10 Over-The-Counter Drugs to Avoid During Pregnancy

Mothers-to-be get headaches and upset stomachs just like everyone else. So it’s not surprising that most pregnant women have used over-the-counter medications. In fact, some data suggest that, overall, women are actually more likely to use certain medications—including cough and cold drugs and acetaminophen (Tylenol, generic)—after they become pregnant.

“There’s a misperception that if a drug is available over-the-counter, that it’s approved by the Food and Drug Administration, so it must be safe for everyone, including pregnant women,” Allen Mitchell, M.D. professor of pediatrics and epidemiology at the Boston University School of Public Health and Medicine, said. “Even doctors may think this is the case.” But some OTC drugs have been shown to pose risks to the developing fetus at different stages of pregnancy.

To help you and your doctor make more informed choices about which medications to take, we’ve identified 10 common ingredients used in OTC drugs that are risky for pregnant women, as well as safer alternatives.

Drug	Found in	Consumer Reports' recommendation	Possible alternative
Aspirin	Bayer; Excedrin Migraine	Not recommended1	Tylenol (acetaminophen)
Bismuth subsalicylate	Kaopectate; Pepto Bismol	Before 20 weeks: Use with caution After 20 weeks: Not recommended	Imodium (loperamide)
Bromphen-iramine	Dimetapp Cold and Allergy	Before 36 weeks: Use with caution After 36 weeks (9th month): Not recommended	Claritin (loratadine); Zyrtec (cetirizine)
Caffeine	Anacin Regular Strength; Excedrin Extra Strength; Excedrin Migraine	Use with caution; To reduce risk of miscarriage, do not exceed 200 milligrams daily, including caffeine from coffee, tea, or soda.	None
Castor Oil	—	Do not take— unacceptable risk	Increase physical activity, drink more fluids and eat fiber-rich foods. Consider psyllium- based fiber supplements.
Chlorphen-iramine	Chlor-Trimeton;  Combination products: Advil Allergy & Congestion Relief; Alka-Seltzer Plus Cold Formula; Dristan Cold	Before 36 weeks: Use with caution After 36 weeks (9th month): Not recommended	Claritin (loratadine); Zyrtec (cetirizine)
Ibuprofen	Advil, Motrin	Weeks 14 to 26 (2nd trimester): Use with caution Before 14 weeks and after 27 weeks (1st and 3rd trimester): Not recommended	Tylenol (acetaminophen)
Naproxen	Aleve	Weeks 14 to 26 (2nd trimester): Use with caution Before 14 weeks and after 27 weeks (1st and 3rd trimester): Not recommended	Tylenol (acetaminophen)
Nicotine	Cigarettes and all other forms of tobacco; Nicorette gum; Nicoderm CQ patches	Not recommended; however the benefits of gum or patches to help stop smoking may exceed risks of smoking during pregnancy.	None
Phenylephrine and pseudo-ephedrine*	Products containing pseudo-ephedrine2: Advil Cold & Sinus; Claritin-D; Sudafed 12 Hour Products containing phenylephrine: Alka-Seltzer Plus Day; Sudafed PE Pressure + Pain; Tylenol Cold Multi-symptom; Vicks Dayquil Cold and Flu Relief	Before 14 weeks: (1st trimester): Not recommended After 14 weeks (2nd and 3rd trimester): Use with caution	Drink plenty of fluids, consider using steam to relieve congestion, avoid irritants like tobacco smoke

Even then, you should use alternatives judiciously, and only as advised by your health care provider. Experts refer to safer medications because, for 98 percent of prescription and OTC drugs, there simply isn’t enough data to say for sure that a drug is entirely safe to take during pregnancy. Due to ethical concerns, most FDA-approved medicines have not been tested in pregnant women.

Bottom line: If you are pregnant or may become pregnant, you should be extremely cautious about anything you take, including OTC and prescription medications, and all vitamins, supplements, and herbals.

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