Drugs and medicines in pregnancy

Some medicines can harm your growing baby. This can include certain standard over-the-counter painkillers, such as ibuprofen (Nurofen for example). 

Because many medicines may be unsafe during pregnancy, it is always best to ask your doctor, midwife, pharmacist or dentist before you take anything.  

This page covers prescribed or over-the-counter medicines (drugs). We have separate information about recreational, street or illegal drugs during pregnancy, such as cannabis, cocaine and heroine.

If you are taking prescription medication

If you are taking any prescription medications, it is important that you talk to your healthcare professional as soon as possible if you are trying to get pregnant or you are already pregnant.  

Some conditions and the medications used to treat them may make it harder to get pregnant. Some medications may be harmful in pregnancy.

Sometimes, the benefits of taking medication to manage a health condition will outweigh any risk to a pregnancy.  

Your healthcare professional will talk to you about what may be best for you, but it is your decision. You may be advised to:

• stay on the medication you are on now
• switch to another medication
• stop or reduce the dose of your medication.

Make sure you understand the risks and benefits of all your options before you decide. 

Do not stop taking any medication before talking to a doctor or specialist as this may be harmful. Make an appointment straight away to discuss the safest choices during pregnancy with you.  

All medication should be taken as instructed on the pack or as prescribed. Do not go over the prescribed dose.

You can find out information on medicines in pregnancy on the bumps (best use of medicines in pregnancy) website. 

What medications should I avoid in pregnancy?

Ibuprofen  

Ibuprofen is not usually recommended in pregnancy, especially after 20 weeks. This is because it can affect your baby's circulation and kidneys.  

A short course of ibuprofen (up to 3 days) may be OK, but it will depend on how many weeks pregnant you are and the reason you need to take the medicine. Other treatments may be more suitable for you.

Always talk to your GP or midwife before taking ibuprofen in pregnancy.  

You can take ibuprofen when you are breastfeeding.

Aspirin

High dose aspirin is not recommended for pain relief in pregnancy as it may affect the baby’s circulation, especially if taken for long periods of time after 30 weeks.

Paracetamol is recommended as the first choice of painkiller in pregnancy.

Aspirin is not usually recommended as a painkiller while you are breastfeeding. Ask your doctor for advice if other painkillers are not suitable.

However, low-dose aspirin (75mg to 150mg per day may be prescribed by your doctor or midwife to help prevent a condition called pre-eclampsia and is safe to take throughout pregnancy. You may also prescribed a low dose of aspirin if you are having fertility treatment.

Isotretinon (Roaccutane) and Co-cyprindiol

These medications are used to treat acne. It is not safe to takeisotretinon or co-cyprindiol during pregnancy. If you find out that you are pregnant during treatment with isotretinoin capsules, stop taking the capsules and speak to your doctor as soon as possible.

A pharmacist can advise you about over-the-counter treatments that may be suitable in pregnancy. Speak to your GP if your acne is severe and you think you need prescription medication. 

Sodium valproate  

This is used to treat epilepsy or bipolar disorder. Sometimes is it used to prevent migraines.

Sodium valproate is not recommended in pregnancy because it can cause problems for a baby's development, including birth defects.

It is important to get advice as soon immediately if you think you are pregnant or might become pregnant while taking sodium valproate. However, do not stop taking your medicine suddenly without talking to your doctor first.

Read more about sodium valproate.

Anticoagulant medicines

Anticoagulants, such as warfarin, are medicines that help prevent blood clots. Warfarin can cause birth defects or excessive bleeding from the placenta or foetus.

The newer anticoagulant medicines apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Lixiana) and rivaroxaban (Xarelto) also are not recommended in pregnancy.

Speak to your GP or anticoagulant clinic about stopping or changing your prescription if you are on anticoagulants and find out you are pregnant (or plan to start trying for a baby).

Do not stop taking any medication before speaking to your doctor.  

Anti-depressants or other mental health medication

Speak to your GP or midwife as soon as possible if you are on anti-depressants and are planning to get pregnant or if you have found out that you are pregnant. Don’t stop taking medication without speaking to your GP.

They will talk to you about the risks and benefits of continuing medical treatment.

St John’s wort is a popular herbal remedy for depression. Do not take St John’s wort in pregnancy because it is not clear whether it is safe. Read more about mental health in pregnancy and treatments for severe mental illness during pregnancy. 

Complementary therapies

Speak to your GP or midwife if you would like to try a complementary (also known as alternative) therapy in pregnancy. This is because some complementary therapies are not safe in pregnancy. For example some herbal remedies, such as blue cohosh, can be harmful to your baby.

What medicines can I take?

There are some medicines listed here that are safe for taking for common conditions.

Coughs and colds

Cough and cold remedies often contain a mixture of ingredients so always check what is in them.  

You can take:

• home-made hot honey and lemon drink (over-the-counter cold and flu drinks be aware that these can contain paracetamol)
• paracetamol – but always stick to the recommended dose on the packet.  
• dextromethorphan, which is found in many cough syrups
• simple linctus (a syrupy liquid) or lozenges containing honey or glycerol to coat your throat, if it is sore
• steam inhalations for a blocked, stuffy nose.

Decongestants are a type of medicine that can provide short-term relief for a blocked or stuffy nose (nasal congestion). It is not clear whether it is safe to take any type of decongestant if you are pregnant, so you should only use them if told to by a healthcare professional.

Constipation (difficulty pooing)

Changing hormone levels in your body can cause constipation in pregnancy. To help prevent constipation, you can:

• eat foods that are high in fibre, such as wholemeal breads and cereals, fruit and vegetables, and pulses such as beans and lentils (find out more about eating well in pregnancy)
• exercise regularly  
• drink plenty of water.

If this doesn’t help you can also try a laxative (medicine that will help you poo), such as lactulose or Fybogel. These laxatives are quite commonly used during pregnancy.  

You may be able to use another laxative called Senna. There is no evidence that this causes harm, but it is better to try other laxatives first. This is because there is more information to say they are safe.

Hay fever and allergies

Loratadine is usually recommended if you need to take an antihistamine in pregnancy. But speak to your doctor before taking any antihistamines.

It is not clear whether it is safe to take any type of decongestant if you're pregnant, so you should only use them if told to by a healthcare professional.

You can use:

• pre-prepared nasal saline powders and solutions
• nasal sprays containing corticosteroids such as beclomethasone (although you should only use these for a short time)
• steam inhalations for a blocked, stuffy nose. 

The Bumps website has more information about treating hay fever during pregnancy.

Heartburn and indigestion

Indigestion is common in pregnancy. Try to:

• eat healthily
• eat small meals often, rather than larger meals 3 times a day
• limit your caffeine intake
• avoid spicy food  
• do not smoke
• do not drink alcohol.

You can take:

• antacids, such as Rennie to neutralise the acid in your stomach. Do not take products containing sodium bicarbonate or magnesium trisilicate, which are not recommended in pregnancy.
• alginates, such as Gaviscon – to relieve indigestion caused by acid reflux by stopping the acid in your stomach coming back up.

If these do not improve your symptoms, your GP may prescribe ranitidine or omeprazole. These are widely used in pregnancy.

Do not take medicines containing aspirin (such as Alka-Seltzer) for pain relief during pregnancy. Aspirin may be listed on a label as salicylate or acetylsalicylic acid.

In some cases low dose aspirin may be recommended by your doctor. You can read about this below.

Pain, such as headache or backache

Headaches are common in early pregnancy and can be caused by dehydration. Try drinking more water first.  

If that doesn’t help, you can take:

• paracetamol – but always stick to the recommended dose on the packet.
• codeine and dihydrocodeine can be prescribed when necessary, however they should only be taken for short periods of time to treat pain in pregnancy. If you use them a lot, particularly at the end of your pregnancy, they may cause withdrawal symptoms or breathing problems in your baby. Codeine is not recommended if you are breastfeeding.

Call your midwife, maternity unit or NHS 111 straight away if you have:

• a very bad headache
• a headache that won’t go away
• a headache affects your vision in any way. This could be a symptom of pregnancy induced hypertension (high blood pressure) or pre-eclampsia.  

Find out more about headaches in pregnancy.

Migraines

Speak to your GP or midwife if you have ongoing migraines. You may be able to take some medications for migraines, but not others.

Sumatriptan may be offered if paracetamol has not controlled the pain. There is no evidence that use of sumatriptan in pregnancy is harmful to the baby.

Cyclizine, prochlorperazine, or metoclopramide may also be offered for nausea and vomiting caused by migraine. These drugs are also used to treat pregnancy sickness and are not known to be harmful to a developing baby.

Naproxen is not usually recommended in pregnancy. This is because it may affect your baby, in particular causing problems with their circulation and amniotic fluid levels.

Bumps has more information about how to manage migraines in pregnancy.

Vomiting and diarrhoea  

DO NOT take any medication to stop diarrhoea in pregnancy, such as loperamide (Imodium, Dioraleze) without speaking to your GP, midwife or pharmacist first. This is because these medications are not usually recommended in pregnancy.

Find out more about how to manage vomiting and diarrhoea.