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Safe Medications During Pregnancy: What to Know

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When you’re pregnant, it’s hard to know what medications are safe and which might cause harm to your unborn baby.

All medicines have risks and come with warnings — boxed warnings are the most serious. You should always talk to your provider and care team before starting, stopping, or continuing any medication. This includes over‑the‑counter (OTC) drugs, supplements, and herbal products.

Safe Medications During Pregnancy

If you’re pregnant and taking a prescription, you’re not alone. According to the U.S. Food & Drug Administration, 80% of pregnant women take at least one medicine.

Sometimes, it’s for a chronic condition that began before pregnancy. Other times, it’s for a temporary condition that starts or worsens during pregnancy, like nausea, high blood pressure, or diabetes.

When you’re pregnant, always consult your care team about prescribed and OTC medications and supplements you take — or may take. They’re not all safe during pregnancy, and experts continue to research their effects on moms and babies.

Factors like timing, dosage, duration, and medical necessity can affect a medication’s safety when you’re pregnant.

Getting the right dose

How much of a drug you took before your pregnancy may not work the same way. It’s why medication timing and dosage are vital.

While pregnant, you should avoid prolonged use of most meds. You should also take the lowest dose possible that still relieves your symptoms.

Your doctor can help you adjust dosages and advise on starting or stopping medications during your pregnancy.

Pregnancy medication safety by trimester

As you move through the trimesters, both what your body needs and how it responds to a medication can change. Guidance on safe medications and dosages can also vary by trimester.

The first trimester is especially important for the development of the fetus. Try to avoid unnecessary medications during these first months, especially nonsteroidal anti-inflammatory drugs (NSAIDs) and decongestants like Sudafed®. This doesn’t include prenatal vitamins, which contain the daily vitamins and minerals your body needs during pregnancy.

NSAIDs are risky during your third trimester, too. Avoid them as much as possible.

Continuing prescriptions during pregnancy

Managing your current needs is important for a healthy pregnancy, but be sure to discuss prescription medications you’re on with your ob-gyn. Suddenly stopping any medication is a risk to both mother and fetus. Your doctor can guide you on stopping harmful medications, changing dosages, or adjusting medications.

Here are some common chronic conditions and safe medications during pregnancy:

  • Allergies — Steroid nasal sprays like Flonase®.
  • Asthma — Standard inhalers are safe.
  • Diabetes — Insulin treatment is often safe.
  • High blood pressure — Ask about labetalol and nifedipine, but avoid ACE inhibitors and ARBs.
  • Thyroid disease — Levothyroxine is safe.

Prenatal vitamins

Prenatal vitamins provide crucial nutrients for your body and baby during pregnancy. They’re considered safe, but speak with your doctor to ensure you don’t get too much or too little of any vitamin. For instance, vitamins D, K, or A can be harmful in high doses.

Other common vitamins to talk with your doctor about during a prenatal visit include:

  • Folic acid — Helps prevent birth defects, usually taken at a dose of 0.4 mg (or 400 mcg).
  • Iron supplements — Often only needed if you’re anemic or have a deficiency.
  • Vitamin C — Helps fetal development and iron absorption.

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Are Any Medications Considered Safer to Take During Pregnancy?

Whether it’s your first or 50th time taking a drug, if you’re pregnant, always check the label for harmful ingredients.

Some common issues and safe medications during pregnancy include:

  • Allergies — Certain antihistamines are safe, such as diphenhydramine (Benadryl®), loratadine (Claritin®), cetirizine (Zyrtec®, Alleroff®), and calamine lotion. Be sure to choose those without a “D” or decongestant added.
  • Constipation — Try to avoid laxatives, but stool softeners like docusate (Colace®) are generally OK during pregnancy. Psyllium (Fiberall®, Metamucil®) and milk of magnesia are safer options.
  • Diarrhea — Depending on your trimester, loperamide (Imodium®) is often the safest option, but check with your doctor. Avoid anything with bismuth.
  • Epilepsy and seizures — Two safer options include lamotrigine (Lamictal®) and levetiracetam (Keppra®).
  • Headaches — Most recommended is acetaminophen (Tylenol®).
  • Heartburn — Look for antacids like Tums®, Pepcid®, Maalox®, and Mylanta®. Avoid medications containing aspirin, such as Pepto-Bismol® and Alka Seltzer®.
  • Hemorrhoids — Options include phenylephrine (Preparation H®), witch hazel (Tucks®), and hydrocortisone (Anusol®).
  • Nausea and vomiting — Try vitamin B6, doxylamine (Unisom®), and ginger or peppermint products.
  • Yeast infection — Treat with miconazole (Monistat® 3 or 7 cream).

Which Cold Medicines Are Safe During Pregnancy?

A good approach for choosing a safe cold medicine for pregnancy is to treat each symptom rather than using combination medicines. These often contain more ingredients than you need — some of which could be harmful.

Safe cold medicine options when you’re pregnant include:

  • Acetaminophen (Tylenol®) for fever and body aches.
  • Cough drops or lozenges (Sucrets®, Ludens®, Ricola®) without phenol or menthol for coughing and sore throat.
  • Dextromethorphan (Robitussin®) for coughing and congestion.
  • Guaifenesin (Mucinex®) for chest congestion.
  • Steroid nasal sprays for congestion.

Avoid aspirin, which is a blood thinner and may cause fetal kidney problems, low amniotic fluid, and bleeding issues. Also, don’t take medicines containing alcohol, like Nyquil®.

If you’re pregnant and unsure about which OTC cold medicine to take, share your symptoms with your doctor.

What Pain Reliever Is Safe to Take While Pregnant?

Being pregnant often involves aches and pain, such as headaches, back pain, and pelvic pain. If drinking water, resting, walking, massage therapy, yoga, and lumbar support don’t bring relief, you may need pain medication.

The most used pain reliever during pregnancy is acetaminophen (Tylenol®). When taken as directed, acetaminophen during pregnancy is safe, but:

  • Don’t exceed 4 grams in 24 hours.
  • Follow the recommended dosage and your doctor’s instructions.
  • Try to avoid prolonged use and take a lower dose if you can.

NSAIDs, such as naproxen or ibuprofen (Advil®, Motrin®), aren’t safe during pregnancy, especially later in pregnancy. They may pose risks to fetal kidneys and the amount of amniotic fluid.

Your doctor may make an exception for low-dose aspirin in cases of preeclampsia. But only take “baby” aspirin when you’re pregnant if your provider advises you to.

Opioids also pose a risk to fetal development of the heart, brain, and spine. Your doctor will guide any short-term dose they prescribe.

Is Tylenol safe in the first trimester of pregnancy?

If taken as directed, you can safely take Tylenol during your first trimester. Acetaminophen during pregnancy is safe throughout all three trimesters. But talk with your doctor and only take it when necessary, at the lowest dosage that relieves pain.

Can I Keep Taking My Antidepressant While Pregnant?

Your mental health during pregnancy is important. That’s why talking with your doctor is the first step.

Untreated depression puts people at risk, as well as the fetus. It can lead to preterm birth, preeclampsia, or even limited access to necessary care.

Selective serotonin reuptake inhibitors (SSRIs) are a common type of antidepressant. Considered safe, they don’t increase the risk of birth defects. But others, such as lithium, may require greater consideration and management.

Not every drug undergoes testing — so nothing’s 100% guaranteed. If you’re concerned about taking an antidepressant while you’re pregnant, talk to your provider. They can help plot the best path forward.

You should never suddenly stop antidepressants. This can cause withdrawal symptoms, especially if you take an SSRI. Instead, talk to your doctor to learn how to taper off an antidepressant safely.

Can I Get Vaccinations During Pregnancy?

Yes — vaccines help you and your baby stay healthy, so you should include them in your routine care. Current recommendations include the:

When you’re pregnant, you’re at a higher risk of getting very sick from respiratory infections, which can also harm the fetus.

Medications to Avoid During Pregnancy

Certain drugs can harm both you and your unborn baby. Doctors recommend avoiding:

  • ACE inhibitors — Later in pregnancy, drugs to treat high blood pressure can cause lower levels of amniotic fluid. This inhibits fetal development.
  • Acne medications — Taking isotretinoin increases the risk of birth defects and miscarriage.
  • Anti-seizure medications — Valproate and valproic acid especially pose risks for neurodevelopmental issues. Talk to your doctor about switching to a safer option before you conceive or as soon as you learn you’re pregnant.
  • Cold medications with alcohol — Any alcohol use can lead to pregnancy loss, birth defects, and developmental problems.
  • Combination medications — These can contain ingredients not suitable for pregnancy. Always read the label.
  • Decongestants — Especially in the first trimester, pseudoephedrine and other OTC drugs for nasal congestion can reduce blood flow to the fetus.
  • NSAIDs — Aspirin, ibuprofen, and naproxen can harm fetal development and reduce amniotic fluid.

This list is by no means complete. Talk with your ob-gyn if you take these or other drugs.

Herbal supplements to avoid during pregnancy

Although not classified as medicines, herbal products can interact with prescription drugs. Your doctor needs to review and approve any supplements you take because they may affect you and your baby’s development.

Many herbal supplements claim to be natural, but that doesn’t mean “dietary supplements” are safe. There are no standards for their ingredients. They may contain contaminants or unlisted ingredients that could harm your growing baby.

Plus, herbal supplements don’t undergo the same testing and Food and Drug Administration (FDA) approvals as pharmaceuticals. They also lack research relating to pregnancy (and breastfeeding). Using herbal supplements while pregnant risks hormone imbalance, miscarriage, and preterm birth.

These reasons, and more, are why you should talk to your doctor about OTC products you take. Herbal supplements to avoid during pregnancy include:

  • Black cohosh — Can cause uterine contractions, leading to premature labor.
  • Dong quai — Stimulates uterine contractions, risking miscarriage.
  • Ephedra — May stimulate uterine contractions; also linked to high blood pressure and stroke.
  • Goldenseal — Can worsen jaundice in infants.
  • Pennyroyal — Historically used to end pregnancies.
  • Red clover — Can act like estrogen, interfering with pregnancy hormones.
  • Saw palmetto — Its hormonal effects may interfere with pregnancy.
  • Tansy — Stimulates the uterus and induces menstruation, risking miscarriage.
  • Yohimbe — Associated with high blood pressure, heart issues, and anxiety.

More herbal supplements than these cause issues during pregnancy. Whether a supplement, herbal remedy, or tincture, discuss its safety with your doctor.

Talk to Your Health Care Team

Research on safe medications during pregnancy is ongoing. But working with your doctor can help reduce risks for you and your baby.

American College of Obstetricians & Gynecologists, Acetaminophen Use in Pregnancy and Neurodevelopmental Outcomes. Accessed February 2026. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/09/acetaminophen-use-in-pregnancy-and-neurodevelopmental-outcomes. Link.

 

Centers for Disease Control and Prevention, Medicine and Pregnancy: An Overview. Accessed February 2026. https://www.cdc.gov/medicine-and-pregnancy/about/index.html. Link.

 

National Center for Biotechnology Information, National Library of Medicine, MotherToBaby, Herbal Products. Accessed February 2026. https://www.ncbi.nlm.nih.gov/books/NBK582743/. Link.

 

National Center for Biotechnology Information, National Library of Medicine, MotherToBaby, Ibuprofen. Accessed February 2026. https://www.ncbi.nlm.nih.gov/books/NBK582759/. Link.

 

U.S. Food & Drug Administration, Medicine and Pregnancy. Accessed February 2026. https://www.fda.gov/consumers/womens-health-topics/medicine-and-pregnancy. Link.

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