Navigating the Pharmacy Aisle with Confidence
When you are pregnant, your immune system is naturally suppressed so your body does not reject the growing baby. This biological necessity comes with a frustrating side effect: you are far more susceptible to catching colds, flu, and suffering from heightened allergies.
Suddenly, getting a simple headache or a scratchy throat feels fraught with anxiety. Standing in the pharmacy aisle reading warning labels is overwhelming. What crosses the placenta? What is safe? What poses a hidden risk?
Below is a clear, provider-approved guide to the most common over-the-counter (OTC) medications.
Before reviewing the list, keep these three unbreakable rules in mind:
- Use all medications sparingly. The goal is symptom management, not necessarily elimination. Use the lowest effective dose for the shortest possible duration.
- Decongestants require caution. Medications like Sudafed can raise your blood pressure. They should be used with extreme caution, generally avoided in the first trimester, and strictly avoided if you have any history of high blood pressure or preeclampsia.
- Always ask us first. If you are ever in doubt, or if you need to start any new prescription medication from another doctor, call MomDoc first.
The Safe OTC Reference Guide
The following medications have extensive historical data supporting their safety profile during pregnancy.
Pain and Fever
If you have a fever over 100.4°F, it is important to reduce it, as prolonged maternal fever carries risks.
| ✅ Safe to Take | ❌ Strictly Avoid |
| Acetaminophen (Tylenol, Extra Strength Tylenol) | Ibuprofen (Advil, Motrin) |
| Cold or warm compresses | Naproxen (Aleve) |
| Aspirin (unless explicitly prescribed as "Low-Dose" by your OB) | |
| Excedrin (contains aspirin and high caffeine) |
Colds, Coughs, and Allergies
Remember to avoid decongestants if you have blood pressure concerns.
| ✅ Safe to Take | ❌ Strictly Avoid |
| Antihistamines: Benadryl, Claritin, Zyrtec, Chlor-Trimeton | Decongestants (Sudafed) in the first trimester |
| Expectorants: Mucinex (guaifenesin) | Decongestants at any time if you have elevated blood pressure |
| Cough: Robitussin (plain and DM), standard cough drops | |
| Topical: Vicks VapoRub, Saline nasal spray |
Nausea and Vomiting (Morning Sickness)
| ✅ Safe to Take | Notes |
| Vitamin B6 (25 mg, 3x daily) | A time-tested, foundational approach. |
| Unisom (Doxylamine) | Take 1/2 tablet at bedtime. Works synergistically with B6. |
| Ginger root | Up to 1000 mg daily (250 mg, 4x daily). |
| Dramamine or Emetrol | For acute motion-sickness style nausea. |
Heartburn and Indigestion
| ✅ Safe to Take | Notes |
| Tums or Rolaids | Excellent for immediate relief and provides extra calcium. Limit to 4 per day. |
| H2 Blockers: Pepcid | Longer-lasting relief. |
| PPIs: Prilosec | Safe for chronic, severe heartburn. |
| Maalox, Mylanta | Safe liquid antacids. |
Constipation and Hemorrhoids
Do not suffer through constipation, as straining directly leads to painful hemorrhoids.
| ✅ Safe to Take | Category |
| Colace (Docusate) | Gentle stool softener. |
| MiraLAX, Metamucil, Fibercon | Osmotic and bulk-forming laxatives. |
| Preparation H, Tucks pads | Topical relief for external hemorrhoids. |
| Hydrocortisone cream (OTC) | Reduces itching and inflammation. |
Diarrhea
If diarrhea persists for more than 48 hours, contact MomDoc as dehydration is a severe risk.
| ✅ Safe to Take | ❌ Strictly Avoid |
| Imodium (Loperamide) | Pepto-Bismol (contains salicylates, related to aspirin) |
| Kaopectate |
A Warning on Herbal Supplements
"Natural" does not mean safe during pregnancy. Because herbal supplements are not regulated by the FDA, their potency varies wildly, and many actively stimulate uterine contractions or cause birth defects.
Strictly avoid the following herbal remedies: Black Cohosh, Blue Cohosh, Buckthorn, Cascara, Ephedra, Feverfew, Mandrake, Mugwort, Senna, Tansy, and Yarrow.
Narcotic Pain Medications
Narcotic medications (Lortab, Percocet, Tramadol, Vicodin) are powerful opioids that cross the placenta. They should only be used when explicitly prescribed by a physician for a severe, specific medical problem (such as surgical recovery or a kidney stone) and for the absolute shortest possible duration to avoid fetal dependency.
Every pregnancy is unique. If you have questions about any specific medication, or if a symptom is not responding to these conservative treatments, contact MomDoc Triage at 480-821-3601.