Medications and Pregnancy

If you are pregnant or thinking about becoming pregnant, talk with your doctor about any medications you are taking or thinking about taking. This includes prescription and over-the-counter medications, as well as dietary or herbal products.

Effects of Medications during Pregnancy

We know little about the effects of taking most medications during pregnancy. This is because pregnant women are often not included in studies to determine safety of new medications before they come on the market. Less than 10% of medications approved by the U.S. Food and Drug Administration (FDA) since 1980 have enough information to determine their risk for birth defects.¹

Because of studies conducted after medications come on the market, we do know that taking certain medications during pregnancy can cause serious birth defects. Examples are thalidomide (also known as Thalomid®) and isotretinoin (also known as Accutane® or Claravis®). Such medications should be avoided by all women who are or might become pregnant. For women who are taking these medications, it is important to discuss effective contraception methods with their doctor.  While some medications are known to be harmful when taken during pregnancy, we don’t know the safety or risk of most medications. The effects depend on many factors, such as:

• How much medication is taken (sometimes called the dose).
• When during the pregnancy the medication is taken.
• Other health conditions a woman might have.
• Other medications a woman takes.

The important thing to remember is to talk to your doctor. Be sure to tell your doctor about all medications and herbal or dietary supplements you’re taking or planning to take, so you can make sure you’re taking only what is necessary.

Lists of Safe Medications during Pregnancy

Many internet websites post lists of medications that are safe to take during pregnancy. But for many of the medications listed, there is not enough known to determine their safety or risk for use during pregnancy.² Don’t make decisions about medication use during pregnancy based on lists you find online. Instead use the lists as a starting point to talk with your doctor. Don’t stop or start taking any type of medication that you need without first talking with a healthcare provider. A conversation with a healthcare provider can help ensure that you are taking only what is necessary.

Discussing Current Medications

Some pregnant women must take medications to treat health conditions. For example, if a woman has asthma, epilepsy (seizures), high blood pressure, or depression, she might need to continue to take medication to stay healthy during pregnancy. If these conditions are not treated, a pregnant woman or her unborn baby could be harmed. It is important for a woman to discuss with her doctor which medications are needed during pregnancy. She should also talk to her doctor about which medications are likely to be the safest to take during pregnancy. It is important to balance the possible risks and benefits of any medication being considered. Suddenly stopping the use of a medication may be riskier than continuing to use the medication while under a doctor’s care. It is also important to know that dietary and herbal products, such as vitamins or herbs added to foods and drink, could be harmful to an unborn baby. These products can have other side effects when used during pregnancy. It’s best for a woman to talk with her healthcare provider about everything she’s taking or thinking about taking.

Accidental Exposure

Sometimes, women take medication before they realize that they are pregnant. When this happens, they may worry about the effects of the medication on their unborn baby. The first thing a woman who is pregnant or who is planning on becoming pregnant should do is talk with her healthcare provider. Some medications are harmful when taken during pregnancy, but others are unlikely to cause harm.

More Information

Below are two resources where you can find more information.

The Organization of Teratology Information Specialists (OTIS)

The Organization of Teratology Information Specialists (also known as OTIS) provides information, in English and Spanish, for women and healthcare providers on the risks and safety of taking medication during pregnancy and breastfeeding. This group maintains a website called Mother to Baby. To speak with an OTIS counselor, you can call 1-866-626-6847. OTIS also conducts studies of pregnant women volunteers who have contacted their services.

LactMed

LactMed is a database of medications that women might be exposed to while breastfeeding. The database is hosted by the National Library of Medicine. It contains information about the medication, ways it might affect the mother or baby, and potential alternatives to consider.

CDC Activities

CDC is partnering with organizations, other federal agencies, and the public to improve the quality of data and information on medication use during pregnancy. CDC’s focus on medications in pregnancy is an initiative called Treating for Two: Safer Medication Use in Pregnancy. This initiative aims to prevent birth defects and improve the health of mothers by working to identify the best alternatives for treatment of common conditions during pregnancy and during the childbearing years. The Treating for Two initiative strives to:

• Better inform clinical management decisions for women who are pregnant or could become pregnant
• Improve women’s health by identifying the best treatment options for common conditions before and during pregnancy
• Protect fetal and infant health by minimizing exposures to potentially harmful medications

Read more about the Treating for Two initiative in this factsheet.
For more information, please visit the Treating for Two website.

Reference

1. Adam MP, Polifka JE, Friedman JM. Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet Part C. 2011;157:175-82.
2. Peters SL, Lind JN, Humphrey JR, Friedman JM, Honein MA, Tassinari MS, Moore CA, Mathis LL, Broussard CS. Safe lists for medications in pregnancy: inadequate evidence base and inconsistent guidance from Web-based information, 2011. Pharmacoepidemiol Drug Saf. 2013;22(3):324-8.