WebMD Ask the Pharmacist

Safe Drugs During Pregnancy: Ask the Pharmacist

Pharmacists Kristen Binaso, RPh, and Macary Marciniak, PharmD, BCPS, answer your questions about safe medicines you can take during pregnancy.

Question:

The video portion of today's event, "Pregnancy Dos and Don'ts," is an all-new premiere.

Answer:

Part of today's Q&A session is a special replay of a Dec. 8, 2009, event called "Safe Drugs During Pregnancy." The pharmacist for this was Kristen Binaso, RPh. Other questions will be answered by Macary Marciniak, PharmD, BCPS, as usual.

Question:

If you think that you are pregnant and you may have possible gall bladder problems but not sure and your doctor prescribed you Pepcid but at the time of the prescription you had no idea of the pregnancy. Can you still take the Pepcid?

Answer:

Pepcid is OK to take during pregnancy, but it is very important that you advise your doctor or health care provider that you are taking it now that you are pregnant. If you have any additional questions about other medications that are OK to take during pregnancy, talk to your pharmacist, we are happy to help and are the medication experts.

Question:

I was taking PrimaCare One prenatal with my first pregnancy and was able to tolerate them perfectly. Now that I'm pregnant again, I've tried several and can't seem to keep them down. I'm 11 weeks pregnant and concerned that I'm not taking a prenatal. Any suggestions on what to take that my stomach will tolerate?

Answer:

This is usually a challenge for many pregnant women. I would advise this patient to try taking her vitamins at night before bedtime or taking them with a big meal like dinner. It is important that she is on some type of prenatal vitamin because they contain essential items like folic acid that are important to the baby's development. If this still has not worked, talk to your health care provider about other options.

Question:

I was given a prescription medication list that says that Vicodin is safe for me to take during pregnancy and I know I should've checked with my OB before taking them, but I didn't. I've had serious back pain for the past two months and I have been taking 1/2-1 Vicodin for my pain as needed. Is that going to harm my baby? I'm so scared and I don't know why I waited this long to say something but I did. I'm now 26 weeks pregnant.

Answer:

As a pharmacist I have to ask, who prescribed the pain medication and did they know you were pregnant? Many mothers-to-be experience back pain when they are pregnant. Vicodin is a pregnancy Category C drug which means we do not have data necessary to determine if it is OK or not. I would call your doctor immediately and advise him, if he was not the physician who wrote for the Vicodin in the first place. When using a drug like Vicodin, the risks and benefits have to be weighed. If you have any questions about safe medications to use during pregnancy, ask your pharmacist. We are the medication experts.

Question:

Can I use Vicks VapoRub during my pregnancy? I have a cough that won't go away. I'm 38 weeks pregnant.

Answer:

I would ask a few additional questions around the duration and type of the cough and if you have seen a health care provider previously for the cough. We do not have well-controlled studies regarding the use of Vicks VapoRub in pregnancy, so I would recommend speaking to your health care provider before using the product.

Question:

Where can I get a blank drug sheet to list my meds to take to the doctor with me?

Answer:

I was so excited when I saw this question! We are encouraging everyone to use a personal medication record which is a list of all your medications, including over-the-counter, vitamins, and herbals. You should bring this to every health care provider visit and show your pharmacist. You can download a template at www.pharmacist.com/pmr and also at the FDA web site at www.fda.gov/Drugs/ResourcesForYou/ucm079489.htm.

Question:

Can I take Imodium AD while pregnant?

Answer:

It is actually not recommended that you take this product while pregnant unless your health care provider has discussed the risks versus the benefits and absolutely feels that you need it. There are no well-controlled studies completed on its effect in pregnant or breastfeeding women.

Question:

Is it safe to take Valerian when you are pregnant?

Answer:

You should not take Valerian if you are pregnant, plan on getting pregnant, or currently breastfeeding due to the risk of birth defects. If you are not sure if you can take a certain medication, vitamin, or supplement while pregnant, talk to your pharmacist.

Question:

I am nursing my baby. Can I take an over-the-counter allergy med like Claritin?

Answer:

Great question and something that you should always ask your pharmacist because you need to be careful with over-the-counter medications even while you are nursing. Allergy medications like Claritin, Benadryl, and Zyrtec have all been found in breast milk. Because of the higher risk of adverse reactions in infants generally, and for newborns and premature infants in particular, antihistamine therapy is not recommended in nursing mothers.

Question:

My wife is pregnant her doc recommended that she take an omega-3 supplement. Are all omega-3 supplements mercury-free or would you recommend a brand?

Answer:

I would be very careful with this and actually advise you to double check with the doctor and ask why he wants this supplement. Omega-3 is pregnancy Category C which means we do not have enough data available and that the risks versus the benefits must be carefully evaluated. It's better to be safe than sorry.

Question:

Hello, I heard that if I get a flu shot then I will never be able to go without a flu shot for the rest of my life. Is that true?

Answer:

This is actually not true. You have to get your seasonal influenza vaccine each year. The virus changes each year, so manufacturers make a new batch that comes close to what strains of flu the CDC thinks may be present for the season.

Question:

Is there any truth to the eggplant dinner before labor? Is there a pharmaceutical equivalent?

Answer:

There are a number of old wives tales regarding foods to eat to induce labor. Unfortunately, there are no studies in this area to prove the truth to these ideas. A prescription medication called Pitocin (oxytocin) is used in the hospital to start or improve contractions.

Question:

I just found out I am pregnant. I currently take Topamax for my migraine control. Can I continue my medication?

Answer:

Good question. I recommend speaking with your health care provider as soon as possible because Topamax is not recommended for use in pregnant women because it may cause harm to the fetus. Your health care provider needs to re-evaluate your condition and truly talk with you about the risks versus the benefits.

Question:

Are there any sleep aids that a pregnant woman can take?

Answer:

Unfortunately, sleep aids are not recommended for use in pregnant women. There are some "best practices" that you may want to try such as creating a relaxing sleep environment (make sure your bed is comfortable, keep your bedroom at a controlled temperature, minimize light and noise, and remove clocks so they cannot be seen from the bed), establish a regular sleep schedule (basically going to bed and waking up around the same time each day), avoiding naps during the day, establishing a relaxing bedtime routine, and avoid activities such as watching television in bed.

Question:

I am taking Strattera and the generic of Celexa. Is that safe for a pregnancy?

Answer:

I always get questions like this in my practice setting and I am more than happy to assist since pharmacists are the medication experts. They should only be used based on a physician's evaluation and there is a clear understanding of the risks and benefits.

Question:

I am 15 weeks pregnant and I have been sick for almost two weeks, the symptoms I have right now are a sinus infection and a cough, but at the beginning I had a sore throat, sneezing, and runny nose. Is there anything I can take to help this clear up? I have been using a neti pot with saline solution, but it is not working.

Answer:

Due to the fact that you are pregnant, your options are limited. I would also like to ask what you mean by "sinus infection" as a symptom. I would also like to know if you went to a health care provider for further evaluation and if you were given any medications. You can continue to use the neti pot (because that is a saline type of solution and safe for you to use) if you have sinus congestion or stuffiness; however, if your sinuses are draining too much, that could be causing your cough. I would highly recommend talking to your pharmacist and possibly going to see a health care provider for evaluation.

Question:

Should I take Valtrex while I'm pregnant?

Answer:

Valtrex is a pregnancy Category B, which means it can be used during pregnancy but only under physician supervision and only if it is truly needed.

Question:

Is it OK for pregnant women to take fexofenadine HCL if they are having sinus congestion?

Answer:

I would advise speaking with your doctor first. Also, this is used for allergy symptoms like a runny nose, sneezing, and runny eyes, not congestion. It is very important that medicine be used to treat the right symptoms. If you have any questions about use of a medication while pregnant, talk to your pharmacist, we are the medication experts.

Question:

I am eight weeks pregnant and I have a cold. What medicine can I take?

Answer:

There are not many choices when you are pregnant with a cold. As a pharmacist, I would also need to ask you some additional questions about your exact symptoms. You can take acetaminophen for a fever/aches/pain. You can also use a saline nasal spray to help loosen sinus congestion, and try running a vaporizer at night in the bedroom while you sleep. If your symptoms do not get better after a few days or you continue to run a fever, contact your health care provider.

Question:

Is taking methylprednisolone while pregnancy safe? I've read that it can rarely cause birth defects.

Answer:

Methylprednisolone is a pregnancy Category C drug. We do not have adequate human studies to determine what the effects are, so it needs to be a case-by-case decision. You should consult your doctor to discuss the risks versus the benefits of taking this medication.

Question:

I am now 43 and I experienced a TIA shortly after giving birth to my 6th child in Nov 05. I have been on aspirin therapy for many years to thin my blood to prevent any further clots following the TIA. It was recommended not to have any further pregnancies due to the increase in hormone levels and the higher likelihood of clot formation. I am now six weeks pregnant. Should I stop the aspirin therapy? Is it healthy for the developing fetus/placenta growth to be on aspirin? My cholesterol was high at the time of my stroke but it is now much lower and I exercise on a regular basis. I have been very healthy following the stroke and have suffered no lasting effects from it.

Answer:

Thanks for the question. Aspirin is a very risky medication to use during pregnancy -- its use is generally cautioned in the 1st and 2nd trimester (pregnancy category C) and should generally be avoided in the 3rd trimester (pregnancy category D). Given your unique situation, it is absolutely important that you talk to your physician and other health care providers to discuss the risks and benefits of your medications, especially during pregnancy.

Also, I encourage you to use one pharmacy with one medication profile so we can check for interactions and check for medications that should be avoided in pregnancy. You should consider having all of your medications on a personal medication list and show this list to your doctor, health care providers, and pharmacist.

Question:

I am breastfeeding; can I take AZO? I think I might be getting a kidney stone.

Answer:

This is an interesting question since AZO is not used for kidney stones. It is an analgesic used in treating urinary tract infections. I would advise you to contact your doctor or health care provider for further evaluation.

Thank you for joining us for WebMD Ask the Pharmacist. Be sure to come back on Dec. 22 at 1 p.m. ET when we'll be focusing on remedies for stomach aches and digestive problems. Sign up if you'd like an email reminder the day before our next premiere event.