What Pain Medications are Safe During Pregnancy?

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Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Pain during Pregnancy, go here. These expert reports are free of charge and can be saved and shared.

Aches and pains are common during pregnancy. Often, these discomforts can be managed with a little rest or relaxation, but what should you do when the discomfort progresses and you need more intense pain relief? Not all pain medications are safe for pregnant woman, so make sure you discuss all choices of medications, including prescription and non-prescription drugs and vitamins and supplements, with your healthcare provider.

Over-the-counter pain relievers

Medicines that are available over-the-counter don’t require a prescription from your doctor. However, that doesn’t mean that they are safe for every woman.

Acetaminophen is a common pain reliever that is generally considered safe during pregnancy. It can reduce fever, as well as provide relief of mild aches and pains such as headache and sore throat. Acetaminophen is available by the brand name “Tylenol” and is also available in countless generic and store-brand products. It is also present in many combination medications (including prescription and over-the-counter pain and cold-and-flu products), so be sure to check the labels of all medicines you are taking. Taking too much acetaminophen can cause liver damage.

Most women take acetaminophen at least once during their pregnancy. Don’t take it if you are allergic to it, if you have liver disease, if you are already taking other medicines that contain acetaminophen, or if you doctor has advised you not to take it.

Non-steroidal anti-inflammatory drugs (NSAIDs) are also commonly available pain relievers. Some are available over-the-counter and others are only available by prescription. NSAIDs treat joint and muscle pain, headaches, and fever. Aspirin is the oldest and most widely used drug in this category, but it should not be taken by women who are pregnant. Other NSAIDs include ibuprofen (brand names “Motrin” and “Advil”) and naproxen (“Aleve”). Often, if these are used occasionally during the first 2 trimesters of pregnancy, they are safe; but, they should not be taken during the last trimester of pregnancy, as they can cause increased bleeding during delivery.

Like acetaminophen, NSAIDs are widely available in many single- and combination-ingredient products. Carefully review all drug labels to make sure you are not taking multiple doses of the same drug or multiple drugs in the same category.

Prescription pain relievers

The most potent pain relievers are opioids (such as morphine, codeine, and oxycodone), which are only available by prescription. These are controlled substances and should only be used for short-term treatment of pain resulting from acute injuries or surgeries. Opioids should be rarely, if ever, used in pregnancy, and only under the strict supervision of your healthcare provider. These drugs can cause harm to your fetus, so they are reserved for extreme, debilitating pain during pregnancy.

Safety first

Non-drug options for pain relief are usually a good first choice when you have aches and pains during pregnancy. Rest, an ice or heat pack, a massage, or gentle yoga practice can often relieve minor discomforts. Homeopathic remedies and supplements have been touted for pain-relieving effects, but data regarding their actual safety and effectiveness during pregnancy are limited. If you consider such options for pain relief, consult an experienced homeopathic provider before taking anything.

If you need a pain-relieving medication, make sure your choice is safe for your growing baby. Talk to your doctor or pharmacist about all the drugs you are taking and explain your pain symptoms so they can help choose the right medicine for you.

All drug manufacturers provide guidance about the safety of their medications related to reproduction, pregnancy, and breastfeeding. Review the drug information that comes with medications or visit the FDA’s website for more information. While some studies have been published linking pain relievers during pregnancy to birth defects, many of these findings have not been definitely proven and more information is needed to understand the risks associated with pain relievers.

Even though some medications can be safely used during pregnancy, it’s always better to take the lowest possible dose for the shortest amount of time. And, always talk to a healthcare provider about all the medications and supplements you are taking when you want to start or stop a medication.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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