 	        			Is it safe to take medicine while you are
pregnant?

It can be hard to plan exactly when you will get
pregnant, in order to avoid taking any medicine.
Most of the time, medicine a pregnant woman is
taking does not enter the fetus. But sometimes it
can, causing damage or birth defects. The risk of
damage being done to a fetus is the greatest in
the first few weeks of pregnancy, when major
organs are developing. But researchers also do not
know if taking medicines during pregnancy also
will have negative effects on the baby later.

Many drugs that you can buy over-the-counter (OTC)
in drug and discount stores, and drugs your health
care provider prescribes are thought to be safe to
take during pregnancy, although there are no
medicines that are proven to be absolutely safe
when you are pregnant. Many of these products tell
you on the label if they are thought to be safe
during pregnancy. If you are not sure you can take
an OTC product, ask your health care provider.

Some drugs are not safe to take during pregnancy.
Even drugs prescribed to you by your health care
provider before you became pregnant might be
harmful to both you and the growing fetus during
pregnancy. Make sure all of your health care
providers know you are pregnant, and never take
any drugs during pregnancy unless they tell you
to.

Also, keep in mind that other things like
caffeine, vitamins, and herbal teas and remedies
can affect the growing fetus. Talk with your
health care provider about cutting down on
caffeine and the type of vitamins you need to
take. Never use any herbal product without talking
to your health care provider first.

What over-the-counter and prescription drugs are
not safe to take during pregnancy?

The Food and Drug Administration (FDA) has a
system to rate drugs in terms of their safety
during pregnancy. This system rates both
over-the-counter (OTC) drugs you can buy in a drug
or discount store, and drugs your health care
provider prescribes. But most medicines have not
been studied in pregnant women to see if they
cause damage to the growing fetus. Always talk
with your health care provider if you have
questions or concerns.

The FDA system ranks drugs as:

    *

      Category A - drugs that have been tested for
safety during pregnancy and have been found to be
safe. This includes drugs such as folic acid,
vitamin B6, and thyroid medicine in moderation, or
in prescribed doses.
    *

      Category B - drugs that have been used a lot
during pregnancy and do not appear to cause major
birth defects or other problems. This includes
drugs such as some antibiotics, acetaminophen
(Tylenol), aspartame (artificial sweetener),
famotidine (Pepcid), prednisone (cortisone),
insulin (for diabetes), and ibuprofin (Advil,
Motrin) before the third trimester. Pregnant women
should not take ibuprofen during the last three
months of pregnancy.
    *

      Category C - drugs that are more likely to
cause problems for the mother or fetus. Also
includes drugs for which safety studies have not
been finished. The majority of these drugs do not
have safety studies in progress. These drugs often
come with a warning that they should be used only
if the benefits of taking them outweigh the risks.
This is something a woman would need to carefully
discuss with her doctor. These drugs include
prochlorperzaine (Compazine), Sudafed, fluconazole
(Diflucan), and ciprofloxacin (Cipro). Some
antidepressants are also included in this group.
    *

      Category D - drugs that have clear health
risks for the fetus and include alcohol, lithium
(used to treat manic depression), phenytoin
(Dilantin), and most chemotherapy drugs to treat
cancer. In some cases, chemotherapy drugs are
given during pregnancy.
    *

      Category X - drugs that have been shown to
cause birth defects and should never be taken
during pregnancy. This includes drugs to treat
skin conditions like cystic acne (Accutane) and
psoriasis (Tegison or Soriatane); a sedative
(thalidomide); and a drug to prevent miscarriage
used up until 1971 in the U.S. and 1983 in Europe
(diethylstilbestrol or DES).

Aspirin and other drugs containing salicylate are
not recommended during pregnancy, especially
during the last three months. In rare cases, a
woman's health care provider may want her to use
these type of drugs under close watch.
Acetylsalicylate, a common ingredient in many OTC
painkillers, may make a pregnancy last longer and
may cause severe bleeding before and after
delivery.
Will there be studies in the future that will look
at whether certain medicines or products are safe
in pregnant women?

To help women make informed and educated decisions
about using medicines during pregnancy, it is
necessary to find out the effect of these
medicines on the unborn baby. Pregnancy Registries
are one way to do this. A Pregnancy Registry is a
study that enrolls pregnant women after they have
been taking medicine and before the birth of the
baby. Babies born to women taking a particular
medicine are compared with babies of women not
taking the medicine. Looking at a large number of
women and babies is needed to find out the effect
of the medicine on the babies.

If you are pregnant and currently taking medicine
-- or have been exposed to a medicine during your
pregnancy -- you may be able to join and help with
this needed information. The Food and Drug
Administration's (FDA) web site
(http://www.fda.gov/womens/registries/) has a list
of pregnancy registries that are enrolling
pregnant women.

Should I avoid taking any medicine while I am
pregnant?

Whether or not you should continue taking medicine
during pregnancy is a serious question. But, if
you stop taking medicine that you need, this could
harm both you and your baby. An example of this is
if you have an infection called toxoplasmosis,
which you can get from handling cat feces or
eating infected meat. It can cause problems with
the brain, eyes, heart, and other organs of a
growing fetus. This infection requires treatment
with antibiotics.

For pregnant women living with HIV, the Centers
for Disease Control and Prevention (CDC)
recommends the drug zidovudine (AZT). Studies have
found that HIV positive women who take AZT during
pregnancy decrease by two-thirds the risk of
passing HIV to their babies. If a diabetic woman
does not take her medicine during pregnancy, she
increases her risk for miscarriage and stillbirth.
If asthma and/or high blood pressure are not
controlled during pregnancy, problems with the
fetus may result. Talk with your health care
provider about whether the benefits of taking a
medication outweigh the risk for you and your
baby.

What about taking natural medications, or herbal
remedies, when you are pregnant?

While some herbal remedies say they will help with
pregnancy, there have been no studies to figure
out if these claims are true. Likewise, there have
been very few studies to look at how safe and
effective herbal remedies are. Echinacea, Gingko
biloba, and St. John's Wort have been popular
herbs, to name a few. Do not take any herbal
products without talking to your health care
provider first. These products may contain agents
that could harm you and the growing fetus, and
cause problems with your pregnancy.

I have heard that some women who were pregnant
between 1938 and 1971 were given a drug called DES
to prevent miscarriages that is now known to cause
cancers. Would I be affected if my mother took
this drug?

The synthetic (or man-made) estrogen,
diethylstilbestrol or DES, was made in London in
1938. DES was used in the U.S. between 1938 and
1971 to prevent miscarriage (losing a pregnancy).
Many women who had problems with earlier
pregnancies were given DES because it was thought
to be both safe and effective. Over time, it was
found that not only did DES not prevent
miscarriage, it also caused cancers of the vagina
(birth canal) and cervix (opening to the uterus or
womb).

While many women were given DES over this time,
many mothers do not remember what they were given
by their health care providers when they were
pregnant. Some prescription prenatal vitamins also
contained DES. If your mother is not sure whether
she took DES, you can talk with the health care
provider she went to when she was pregnant with
you or contact the hospital for a copy of her
medical records.

DES can affect both the pregnant woman and the
child (both daughters and sons). Daughters born to
women who took DES are more at risk for cancer of
the vagina and cervix. Sons born to women who took
DES are more at risk for non-cancerous growths on
the testicles and underdeveloped testicles. Women
who took DES may have a higher risk for breast
cancer.

If you think or know that your mother took DES
when she was pregnant with you, talk with your
health care provider right away. Ask her or him
about what types of tests you may need, how often
they need to be done, and anything else you may
need to do to make sure you don't develop any
problems.

For more information...

You can find out more about pregnancy and
medications by contacting the National Women's
Health Information Center (NWHIC) at (800)
994-WOMAN (9662) or the following organizations:

Food and Drug Administration
Phone Number(s): (888) 463-6332 (Consumer
Information)
Internet Address: http://www.fda.gov

Food and Drug Administration
Office on Women's Health
Guide to Pregnancy Registries
Internet Address:
http://www.fda.gov/womens/registries

National Institute of Child Health and Human
Development
Phone Number(s): (800) 370-2943
Internet Address: http://www.nichd.nih.gov

Center for the Evaluation of Risks to Human
Reproduction (CERHR)
National Institutes of Health
Internet Address: http://cerhr.niehs.nih.gov

American College of Obstetricians and
Gynecologists (ACOG) Resource Center
Phone Number(s): (800) 762-2264 x 192 (for
publications requests only)
Internet Address: http://www.acog.org

March of Dimes Birth Defects Foundation
Phone Number(s): (888) 663-4637
Internet Address: http://www.modimes.org

All material contained in the FAQs is free of
copyright restrictions, and may be copied,
reproduced, or duplicated without permission of
the Office on Women's Health in the Department of
Health and Human Services; citation of the source
is appreciated. 
Source: Womenhealth.gov