Medications can be bought over the counter, or prescribed by doctors. As far as how safe they can be, both can be dangerous to the developing fetus. However, most over the counter medications and medicines prescribed by doctors for common ailments are generally safe. The consumption of any medicine, however, must be discussed with 
your doctor with regards to safety in pregnancy.
Especially during the first trimester, some medications can be more harmful to the developing fetus. It’s a balance of risk versus benefits when medications are being used.
The ideal thing is to have a conversation with your doctor before conceiving if you have a health condition, which may require medication. If you need a medication during pregnancy, we need to know what is safe and what’s not. The FDA categorizes medicines according to their safety in pregnancy. Drugs are generally categorized into Cat A, B, C, D and X. A and B are considered safe in pregnancy. Cat C means probably safe but there is not enough studies to be sure. Cat D and X have been shown to have harmful effects and is contraindicated in pregnancy.
Herbs are medications. Some are safe and some are not. Many are not tested in pregnancy. Consultation with your obstetrician is strongly advised if you intend to take any herbs during pregnancy.
What kind of medication is safe to consume during pregnancy?
Paracetamol – the pain reliever of choice during pregnancy. It is completely safe in pregnancy.
Cold medications – most antihistamines such as chlorpheniramine, clarityne, pseudoephedrine are safe during pregnancy.
Cough syrups – most are safe to consume during pregnancy.
Allergy – almost any of the allergy medicines are safe during pregnancy.
Constipation – drink more water, increase fibers. If constipation is bad, any of the stool softeners are safe.
Diarrhoea – Imodium is safe during pregnancy.
Yeast infections – any of the OTC medicines are safe during pregnancy. Diflucan is technically safe during pregnancy.
Sore throat – any kind of lozenges is safe in pregnancy.
What is not safe to take during pregnancy?
Diet medications – are not safe during pregnancy. Dieting during pregnancy is also strongly discouraged as fetal growth can be affected.
Vitamin A (Oral) – used to treat severe acne, oral vitamin A (Roaccutane, Acnotin) is strictly contraindicated during pregnancy due to the high risk of fetal teratogenicity.
Antibiotics – Certain antibiotics such as tetracycline is contraindicated during pregnancy due to possible effects on dentition in the child.
Pain killers belonging to the Non-steroidal anti-inflammatory drug group – these should be avoided during pregnancy.
Herbal remedies – some herbs can have harmful effects to the fetus. There is lack of data on herb usage during pregnancy. A check with the herbalist / Chinese physician is advised before consuming herbs.
In what conditions will the pregnant woman need to take medications?
Medications can be required when one has common ailments like respiratory tract, urinary tract infections and gastrointestinal illnesses (diarrhoea).
There are also medical conditions that are risky enough to the mother and child to require treatment. Some of these conditions include epilepsy, pneumonia, asthma and high blood pressure.
By Dr Ben Choey
Specialist in Obstetrics and Gynaecology
Practice Address:
SBCC Women’s Clinic (Clementi)
Blk 443 Clementi Ave 3 #01-53 Singapore 120443
Tel: 6774 1654
