Pain meds safe for pregnancy

What Pain Meds Can I Take?

Written by WebMD Editorial Contributors

Reviewed by Nivin Todd, MD on January 20, 2021

Acetaminophen

This common over-the-counter medication may be your pain reliever of choice if you have a fever, a headache, or joint or muscle pain. You can buy acetaminophen over the counter by itself or in combination with other medicines. Your doctor can also prescribe it at higher doses, alone, or combined with other medications as well.

Most pregnant women can take acetaminophen if their doctor gives them the thumbs-up. It’s the most common pain reliever that doctors allow pregnant women to take. Some studies have found that about two-thirds of pregnant women in the U.S. take acetaminophen sometime during their nine-month stretch.

Just steer clear of acetaminophen if you’re allergic to it, if you have liver problems, or if your doctor says it’s not safe for you.

Even if your doctor says it’s OK to take acetaminophen, take as little of it as you can for as short a time as possible. Acetaminophen isn’t linked to big problems like miscarriage or birth defects, but studies suggest that babies could later feel the effects.

Some research suggests that taking acetaminophen daily for long periods (28 days or longer) could put your baby at greater risk of mild developmental delays or attention deficit hyperactivity disorder (ADHD).

Other research has shown that taking acetaminophen daily, or almost daily, during the second half of your pregnancy increases your baby’s odds of wheezing or having asthma.

None of the research proves that acetaminophen causes these problems and further studies are necessary to understand the link.

NSAIDs

You may have taken ibuprofen plenty of times in your adult life, but your doctor will likely ask you to take something else to treat fever, headaches, and muscle pain when you’re pregnant. Non-steroidal anti-inflammatory drugs (NSAIDs) are sold over the counter and by prescription, but there are safer choices for pregnant women.

Some studies have found that taking NSAIDs (ibuprofen, naproxen, aspirin, celecoxib) during the early part of pregnancy may increase your risk of miscarriage.

Research has also looked at the connection between NSAIDs and birth defects. Some studies suggest that there may be a slight increase in the chances of a problem with your baby’s heart or gastrointestinal (digestive) system if you take NSAIDS early in your pregnancy.

But more research is needed to prove that NSAIDs cause these problems. Even though the link hasn’t been proven, your doctor may suggest you take acetaminophen instead.

NSAIDs are definitely not recommended during the last 3 months of your pregnancy because they can cause a blood vessel in your baby’s heart to close before it should. If this happens, it can cause high blood pressure in your baby’s lungs.

Taking NSAIDS can also make it harder for you to go into labor or can reduce the level of amniotic fluid that surrounds your baby in your womb. For these reasons, you should only use NSAIDs under your doctor’s supervision to ensure no problems crop up.

Opioid Painkillers

Opioids (codeine, morphine, oxycodone) are a class of strong medicines that doctors can prescribe to treat pain. They’re also the most commonly abused prescription medications in the U.S.

Some studies suggest that opioid use can increase your odds of having a baby with certain birth defects, such as a heart problem. They also may raise your chances of premature birth, preterm labor, or even having a stillbirth.

If you already take opioids, your doctor may not want you to stop taking them once you’re pregnant, because a sudden stop could harm your health or your pregnancy. Instead they may want to reduce the amount of medicine you take at a gradual pace to prevent any withdrawal symptoms.

But if you take opioids during your pregnancy, your baby will be exposed to them in the womb and could become addicted. They will go through withdrawals from them after they're born. This is called neonatal abstinence syndrome, or NAS. NAS can be serious, and could cause your baby to be too small or have breathing problems, even if you take the opioid exactly as prescribed.

Is a common pain reliever safe during pregnancy?

For years, products containing acetaminophen, such as the pain reliever Tylenol, were largely viewed as safe to take during pregnancy. Hundreds of widely available over-the-counter remedies, including popular cold, cough, and flu products, contain acetaminophen. Not surprisingly, some 65% of women in the US report taking it during pregnancy to relieve a headache or to ease an aching back.

But recently, a group of doctors and scientists issued a consensus statement in Nature Reviews Endocrinology urging increased caution around acetaminophen use in pregnancy. They noted growing evidence of its potential to interfere with fetal development, possibly leaving lingering effects on the brain, reproductive and urinary systems, and genital development. And while the issue they raise is important, it’s worth noting that the concerns come from studies done in animals and human observational studies. These types of studies cannot prove that acetaminophen is the actual cause of any of these problems.

An endocrine disruptor

Acetaminophen is known to be an endocrine disruptor. That means it can interfere with chemicals and hormones involved in healthy growth, possibly throwing it off track.

According to the consensus statement, some research suggests that exposure to acetaminophen during pregnancy — particularly high doses or frequent use — potentially increases risk for early puberty in girls, or male fertility problems such as low sperm count. It is also associated with other issues such as undescended testicles, or a birth defect called hypospadias where the opening in the tip of the penis is not in the right place. It might play a role in attention deficit disorder and negatively affect IQ.

Risks for ill effects are low

If you took acetaminophen during a current or past pregnancy, this might sound pretty scary — especially since you’ve probably always considered this medicine harmless. But while experts agree it’s important to consider potential risks when taking any over-the-counter or prescription medicines during pregnancy, you shouldn’t panic.

"The risk for an individual is low," says Dr. Kathryn M. Rexrode, chief of the Division of Women's Health, Department of Medicine at Harvard-affiliated Brigham and Women's Hospital.

Chances are pretty good that if you took acetaminophen during a pregnancy, your baby likely did not, or will not, suffer any ill effects.

The research on this topic is not conclusive. Some information used to inform the consensus statement was gathered from studies on animals, or human studies with significant limitations. More research is needed to confirm that this medicine is truly causing health problems, and to determine at what doses, and at what points during a pregnancy, exposure to acetaminophen might be most harmful.

Sensible steps if you’re pregnant

Three common-sense steps can help protect you and your baby until more is known on this topic:

Avoid acetaminophen during pregnancy when possible. Previously during preconception and pregnancy counseling, Dr. Rexrode had warned patients against using NSAID drugs, such as Advil and Aleve, and suggested taking acetaminophen instead. "Now I also tell people that some concerns have been raised about acetaminophen use during pregnancy, and explain that its use should be limited to situations where it is really needed," says Dr. Rexrode. In short, always consider whether you really need it before you swallow a pill.
Consult with your doctor. Always clear acetaminophen use with your doctor, particularly if you are going to be using the medicine for a long period of time. They might agree that taking it is the best option — or suggest a safer alternative.
Minimize use. If you do need to take acetaminophen during pregnancy, take it for the shortest amount of time possible and at the lowest effective dose to reduce fetal exposure. "This advice about the lowest necessary dose for the shortest period of time is generally good counseling for all over-the-counter medication use, especially during pregnancy," says Dr. Rexrode.

While all of this is good advice for using acetaminophen, there are times when it’s riskier not to take it. For example, if you have a high fever during pregnancy — which can harm your baby — acetaminophen may be needed to bring your fever down. Provided it’s advised by your doctor, the benefits of acetaminophen use in this case outweigh the potential risks.

Anesthesia in gentle beriod

Answers questions

Sergeev Viktor Mikhailovich

dentist of the network of dental clinics "Smile"

Pregnancy is a long-awaited, and as doctors say, a completely normal physiological state of the female body. However, it is fundamentally different from the usual state of the female body, primarily by changing the hormonal background. The best motto that every woman should be guided by in anticipation of a child is better to prevent than to cure.

What should I do if I have a toothache during pregnancy?

Unfortunately, there is no “magic pill” or “guaranteed remedy” for caries. Dental caries is a multifactorial, infectious disease.

The normal growth and development of the fetus during pregnancy depends on the health of the teeth of the expectant mother. The threat posed by untreated caries should not be underestimated. It is important to visit a dentist when planning a pregnancy, to cure foci of infection.

And during pregnancy, pay more attention to oral hygiene and good nutrition of the expectant mother.

If you still have a toothache during pregnancy, you should contact your dentist as soon as possible.

Therefore, in order for the treatment of teeth in pregnant women to be reduced only to regular examinations at the dentist, it is necessary to carefully maintain oral hygiene.

Unified reference telephone

+7 384 234-44-19

Painkillers for pregnant women

Let's say right away that the safest drugs are Paracetamol and Ibuprofen . Here it should only be noted that Ibuprofen is contraindicated in pregnant women in the 3rd trimester (in the 1st and 2nd trimesters it is approved for use). Pain tablets for pregnant women, see Table #1 below.

Taking medications, dosages, duration of administration - you need to coordinate with your doctor. Because there may be certain conditions and chronic diseases in the mother's body that can make these drugs less safe than they are, for example, for a healthy pregnant woman.

Antibiotics for pregnant women

Can pregnant women drink an antibiotic, and which antibiotics can pregnant women take?

In the treatment of pregnant women, the drugs of choice are beta-lactam antibiotics, for example, a group of penicillins. In Table No. 1 you will see a list of the safest antibiotics (safety category "B").

Antibiotics of the following groups are prohibited for use: tetracyclines and fluoroquinolones. With caution (undesirable, but in some cases necessary) - sulfonamides and some representatives of aminoglycosides.

IMPORTANT: It is best to discuss this with your attending OB/GYN before starting antibiotics.

Anesthesia during lactation

Medicines and breastfeeding

When deciding on the appointment of the drug
to a nursing woman, the doctor takes into account:

Drug toxicity index
Dose and duration of administration of the drug
Breastfeeding age
Amount of milk consumed
Effect of the drug on lactation

Ways to reduce the amount of medication

in the mother's milk to the baby

Suspension of breastfeeding
Refusal to feed the child during peak plasma concentrations of the drug
Taking the drug during the longest sleep of the child

What antibiotics can be used for pregnant and lactating women, as well as painkillers and injections for dental treatment - are listed in Table No. 1 .

Table 1.

Medicines used in dentistry during pregnancy and lactation.

Medicine	Pregnancy risk category *	Risk category for lactation *
Local anesthetics (injections for dental treatment)
Lidocaine	In (maybe)	Safe
mepivacaine	C (unwanted)	Safe
Analgesics
Paracetamol	In (maybe)	Safe
Ibuprofen (1st and 2nd trimesters)	In (maybe)	Safe
Ibuprofen (3rd trimester)	D (absolutely impossible)	Safe
Antibiotics
Penicillins	In (maybe)	Safe
Cephalosporins	In (maybe)	Safe
Clindamycin	In (maybe)	Safe
Metronisazole	In (maybe)	Safe
* - in accordance with the classification of the Food and Drug Administration (FDA, USA). Description of risk categories "B", "C", "D" is given below

What are drug safety categories?

Today, the safety of drugs for the fetus is classified according to the recommendations of the experts of the Food and Drug Administration.

This classification was developed in the USA and is generally followed by physicians in all countries. You can see the drugs of choice for emergency dental interventions in pregnant and lactating women in Table No. 1 .

The level of drug safety is determined by risk categories, which are denoted by Latin letters A, B, C, D:

Category B drugs - Considered to be very safe.
Category C drugs - not recommended.
Category D drugs - dangerous to use (use only if the possible benefit outweighs the possible harm, and if there is no safer similar drug).

Anesthesia for high and low blood pressure
If the patient has high blood pressure or cardiac dysfunction (heart disease, heart rhythm disturbances, failure, etc. ). Moreover, with moderate hypertension, anesthetics with a reduced concentration of adrenaline are recommended, with severe - anesthetics with its complete absence.

Anesthetics without adrenaline

This group of anesthetics includes Scandonest and Mepivastezin (Mepivacaine) .

They have a moderate vasodilating effect, so they are used without a vasoconstrictor. After the introduction of the drug, anesthesia occurs quickly (3–5 minutes), the effect lasts 3–40 minutes with pulp anesthesia, and up to 3 hours with soft tissue anesthesia. It is used for all types of manipulations, as well as for maxillofacial operations. Indicated for children weighing at least 15 kg.

Would you like to learn more about anesthesia during pregnancy and get advice from a dentist? Just give us a call or sign up using the form on the website.

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Pain medication during pregnancy

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Pain reliever during pregnancy

Can I take painkillers during pregnancy if I have a toothache?

Dental problems during pregnancy occur due to hormonal changes and changes in the body. Often there is a deficiency of various substances, minerals, in the first place - calcium, on which the health of the teeth depends. Also, pathogenic microorganisms multiply more actively in the mouth of a pregnant woman. All this often leads to dental diseases and pain.

When it is not possible to see a doctor immediately after the onset of pain, one has to take painkillers. This is necessary, because due to acute and constant pain, a pregnant woman experiences stress, and this negatively affects the fetus. However, there are many nuances, and not every drug can be used by a future mother.

For which diseases do pregnant women need painkillers?

Caries, medium and deep.
Pulpitis.
Periodontitis.
Gingivitis.
Inflammation of the mucous membranes in the oral cavity caused by various factors.

Which pain medications can be taken during pregnancy?

It is best to consult a dentist before becoming pregnant to avoid situations where you may need pain medication. We invite you to contact the doctors of the Planet of Childhood clinic in Moscow to undergo a complete dental examination and receive individual recommendations.

When buying any medication, read the package leaflet carefully. The instructions will always tell you exactly how you should or should not use this drug during pregnancy. Also pay attention to other contraindications.

Here are some painkillers that pregnant and breastfeeding women are usually allowed to take:

Papaverine - temporary relief, usually works for mild pain;
Paracetamol - relieves inflammation and fever that may occur due to dental disease;
No-shpa - relieves pain;
Ibuprofen - effective pain relief, but contraindicated in the third trimester;
1-Riabal is a gentle pain reliever.

Even after choosing a remedy from this list, you must first contact your doctor for advice. In any case, all these means cannot be called potent. Although they reduce pain or eliminate them for a while, you still need to come to the dental clinic as soon as possible with a toothache.

In addition to pills, special baby gels, which are usually used during teething in babies, can be a way out for the expectant mother. These gels relieve pain and itching.

Chlorhexidine and Miramistin sprays are another option.