What every pregnant woman needs to know about over-the-counter drugs.
Pregnant women are often given so much conflicting advice about what’s off-limits for them – from alcohol to cheese and ice-cream – they end up avoiding anything that isn't certified organic and 100% natural. But they don’t always have to - especially when it comes to over-the-counter drugs.
A new study published in the International Journal of Clinical Pharmacy has found up to three quarters of pregnant women are suffering in silence from minor injuries because they wrongly fear that over-the-counter drugs could harm their babies. Researchers found that women are so confused about conflicting advice on medications such as paracetamol, ibuprofen and antihistamines that they are steering clear of them altogether – sometimes unnecessarily.
To clarify what is and what is not acceptable to take during pregnancy, we spoke to Doctor Justine Setchell. Here, Dr Setchell helps bust myths about pregnancy and non-prescription drugs to set out the facts:
1. Paracetamol is OK.
Dr Setchell explains: “In small doses, occasional use of paracetamol in pregnancy is fine. But a lot of headaches are caused from people rushing around too much, not being hydrated enough and so on, so it’s best to try and alleviate them with rest and lots of liquids first.”
If that doesn't work, it's fine to take some paracetamol. The NHS Choices website clarifies: “Paracetamol has been used routinely during all stages of pregnancy to reduce a high temperature and for pain relief. There is no clear evidence that it has any harmful effects on an unborn baby.”
But as with all medicine taken during pregnancy, it’s best to use the lowest possible dose for the shortest possible time. In other words: only take something for when you really need it.
2. Avoid ibuprofen. Especially after week 30.
Ibuprofen is a different type of painkiller to paracetamol, in that it also contains decongestants that affect blood vessels. It means it could possibly increase the risk of heart problems for a baby, and reduce the amount of amniotic fluid in the womb.
“It means that pregnant women should avoid ibuprofen,” says Dr Setchell. “Women definitely SHOULD NOT take it after 30 weeks of pregnancy.
And before that? "They need to discuss with their doctor to see if the benefits outweigh the risks.”
3. Prescribed aspirin is OK.
Aspirin generally should be avoided during pregnancy. But don't necessarily be alarmed if your doctor prescribes it - it's common for doctors to suggest a low dose, as it can help reduce the risk of miscarriage in some women. It’s why Dr Setchell suggests all pregnant women speak to their doctor when considering taking over the counter medicine.
4. Some antihistamines are fine. Others...
Dr Setchell believes that antihistamines are generally OK to take during pregnancy, though it is best to always discuss it with a pharmacist beforehand. The NHS Choices website clarifies: “You can take some oral antihistamines when you’re pregnant, but not others.”
The best options are a corticosteroid nasal spray, antihistamine eye drops and then if necessary, speak to a medical expert who may recommend an antihistamine called loratadine. If that doesn’t work, they may recommend cetirizine.
5. Watch out for caffeine. Some OTC medicines contain caffeine
The recommended limit of daily caffeine for pregnant women is 200 milligrams a day – the equivalent of two mugs of instant coffee. But a number of cold and flu remedies can contain caffeine, so it is best to speak to a healthcare professional before taking any over-the-counter remedies.
“The best thing is to try ‘granny remedies’ first,” says Dr. Setchell. “Like putting a towel over your head while you lean over hot water for steam inhalation.”
6. Be careful with laxatives. Not all laxatives are the same.
There are two types of laxatives – ones that stimulate the gut, or ones that attract water into the gut to soften the stool.
Dr Setchell explains that for pregnant women, the best option is the latter: lactulose.
“That is typically prescribed and it can benefit pregnant women, who will typically experience constipation at the beginning of pregnancy when their progestogen levels are high. But they can also try natural remedies of drinking plenty of fluids and eating a high fiber diet.”
7. Please research whatever you take.
This doesn’t mean turning to ‘Doctor Google’ warns Dr. Setchell, but speaking to GPs, healthcare experts and pharmacists.
“Always tell a pharmacist you are pregnant before you buy anything,” she says. “If in doubt, ask. But don’t suffer in silence, and once you’ve been told it is fine to take something, don’t worry about it. Just use common sense.”
****As always, this article is only meant to offer general health advice. Please speak with your doctor before taking any over the counter medicine or prescribed medication, as everyone reacts differently depending on diet, metabolism, or allergic reactions.****