Which Medications Are Safe During Pregnancy?

Pregnancy is a time of major physical changes, and with it comes a need to be extra cautious about what you put into your body.

Taking certain medications during pregnancy can increase the chances of congenital (birth) defects, especially in the first three months of pregnancy (first trimester) when the baby’s organs are forming.

More than 90% of the drugs approved by the FDA from 1980 to 2000 had not been adequately studied regarding their safety during pregnancy. Therefore, pregnant women are typically advised to avoid medications, including prescription and over-the-counter drugs, especially during early pregnancy.

Understanding which medications are safe during pregnancy and which should be avoided can help protect both you and your baby’s health. This guide breaks down pregnancy-safe medications, supplements, and alternatives so you can make informed choices throughout your pregnancy.

What Are the Safest Medicines During Pregnancy?

There are several categories of medications that are considered safe during pregnancy and are must-haves for OTC relief of common symptoms during pregnancy. Examples include:

Fever and pain relief: Tylenol (acetaminophen)
Nausea: Vitamin B6 (pyridoxine), Unisom (doxylamine), or Emetrol (fructose/dextrose/phosphoric acid)
- There is limited evidence regarding the effectiveness of pyridoxine and doxylamine combined compared to pyridoxine alone. However, a 2010 study indicates that the combination therapy is more effective than a placebo (an inactive substance or "sugar" pill).
Heartburn: Gaviscon, Maalox, Mylanta, and Tums
Skin rash: Benadryl (diphenhydramine) or hydrocortisone cream
Cough and cold: Robitussin (dextromethorphan) and Robitussin DM (dextromethorphan/guaifenesin)
Allergies: Benadryl (diphenhydramine), Zyrtec (cetirizine), Allegra (fexofenadine), and Claritin (loratadine)
Nasal congestion (stuffy nose): Nasal sprays like Nasalcrom (cromolyn), Rhinocort (budesonide/beclomethasone), Flonase (fluticasone), and Afrin (oxymetazoline)
- Afrin can be used during all three trimesters of pregnancy; however, your provider will likely suggest trying alternatives such as Nasalcrom (cromolyn) or corticosteroid nasal sprays, like Rhinocort and Flonase, first. If these initial options are not effective, then Afrin may be an option to try.
Constipation: Citrucel, Metamucil, Colace, and Milk of Magnesia
Hemorrhoids: Anusol
Vaginal yeast infections: Monistat and Lotrimin AF

It is essential to use the lowest effective dose for the shortest period of time and to consult your obstetrician before taking any over-the-counter medications. Additionally, reach out to your doctor if your symptoms do not improve or worsen after a few days.

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Safe Over-the-Counter Medications During Pregnancy

Fever and Pain Reliever

Acetaminophen (Tylenol) is the most common pain reliever that doctors recommend for pregnant women to relieve minor aches, pain, fever, and common cold symptoms.

However, although it is one of the pregnancy-safe medications, you should steer clear of acetaminophen if you’re allergic to it, if you have liver problems, or if your healthcare provider says it’s not safe for you. Talk to your healthcare provider to learn about the safe use of Tylenol.

Tylenol and Pregnancy: Recent Updates

Acetaminophen (Tylenol) is widely recommended by healthcare providers for relieving mild pain, fever, or cold symptoms during pregnancy. It is generally considered safe when used at recommended doses and for short periods.

However, some studies have suggested a possible link between prolonged or high-dose acetaminophen use during pregnancy and an increased risk of neurodevelopmental issues, including autism, in children. It’s important to note:

Most research shows the risk is associated with long-term, frequent, or high-dose use.
Occasional use at recommended doses is still considered safe for most pregnant people.
Experts emphasize weighing the benefits of pain relief against potential risks.

In September 2025, the U.S. Food and Drug Administration announced the latest recommendations regarding acetaminophen and pregnancy, which include:

Use acetaminophen at the lowest effective dose for the shortest necessary duration.
Avoid combining multiple products that contain acetaminophen to prevent accidental overdose.
Always consult your healthcare provider before using acetaminophen regularly or in higher-than-recommended doses.

In fact, the American College of Obstetricians and Gynecologists (ACOG) reaffirms that acetaminophen (Tylenol) remains the medication of choice for fever and pain relief during pregnancy.

In a statement from September 2025, the ACOG confirmed that Tylenol (acetaminophen) is safe and plays a crucial role in the well-being of pregnant women.

Digestive Aids and Anti-Nausea Medications

Nausea and morning sickness are common symptoms of pregnancy. Some safe over-the-counter options for nausea relief during pregnancy include:

Pyridoxine (vitamin B6) used alone or in combination with doxylamine
Diclegis (pyridoxine/doxylamine)
Emetrol
Acupressure wrist bands (Sea-Bands)
Ginger (tea, oral capsule form, or ginger ale)

In addition to these medications, small, frequent meals are also recommended to reduce the uncomfortable side effects of pregnancy.

Heartburn Medications

To safely alleviate heartburn or acid reflux during pregnancy, the following options are available:

Gaviscon
Maalox
Mylanta Gas
Riopan
Titralac
Tums

Rash Treatments

Rashes are not uncommon during pregnancy. The following over-the-counter medications are recommended for pregnant patients:

Benadryl cream
Caladryl lotion or cream
Hydrocortisone cream or ointment

An oatmeal bath is also safe and effective in treating rashes.

Cough and Cold Medicine

Over-the-counter cough and cold medicines listed below are safe to take during pregnancy:

Guaifenesin (Robitussin)
Guaifenesin plus dextromethorphan (Robitussin-DM)
Cough drops
Vicks VapoRub
Acetaminophen

Allergy Relief Medications

These over-the-counter antihistamine medications are acceptable to take during pregnancy:

Diphenhydramine (Benadryl)
Cetirizine (Zyrtec)
Chlorpheniramine (Chlor-Trimeton, Efidac, Teldrin)
Doxylamine fexofenadine (Allegra)
Loratadine (Alavert, Allegra, Claritin, Loradamed, Tavist ND Allergy)
Nasal spray oxymetazoline (Afrin, Neo-Synephrine)—Should only be used for 3 days.
Steroid nasal spray (Flonase, Nasacort, Rhinocort)

Constipation Relief

The following over-the-counter remedies for constipation are considered safe to take during pregnancy:

Citrucel
Colace
Fiberall/FiberCon
Metamucil
Milk of Magnesia
Senokot

These stool softeners and fiber supplements are effective at relieving constipation without major side effects.

Gas Relief

Anti-gas medicine containing simethicone can also be used during pregnancy, such as Mylanta Gas, Gas-X, and Maalox Anti-Gas.

Supplements Considered Safe During Pregnancy

It’s important to know which supplements and vitamins are safe to take during pregnancy to ensure you are getting the right nutrients for a healthy pregnancy. The following are considered safe:

Prenatal vitamins
Iron
Folate
Vitamin D
Magnesium
Ginger
Fish oil
Probiotics
Choline

Note that folic acid is important before and during the first few weeks of pregnancy. However, you should limit to 1,000 mcg of folic acid daily, unless instructed otherwise by your healthcare provider.

Prescription Drugs Safe for Pregnancy

Anxiety and Depression Medications

Antidepressants that are safe meds for pregnancy include:

Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft), escitalopram (Lexapro), citalopram (Celexa), and fluoxetine (Prozac) can be used to treat anxiety and depression during pregnancy.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor XR) and duloxetine (Cymbalta) are also pregnancy-safe medications.
Bupropion (Wellbutrin SR) is another option for pregnant people with depression and anxiety who have not responded to other antidepressant drugs. However, it has been linked to a small risk of birth defects and miscarriage.
Tricyclic antidepressants (TCAs) such as amitriptyline and nortriptyline (Pamelor) are an option if other antidepressants don’t work.

Antibiotics

Healthcare providers may prescribe antibiotics such as:

Medications for Chronic Conditions

Many pregnant people with chronic health conditions need to take prescription medications. It’s important to work with your primary care provider and OB/GYN to manage chronic health conditions such as high blood pressure, diabetes, asthma, autoimmune diseases, epilepsy, HIV, and mental health conditions and their treatments before, during, and after pregnancy.

Medications and Substances to Avoid During Pregnancy

Over-the-Counter Drugs to Avoid

Common nonprescription medications that you should not take during pregnancy are:

NSAIDs such as aspirin (Anacin, Bayer) and ibuprofen (Advil, Motrin).
Decongestants such as pseudoephedrine and phenylephrine (Sudafed, DayQuil, Claritin-D), especially during the first trimester.

Prescription Drugs to Avoid

Other medications may be linked to serious birth defects and should be avoided, including:

Prescription medications for pain relief, such as opiate pain medication.
Benzodiazepines such as Klonopin®, Xanax®, Valium®
Chloramphenicol (an antibiotic used to treat bacterial infections) can potentially cause congenital effects, including “grey baby syndrome,” when used later in the pregnancy.
Certain antidepressants, such as paroxetine (Paxil) and clomipramine (Anafranil), have been linked to an increased risk of birth defects and are not recommended during pregnancy.
ACE inhibitors (angiotensin-converting enzyme inhibitors) such as lisinopril, benazepril, and quinapril are blood pressure medications that are likely to cause birth defects. Tell your doctor immediately if you become pregnant while taking an ACE inhibitor.
Isotretinoin (Accutane) for nodular or cystic acne is linked to an increased risk of miscarriage and birth defects.
Valproic acid, prescribed for epilepsy, migraines, and bipolar disorder, can cause birth defects.
Methotrexate, prescribed for rheumatoid arthritis and psoriasis, can increase the risk of miscarriage and birth defects.
Alcohol, tobacco, and recreational drugs can lead to premature birth, birth defects, and developmental problems later on in the child’s life.

Remember to always consult your doctor before stopping or starting any medication— both prescription and over-the-counter medicines.

Natural Remedies to Avoid

Avoid the following dietary supplements and herbs if you are pregnant:

Arbor vitae
Blue cohosh
Black cohosh
Beth root
Chaste tree berry
Cascara
Cinchona
Chinese angelica (dong quai)
Cotton root bark
Feverfew
Goldenseal
Ginseng
Juniper
Meadow saffron
Kava kava
Licorice
Poke root
Pennyroyal
Sage
Rue
Senna
Saint John’s wort
White peony
Tansy
Wormwood
Yellow dock
Yarrow

Also, avoid aromatherapy oils, such as:

Mugwort
Calamus
Pennyroyal
Wintergreen
Sage
Hyssop
Thyme
Basil
Marjoram
Myrrh

Safer Natural Remedies and Therapies

Alternative therapies that are pregnancy safe include:

Meditation and relaxation techniques such as progressive muscle relaxation and Lamaze (patterned breathing)
Psychotherapy, hypnosis, and emotional support
Acupressure and acupuncture
Aromatherapy (avoid certain essential oils, see above)
Massage
Chiropractic manipulations

Taking prenatal vitamins and supplements can cover gaps in certain nutrients like folic acid and iron to protect both mother and baby.

General Tips for Medication Use During Pregnancy

Consult with Healthcare Professionals

Never take any prescription drug, nonprescription medication, dietary supplement, or herbal remedy without checking with your healthcare provider. Other precautions for medication safety during pregnancy include:

Inform all your doctors that you're expecting.
Discuss prescription medications for chronic health conditions with your doctor and whether they are pregnancy-safe medications.
Make sure you understand how to take prescribed medicines (with or without food, at what time of day, etc.).

Read Medicine Labels Carefully

To safely take medications during pregnancy, always check the label and confirm it’s the right medicine, avoid taking multiple medications that contain the same active ingredient, and read the patient information sheet to understand the medicine’s correct use and side effects.

Keeping a Medication Diary and Other Tips

Make a list of all your prescription medications and other medicines. Take the list to all healthcare appointments and prenatal care visits.
Take medications as directed. Don't change the dose, skip doses, or stop treatment without consulting your healthcare provider.
Don't share medicines. Never use someone else’s medicine or give your medicines to others.

Frequently Asked Questions

How safe is Tylenol (acetaminophen) during pregnancy?

Tylenol is generally considered safe for short-term use at recommended doses during pregnancy. Recent studies have suggested a potential link between long-term or high-dose use and neurodevelopmental risks, including autism.

Recommendations for use include using the lowest effective dose for the shortest necessary time, avoiding taking multiple medications that contain acetaminophen, and consulting your healthcare provider before regular or higher-dose use.

When used responsibly, Tylenol remains the most commonly recommended pain reliever for pregnant people.

Is Omeprazole Safe In Pregnancy?

Omeprazole is safe to take during pregnancy to treat gastroesophageal reflux disease (GERD) and other health conditions associated with excessive stomach acid.