What You Need to Know About Medication, Supplements and Pregnancy

September 08, 2019

At some point during your pregnancy, the need to take medicine will most likely arise. You might also want to continue taking supplements or start up new supplements while pregnant. But how will you know what’s safe and what isn’t safe to take? We spoke with Maria LaNasa, D.O., and Heather Bartos, M.D., OB/GYNs and physicians on the medical staff at Texas Health Frisco and at be. Women’s Health & Wellness in Frisco, to understand what’s safe and what to avoid, and what you should do if you have concerns.

Come prepared

If you currently take medication or supplements, or you are thinking about adding new medication or supplements while pregnant, make sure to bring that list with you at your first prenatal appointment. Your health care provider can go through the list with you and discuss what is OK to continue taking (or adding), what should be watched, or the dosage lowered, and what should be avoided. If your medication dosage should be lowered or eliminated while pregnant, your physician can coordinate with your primary care provider. Sometimes they may be able to prescribe an alternative until you deliver.

“I always think it’s a great idea to bring any supplements to your visit so we can review,” Bartos says. “My best advice is: if you’re not sure, just ask! Always talk to your personal OB who knows your history.”

You’re bound to have a lot of questions throughout your pregnancy, so never hesitate to ask! Many physicians’ offices have a nurse on hand to answer any questions you call about or offer an online portal where you can ask a question virtually if it’s after hours or you’re not able to connect with someone at the moment. Also, if you find yourself at the pharmacy wondering if a certain medication is safe, don’t hesitate to ask the pharmacist if there’s one in the store. They can go over specifics and give guidance.

Can I take herbal supplements, or something labeled “All-Natural?”

An herbal supplement or something labeled “natural” may not initially bring up any red flags, but it’s still important to discuss these products with your health care provider because there is very little research on how they may affect pregnancy.

“As a good rule of thumb, I would stay away from stimulants such as ma-huang and garcinia Cambogia,” says Bartos. “Some of the essential oils aren’t great for pregnancy and can ‘stimulate’ labor, so be careful on those. I am ok with my patients having some caffeine during pregnancy and often recommend a cola-type product to help combat nausea, fatigue, etc. But I don’t recommend any full body cleansing products for my moms-to-be.”

What about over-the-counter products?

When it comes to OTC medications, many times when you read the label it will say that pregnant women should talk to their provider before using. This is because some OTC medicines may cause certain health problems during pregnancy.

For example, the pain reliever aspirin (such as Bayer®) may increase the risk of bleeding problems during pregnancy or childbirth, while the pain reliever ibuprofen (such as Advil®) can cause serious blood flow problems to your baby during the last 3 months of pregnancy. Most pregnant women can take acetaminophen (such as Tylenol®) to relieve pain if they follow the directions on the product label. But taking too much can lead to liver damage.

“The biggest thing that most women are not aware of is to stay away from any NSAID, such as ibuprofen (Advil®, Motrin®),” LaNasa adds. “We often suggest Tylenol® and Benadryl® as being safe in pregnancy, but literature is always changing on what is and what is not suggested. I’d suggest always asking your health care provider about what is safe.”

OK, what about my prescriptions?

“Since many prescription medications are safe in pregnancy — and other providers may not be aware — I always suggest a prenatal counseling appointment for women that are taking a lot of different prescribed medications,” LaNasa says.

Some prescription drugs — including the ones in this list — can cause birth defects in your baby. If you’re pregnant and taking any of these medicines, call your provider immediately. You may need to stop taking it or switch to a different drug or dose that’s safe for your baby.

Captopril (Capoten®)
Carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®)
Codeine
Enalapril (Vasotec®)
Fluoxetine (Prozac®)
Hydrocodone (Vicodin®)
Isotretinoin (Accutane®, Amnesteem®, Claravis®, Sotret®)
Morphine
Oxycodone (OxyContin®, Percocet®)
Paroxetine (Paxil®)
Thalidomide (Thalomid®)
Tramadol (ConZip®, Ryzolt®, Ultram®)
Valproic acid (Depacon®, Depakene®, Depakote®, Stavzor®, Valproic®)
Warfarin (Coumadin®, Jantoven®)

When in doubt, always ask your doctor, nurse, or pharmacist about anything you are currently taking or considering taking.

Be mindful of information resources

While this isn’t a supplement or medication, LaNasa adds that you should be very careful about where you get your information from when it comes to researching anything regarding your pregnancy, no matter how well-meaning or convincing.

“I know a lot of women may seek guidance from online forums or even well-meaning family or friends who suggest a certain supplement that may or may not be effective or safe,” she says.

“Don’t depend on blogs or user-generated forums — you don’t always know who is giving you advice,” Bartos seconds.

Some websites may say certain drugs are safe to take during pregnancy, but you should always check with your health care provider first. Because every woman’s body is different, what is safe for one woman may not be safe for you.

Well, what about prenatal vitamins?

If there’s one universal supplement health care providers recommend to pregnant women it’s, as you might have guessed, the prenatal vitamin. If you haven’t started taking a prenatal vitamin before your first visit, your provider will most likely recommend you start taking one and can give guidance on what to look for in a good prenatal formula.

But one trip down the vitamin aisle will prove that there are A LOT of options to choose from, which can be daunting. The good news is that most are pretty good for you, and if you have a hard time swallowing large pills (especially during times when you’re nauseous), there are gummy versions that are just as effective!

LaNasa warns that you should always take prenatal vitamins as suggested, even if you think you might have a deficiency that warrants doubling up.

“A standard prenatal vitamin (of any brand!) will satisfy the daily vitamin and mineral requirements of most pregnant women,” she explains. “I would never take more than what is recommended without discussing with your obstetrician first. In the U.S., a lot of our food is vitamin-fortified and most pregnant patients are not deficient.”