Pregnant women have hundreds of health decisions to make to protect their baby, while, at the same time, get relief from illness symptoms and get much-needed sleep.
What’s safe for over-the-counter meds for both pregnant and breast-feeding women is an important decision and one that requires balancing the risks versus the benefits.
Here today is OB/GYN Nancy Dickerson to provide guidance.
Selected Podcast
Over the Counter Meds: What’s Safe When You're Pregnant?
Featured Speaker:
Nancy Dickerson, MD – OB/GYN
A long-time Minnesota resident, Nancy Dickerson enjoys spending time in northern Minnesota and at her lake. She loves to travel and specifically enjoys participating in medical missions in Ecuador and the Dominican Republic. In her professional practice, she enjoys both women’s health overall and obstetric care. Transcription:
Over the Counter Meds: What’s Safe When You're Pregnant?
Melanie Cole (Host): Pregnant women have hundreds of health decisions to make to protect their baby, while at the same time, they need relief sometimes from illness symptoms and to get that much needed sleep. What’s really safe for over-the-counter medications for pregnant and breastfeeding women? My guest today is Dr. Nancy Dickerson. She’s an OB-GYN with Women’s Health at Coon Rapids. Welcome to the show, Dr. Dickerson. What are the general guidelines for pregnant women and breastfeeding women when it comes to over-the-counter medications?
Dr. Nancy Dickerson (Guest): Well, in general, over-the-counter medications like Tylenol can be taken without worrying, but there are many medications that we don’t know the effects of these. We have a list of over-the-counter medications that are safe to use during pregnancy that we give to all our pregnant patients. We certainly could also give it out to people contemplating a pregnancy. In general, prenatal vitamins are safe to take, as are multivitamins, and we encourage all women of childbearing years to take a multivitamin every day to get the folic acid that’s in there.
Melanie: Well, I’d like to ask you first also about medications that women may need for their health, like blood pressure medication or cholesterol medication. Are those safe? You checked with your doctor, obviously, but if you’ve been on those medications for a while, do you continue to take them while you’re pregnant?
Dr. Dickerson: Well, blood pressure medication, yes, it’s generally safest to continue with that until you’re seen by your physician, and then we will often be able to take a pregnant woman off her blood pressure medication, at least in the beginning of pregnancy, although some people do still need it. They often need it again in the third trimester if they were taken off in the beginning. Cholesterol medication is a little bit different and is not recommended during pregnancy because cholesterol is a major building block for growing a baby. We do take people off their cholesterol medication prior to pregnancies.
Melanie: What a great answer, that cholesterol is a major building block for growing a baby. Women, that should answer that question. Now, what about common cold and flu remedies? You mention that Tylenol is safe, but there’s everything from Afrin to Sudafed to all these things on the market. What does a woman to do?
Dr. Dickerson: Well, we hope that they will use the common sense approach to colds and flu, especially colds, because colds generally are gone within a week no matter what you do. So the important thing is that you try and feel better. Chicken soup is really good. The salt water, the humidity from the soup, all those are very soothing. We generally recommend bedside humidifier, which helps prevent nosebleeds, which are so common in pregnant women. Also, you can use it for your baby once the baby is born. Tylenol is good to help just reduce the inflammation, the swelling in your sinuses, the sore throat, fever. Especially if you have a fever, you should be taking Tylenol fairly regularly. Then we’re fortunate in that a lot of medications for colds are safe to use during pregnancy. You can take Benadryl at bedtime to help you sleep. You can take allergy medication. You can use the little neti pots to help clear your sinuses. There are things that are safe. And colds are very common. But again, they will get better even if you don’t take any medication for your colds.
Melanie: What about ibuprofen if you’re suffering muscular soreness or headaches or, really, anything else? What is the difference between the safe Tylenol and ibuprofen?
Dr. Dickerson: Well, ibuprofen is in a class of drug called nonsteroidal anti-inflammatory medication, and we used to think these were safe in pregnancy. But more recently, we have information that ibuprofen may increase the risk of miscarriage. That’s certainly not anything that we will take a chance with. At this point, we do not consider ibuprofen or Aleve, naproxen sodium to be safe to take during pregnancy. Tylenol is our major pain reliever.
Melanie: What can you do for a headache or soreness? What do you recommend as some sort of home remedies for these kinds of things?
Dr. Dickerson: Well, for headaches, again, Tylenol taken at the first sign of a headache can usually be very helpful, and you can take two of the regular strength or even two extra strength. But if you’re taking 1000 milligrams or two extra strength, you shouldn’t take more than that every six hours because 4,000 milligrams a day is the limit for acetaminophen or Tylenol. Otherwise, you can do home remedies like trying to go into a dark room and sleeping, using ice on your head, massage, anything like that that generally is going to be safe. Sometimes women have migraines, and migraines are really difficult because most of the prescription migraine medications are not safe to take during pregnancy. Sometimes, we actually have to work with the patient’s neurologist and come up with a new plan for those women.
Melanie: What about herbal supplements? You said that we should be taking our prenatal vitamins and even a multivitamin, but some people take really large amounts of vitamin D, or they try ginseng for energy or gingko biloba or any of these other herbal supplements. CoQ10, even. Which ones are really good and which ones might be dangerous for baby?
Dr. Dickerson: Well, the problem with the herbal supplements is that they really haven’t been proven to be safe or effective by the FDA, and the amount of medication that you get in every tablet tends to be different from brand to brand and even sometimes from tablets in the same bottle. We generally don’t recommend any herbal supplements because we can’t prove that they are safe. Pregnancy is a time where you really want to get your nutrition from healthy food. Fruits and vegetables, fresh fruits, are really what we recommend. Then one prenatal vitamin daily should get you through everything.
Melanie: Give us another good source for reliable information in addition to your doctor.
Dr. Dickerson: Well, there is a CDC website called Treating for Two, and this has a lot of information on medications. Also, what we do when women are breastfeeding is we tend to use our lactation consultants. Every Allina Hospital has a few nurses who are lactation consultants, and they actually send you home with a hotline telephone number. They call it the warm line because it’s usually not truly emergencies like a hotline. But it’s questions a pregnant women or women who are breastfeeding have, and they have a list of medications that can be used during breastfeeding safely. So we often refer to our lactation consultants.
Melanie: In just the last minute or so, give us your best advice for pregnancy and/or breastfeeding and safe medication use while that’s going on.
Dr. Dickerson: Well, in general, I would say with the over-the-counter medications, if you’re not sure, don’t take it. This is your baby we’re talking about after all, and we want you to be safe, first of all. Eye easy home remedies first. Tylenol is generally considered safe. And remember, multivitamins taken before pregnancy can be very helpful and actually reduce the risk of certain birth defects like spina bifida. Folic acid is very important before conceiving.
Melanie: Thank you so much. You are listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.
Over the Counter Meds: What’s Safe When You're Pregnant?
Melanie Cole (Host): Pregnant women have hundreds of health decisions to make to protect their baby, while at the same time, they need relief sometimes from illness symptoms and to get that much needed sleep. What’s really safe for over-the-counter medications for pregnant and breastfeeding women? My guest today is Dr. Nancy Dickerson. She’s an OB-GYN with Women’s Health at Coon Rapids. Welcome to the show, Dr. Dickerson. What are the general guidelines for pregnant women and breastfeeding women when it comes to over-the-counter medications?
Dr. Nancy Dickerson (Guest): Well, in general, over-the-counter medications like Tylenol can be taken without worrying, but there are many medications that we don’t know the effects of these. We have a list of over-the-counter medications that are safe to use during pregnancy that we give to all our pregnant patients. We certainly could also give it out to people contemplating a pregnancy. In general, prenatal vitamins are safe to take, as are multivitamins, and we encourage all women of childbearing years to take a multivitamin every day to get the folic acid that’s in there.
Melanie: Well, I’d like to ask you first also about medications that women may need for their health, like blood pressure medication or cholesterol medication. Are those safe? You checked with your doctor, obviously, but if you’ve been on those medications for a while, do you continue to take them while you’re pregnant?
Dr. Dickerson: Well, blood pressure medication, yes, it’s generally safest to continue with that until you’re seen by your physician, and then we will often be able to take a pregnant woman off her blood pressure medication, at least in the beginning of pregnancy, although some people do still need it. They often need it again in the third trimester if they were taken off in the beginning. Cholesterol medication is a little bit different and is not recommended during pregnancy because cholesterol is a major building block for growing a baby. We do take people off their cholesterol medication prior to pregnancies.
Melanie: What a great answer, that cholesterol is a major building block for growing a baby. Women, that should answer that question. Now, what about common cold and flu remedies? You mention that Tylenol is safe, but there’s everything from Afrin to Sudafed to all these things on the market. What does a woman to do?
Dr. Dickerson: Well, we hope that they will use the common sense approach to colds and flu, especially colds, because colds generally are gone within a week no matter what you do. So the important thing is that you try and feel better. Chicken soup is really good. The salt water, the humidity from the soup, all those are very soothing. We generally recommend bedside humidifier, which helps prevent nosebleeds, which are so common in pregnant women. Also, you can use it for your baby once the baby is born. Tylenol is good to help just reduce the inflammation, the swelling in your sinuses, the sore throat, fever. Especially if you have a fever, you should be taking Tylenol fairly regularly. Then we’re fortunate in that a lot of medications for colds are safe to use during pregnancy. You can take Benadryl at bedtime to help you sleep. You can take allergy medication. You can use the little neti pots to help clear your sinuses. There are things that are safe. And colds are very common. But again, they will get better even if you don’t take any medication for your colds.
Melanie: What about ibuprofen if you’re suffering muscular soreness or headaches or, really, anything else? What is the difference between the safe Tylenol and ibuprofen?
Dr. Dickerson: Well, ibuprofen is in a class of drug called nonsteroidal anti-inflammatory medication, and we used to think these were safe in pregnancy. But more recently, we have information that ibuprofen may increase the risk of miscarriage. That’s certainly not anything that we will take a chance with. At this point, we do not consider ibuprofen or Aleve, naproxen sodium to be safe to take during pregnancy. Tylenol is our major pain reliever.
Melanie: What can you do for a headache or soreness? What do you recommend as some sort of home remedies for these kinds of things?
Dr. Dickerson: Well, for headaches, again, Tylenol taken at the first sign of a headache can usually be very helpful, and you can take two of the regular strength or even two extra strength. But if you’re taking 1000 milligrams or two extra strength, you shouldn’t take more than that every six hours because 4,000 milligrams a day is the limit for acetaminophen or Tylenol. Otherwise, you can do home remedies like trying to go into a dark room and sleeping, using ice on your head, massage, anything like that that generally is going to be safe. Sometimes women have migraines, and migraines are really difficult because most of the prescription migraine medications are not safe to take during pregnancy. Sometimes, we actually have to work with the patient’s neurologist and come up with a new plan for those women.
Melanie: What about herbal supplements? You said that we should be taking our prenatal vitamins and even a multivitamin, but some people take really large amounts of vitamin D, or they try ginseng for energy or gingko biloba or any of these other herbal supplements. CoQ10, even. Which ones are really good and which ones might be dangerous for baby?
Dr. Dickerson: Well, the problem with the herbal supplements is that they really haven’t been proven to be safe or effective by the FDA, and the amount of medication that you get in every tablet tends to be different from brand to brand and even sometimes from tablets in the same bottle. We generally don’t recommend any herbal supplements because we can’t prove that they are safe. Pregnancy is a time where you really want to get your nutrition from healthy food. Fruits and vegetables, fresh fruits, are really what we recommend. Then one prenatal vitamin daily should get you through everything.
Melanie: Give us another good source for reliable information in addition to your doctor.
Dr. Dickerson: Well, there is a CDC website called Treating for Two, and this has a lot of information on medications. Also, what we do when women are breastfeeding is we tend to use our lactation consultants. Every Allina Hospital has a few nurses who are lactation consultants, and they actually send you home with a hotline telephone number. They call it the warm line because it’s usually not truly emergencies like a hotline. But it’s questions a pregnant women or women who are breastfeeding have, and they have a list of medications that can be used during breastfeeding safely. So we often refer to our lactation consultants.
Melanie: In just the last minute or so, give us your best advice for pregnancy and/or breastfeeding and safe medication use while that’s going on.
Dr. Dickerson: Well, in general, I would say with the over-the-counter medications, if you’re not sure, don’t take it. This is your baby we’re talking about after all, and we want you to be safe, first of all. Eye easy home remedies first. Tylenol is generally considered safe. And remember, multivitamins taken before pregnancy can be very helpful and actually reduce the risk of certain birth defects like spina bifida. Folic acid is very important before conceiving.
Melanie: Thank you so much. You are listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.