Medicines in pregnancy

After a positive pregnancy test, review your medicines with the prescriber. Do not stop them yourself. Both NHS and CDC guidance warn that stopping a medicine can sometimes cause harm. Contact your GP or prescribing specialist promptly and tell them you are pregnant.

Include medicines you buy yourself

Check before taking a medicine bought from a pharmacy, supermarket or shop, as well as one supplied on prescription. This includes painkillers. Tell the pharmacist or clinician that you are pregnant, even when the product is familiar or something you have used for years.

Tell your dentist and other treating professionals too. They need to know about the pregnancy before prescribing or providing treatment. It can help to bring the packets, or photographs showing the names and ingredients, so you can discuss the exact products.

Write your questions beside the list. You might ask what the medicine is treating, what happens if the condition is left untreated, and whether the plan needs review during pregnancy. Ask who to contact if you cannot take the medicine or have further questions before the next appointment.

Why there is no universal safe list

Many medicines reach the baby through the placenta. That fact alone does not settle whether a particular treatment is appropriate. Some conditions need continuing treatment during pregnancy, and CDC says avoiding or stopping a medicine can sometimes be more harmful than taking it. Your clinician can help you weigh up the benefits and risks.

CDC cautions against treating online “safe medicine” lists as a complete answer. For many medicines there is not enough pregnancy safety evidence, partly because pregnant people are often excluded from studies of new medicines. An article can help you prepare questions, but ask your pharmacist or doctor to check the product.

Paracetamol and acetaminophen: advice differs

Paracetamol is also called acetaminophen, the name used in the US. Advice has changed recently and differs between authorities. UK MHRA guidance continues to recommend paracetamol for pain relief in pregnancy when used as directed, and says there is no evidence that it causes autism in children.

The FDA announced that it was starting a label-change process to reflect evidence of a possible association between acetaminophen use in pregnancy and conditions including autism and ADHD. Its announcement also says a causal relationship has not been established and that there are contrary studies. A proposed warning is not proof of causation.

The current CDC medicines page advises pregnant people to consider avoiding acetaminophen as a precaution, while acknowledging that a direct causal relationship has not been established. ACOG takes a different position: it supports use when needed, in moderation, after talking with an ob-gyn. These US organisations do not give identical advice.

WHO says there is no conclusive scientific evidence confirming a link between use in pregnancy and autism. It advises people to follow their doctor’s or health worker’s advice about necessary medicines. Bring the question to your pharmacist or doctor; do not change a prescribed treatment because of a headline.

If you need help with pain or fever, ask your clinician which treatment is appropriate. MHRA notes that untreated pain and fever can pose risks, while FDA also acknowledges risks from high fevers. Discuss both the illness and its treatment with your clinician.

Mention natural remedies too

“Natural” does not guarantee a product is suitable in pregnancy. The NHS warns that some herbal or complementary products may contain harmful substances, and advises telling your midwife, doctor or pharmacist about herbal, homeopathic and aromatherapy products. Include these in your review even if you do not think of them as medicines.

If you have already taken something

Contact your pharmacist, midwife or doctor if you are concerned about a medicine taken before you knew you were pregnant. CDC says some medicines may cause harm while others are unlikely to do so. Give the exact name and explain when you took it so they can assess your circumstances.

If you take regular medicine and have just found out you are pregnant, contact your GP or prescribing specialist today in the UK, or your prescribing doctor in the US and elsewhere, to arrange a review. Do not stop a prescribed medicine without talking to your doctor.