates in New York City. She received her medical degree from Tulane University in 1998 and has been included in the "Best Doctors in America" database since 2007.

Daniel F. Roshan, MD, FACOG, FACS, is a board-certified ob-gyn and maternal-fetal medicine specialist with an expertise in high-risk pregnancies. He is also the director at Rosh Maternal & Fetal Medicine in New York City. After earning his medical degree from Tel Aviv University, Roshan received residency training in obstetrics and gynecology at Maimonides Medical Center in Brooklyn and completed a fellowship in maternal-fetal medicine at Johns Hopkins University in Baltimore. He’s an active member of the American College of Obstetricians and Gynecologists (ACOG) and the American College of Surgeons (ACS).

Sherry Ross, MD, is an ob-gyn, women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period. and She-ology, The She-quel. She earned her medical degree from New York Medical College.

Johns Hopkins University, Taking Tylenol during pregnancy associated with elevated risks for autism, ADHD, November 2019

BMJ, Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study, August 2003

US Food and Drug Administration, FDA Updates and Press Announcements on NDMA in Zantac (ranitidine), April 2020

American Academy of Family Physicians, Over-the-Counter Medications in Pregnancy, October 2014

American Journal of Epidemiology, Use of Decongestants During Pregnancy and the Risk of Birth Defects, July 2013

American College of Obstetrics and Gynecologists, What medicine can I take for allergies while I'm pregnant?, February 2021

American Pregnancy Association, Laxatives During Pregnancy, 2023

Learn how we ensure the accuracy of our content through our editorial and medical review process.

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