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counter drugs
to avoid
during pregnancy
These surprising, safer alternatives
may be a better choice
1
September 2014
We were surprised to discover research suggesting that pregnant women may be more
likely to turn to over-the-counter (OTC) drugs to treat coughs and colds or aches and
pains than they might otherwise. Women may believe these drugs are safer to use,
while pregnant, than prescription medications.
In fact, many of the OTCs are not good choices for pregnant women. Yet we found
little reliable, clear information available about which ones are safe for a pregnant
woman to take and which she should avoid. The enclosed report, “10 over-the-counter
drugs to avoid during pregnancy,” is our answer to consumers’ need for better
information about these everyday medications.
The recommendations are based on our assessments of data from the Organization
of Teratology Information Specialists, a nonprofit organization that provides
evidence-based information on medications and exposures to other potential toxins
during pregnancy and while breast feeding.
Consumer Reports’ Best Buy Drugs consumer education program, from which this
report was developed, is housed in the Consumer Reports Health Ratings Center.
The program aims to help consumers understand the safety, effectiveness, and cost of
medications. We do not accept funding from any industry, including pharmaceutical
companies, and our staff (including writers and editors) does not have any relation-
ships with industry. Because of our independence, consumers can be confident that
they are receiving unbiased advice, based on the best available evidence.
We hope you will find the article informative and share it with others who may
find it useful. We also look forward to hearing your feedback via email at
HealthImpact@cr.consumer.org.
Consumer Reports
Headquarters
101 Truman Avenue
Yonkers, New York 10703-1057
914-378-2000
2
10 over-the-counter drugs to
avoid during pregnancy
These surprising, safer alternatives may be a better choice
Mothers-to-be get headaches and upset stomachs just like to pose risks to the developing fetus at different stages of
everyone else. So it’s not surprising that most pregnant pregnancy.
women have used over-the-counter medications. In fact,
some data suggest that, overall, women are actually more To help you and your doctor make more informed choic-
likely to use certain medications—including cough and es about which medications to take, we’ve identified 10
cold drugs and acetaminophen (Tylenol, generic)—after common ingredients used in OTC drugs that are risky for
they become pregnant. pregnant women, as well as safer alternatives.
“There’s a misperception that if a drug is available over- Even then, you should use alternatives judiciously, and
the-counter, that it’s approved by the Food and Drug only as advised by your health care provider. Experts refer
Administration, so it must be safe for everyone, including to safer medications because for 98 percent of prescription
pregnant women,” Allan Mitchell, M.D. professor of pe- and OTC drugs, there simply isn’t enough data to say for
diatrics and epidemiology at the Boston University School sure that a drug is entirely safe to take during pregnancy.
of Public Health and Medicine, said. “Even doctors can Due to ethical concerns, most FDA-approved medicines
fall for this idea.” But some OTC drugs have been shown have not been tested in pregnant women.
3
For example, acetaminophen has long been considered a Tension Headache, is indeed, free of aspirin, but still
safer way for pregnant women to reduce fever and allevi- contains caffeine.
ate pain than nonsteroidal anti-inflammatory drugs such
as aspirin, ibuprofen (Advil and generic), and naproxen
(Aleve and generic.) But children whose mothers use the
pain reliever during pregnancy may be at higher risk for Where to find reliable
asthma, behavior problems, and attention deficit disor-
der, according to preliminary research. information on the web
“For women who use acetaminophen only occasionally, An Internet search will turn up lots of websites with
the risk appears to be quite small,” Mitchell said. But advice on “safe medications to use during pregnancy.” But
frequent use—more than three times a month through- the advice is inconsistent and recommendations are often
out pregnancy—is cause for more concern, according to based on a lack of data, rather than evidence for safe use
Mitchell. So, while it’s reasonable to treat a fever or the according to a study of Web-based information published
occasional severe headache with medication, women who in 2013.
find themselves needing to take a pain reliever several
days in a row or more than once every few weeks should For up-to-date, reliable information, we recommend
consult their providers to help find and address the under- www.MotherToBaby.org, the consumer website of the
lying cause of their symptoms. Organization of Teratology Information Specialists, a non-
profit organization dedicated to providing evidence-based
Bottom line: If you are pregnant or may become pregnant, information on medications and exposures to other sub-
you should be extremely cautious about anything you stances during pregnancy and while breastfeeding. You
take, including OTC and prescription medications, and all can also call toll-free at 1-866-626-6847 to talk to an infor-
vitamins, supplements, and herbals. mation specialist free of charge.
Information from Briggs GG, Freeman RK, Yaffe SJ eds. Drugs in 1. Low-dose aspirin (40 to 150 mg daily) may be prescribed for
pregnancy and lactation: a reference guide to fetal and neonatal certain conditions associated with pregnancy such as gestational
risk. 9th ed. Wolters. high blood pressure and pre-eclampsia.