Are Over the Counter Drugs Safe During Pregnancy?

Why You Might Want to Think Twice Before Popping That Pill

pregnant woman looking at medication in pharmacy aisle
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If a drug is available over the counter, it must be safe, right? Not quite, especially if you're pregnant. In fact, over the counter (OTC) drugs that cause miscarriage or birth defects could be in your medicine cabinet or purse without you even realizing it. Use this guide to keep yourself and your baby safe during pregnancy.

Avoid Aspirin

An estimated 10 percent to 45 percent of pregnant women in the first trimester, unaware that they are pregnant, reach for the most common OTC drug, aspirin.

Aspirin and other drugs containing salicylate are not recommended throughout pregnancy, especially during the last three months, except under a doctor's supervision. Acetylsalicylate, a common ingredient in many over the counter painkillers, may prolong pregnancy and cause excessive bleeding before and after delivery.

Heed Warning Labels

Overall, most other OTC drugs can be used during pregnancy with the supervision of a physician. Although scientists do not know the effects on the fetus of all OTC and prescription drugs, some are known to cause birth defects and should be avoided.

Since 1984, all OTC drug products have carried the following warning: "As with any other drug, if you are pregnant or nursing, seek the advice of a health professional before using this product."

In July 1990, the US Food & Drug Administration issued a regulation requiring all oral and rectal nonprescription aspirin and drugs that contain aspirin to include the additional warning "It is especially important not to use aspirin during the last three months of pregnancy unless specifically directed to do so by a doctor because it may cause problems in the unborn child or complications during delivery."

Non-OTC Drugs to Avoid

One prescription drug that can cause severe birth defects is Accutane, or isotretinoin. Accutane, a derivative of vitamin A, is a powerful prescription drug that can clear severe cystic acne, but can cause birth defects (such as heart defects, small jaw, cleft palate and skull and facial disfigurements) in about one out of every four exposed fetuses.

Accutane can also cause miscarriages.

Since its approval, Accutane has been labeled as being in pregnancy category X, meaning it should not be used during pregnancy. However, due to persistent reports of birth defects associated with the use of the drug in 1988, the manufacturer, Hoffman-La Roche, began including additional patient information in the packaging, including a drawing of a baby with birth defects associated with the drug. Before being permitted to take Accutane, a woman of childbearing age must sign a consent form stating that she has been fully informed of the drug's side effects.

Another derivative of vitamin A, etretinate, or Tegison, was approved in the mid-1980s to treat psoriasis. This drug is also forbidden for use by women who are pregnant or who are likely to become pregnant either while taking it or for a certain period after they have stopped taking it.

Both Accutane and Tegison come with very strict warnings and it is very unlikely that you would be prescribed either one if you are pregnant, but it doesn't hurt to understand the risks.

The Bottom Line

With the exception of aspirin, most OTC drugs are OK to take while pregnant. Talk to your doctor about any OTC drugs or supplements you take or plan to take while pregnant to ensure a safe pregnancy and a healthy baby.

Following are some names under which DES and other Nonsteroidal Estrogens have been sold in the United States:

Nonsteroidal Estrogens

Benzestrol

Diphosphate

Hexoestrol

Oestromon

Stilpalmitate

Chorotrainisene Macrocyte

Diethylstilbestrol

Hi-Bestrol

Orestol

Stiphostrol

Comestrol

Dipropianate

Menocrin

Pabestrol D.

Stilronate

Cyren

Diethlstilbenediol

Meprane

Restrol

Stilrone

Cyren B.

Digestil

Mestilbol

Stil-Rol

Stils

Delevinal

Domestrol

Mikarol

Stilbal

Synestrin

DES

Estilben

Mikarol forti

Stilbestrol

Synestrol

DesPlex

Estrobene

Milestrol

Stilbestronate

Synthoestrin

Dibestil

Estrobene DP

Monomestrol

Stilbetin

Valestril

Diestryl

Estrosyn

Neo-Oestrano I

Stilbinol

Willestrol

Dienestrol

Fontal

Neo-Oestranol II

Stilbestroform

Dienoestrol

Gynben

Nulabort

Stilboestrol

Dipalmite

Gyneben

Oestrogenine

Stilboestrol DP

Diethlstilbestrol Palestrol

Hexestrol

Oestromenin

Stilestrate

Nonsterodial Estrogen-Androgen Combinatons

Amperone

Di-Erone

Eston

Metystil

Teserene

Tylandril

Tylosterone

Nonsteroidal Estrogen-Progesterone Combination

Progravidium

Vaginal Cream Suppositories w/Nonsteroidal Estrogens

AVC Cream w/Dienestrol

Dienestrol Cream

What kind of health problems can women and children exposure to DES have?

WOMEN WHO TOOK DES

  • Women who took DES are advised to pay particular attention to their breast care because they may have a small increase inthieir risk of breast cancer.

    Mothers are advised to tell their DES-exposed sons and daughters about their exposure, even if these children have not had health problems. They need to know about DES so they can get the health care they need.

    DES CHILDREN

    • DES Sons

      Men exposed to DES before birth

      DES sons are at increased risk for non-cancerous cysts on the back of the testicles (on the epididymis) and for underdeveloped testicles. DES sons should practice testicular self-examination regularly.

      There has been little research on the effects of DES exposure in DES sons, but new studies are in progress. To protect your health, find out if you were exposed, and stay informed of new research findings.

      DES DAUGHTERS

      • Women exposed to DES before birth

        All Des daughters need regular screening exams for a rare form of vaginal cancer (early detection saves lives). This exam is somewhat different form the one for non-expose women (see page 17). It should begin at puberty and continue throughout their lives.

        All DES daughters need special care beginning in the first weeks of pregnancy, even if they have already had children. You can learn about the pregnancy care you need in this booklet. With proper care most DES daughter can have successful pregnancies.

      Where can I obtain more information on DES?

      This information was taken from "DES: The Basic Booklet", National Institutes of Health, National Cancer Institute, National Institute of Child and Human Development, January 1995.

      For more information...

      You can find out more about pregnancy and medication by contacting the following organizations:

      Food and Drug Administration

      National Maternal and Child Health Clearinghouse

      National Institute of Child Health and Human Development

      Reprinted from the Office on Women's Health, Department of Health and Human Services.

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