Keep This List of Pregnancy-Safe Medications on Hand
Getting sick or sore during pregnancy raises a stressful question: is it safe to take anything for it? The reassuring news is that many common medications are considered safe in pregnancy — and you rarely have to choose between your own comfort and your baby’s well-being. The key is knowing which medications fall into which category, and checking with your provider before you start or stop anything.
This guide walks through what’s generally considered safe, what to avoid, and the situations that call for a conversation with your OB-GYN or midwife. It’s meant to inform that conversation, not replace it.
What You Need to Know
Several over-the-counter medications are considered safe during pregnancy — such as acetaminophen (Tylenol) for pain and fever, second-generation antihistamines like Zyrtec and Claritin for allergies, and vitamin B6 or ginger for nausea. However, others, like NSAIDs such as ibuprofen (Advil) and naproxen (Aleve), are best avoided. Similarly, you should avoid aspirin unless your provider specifically prescribes it. The most important rule is to never start or stop a medication on your own, especially those for chronic conditions or mental health, since abruptly quitting can sometimes pose a greater risk than continuing. If you have a fever, seek medical attention, and when in doubt about any medication or symptom, a quick conversation with your provider is always the safest next step.
How We Assess Medication Safety in Pregnancy
You’ve probably seen some conflicting information about pregnancy-safe medications online, which can be frustrating. But there’s a reason for that; It’s challenging to find high-quality research on the safety of medications in pregnancy because pregnant people are often excluded from drug trials. As a result, much of what’s known comes from observational studies rather than randomized trials — which is why guidance may evolve and change.
As you’re researching, keep two things in mind: Correlation isn’t causation: a condition that appears after someone takes a medication doesn’t necessarily mean the drug caused it. Rely on evidence-based guidance from organizations like the American College of Obstetricians and Gynecologists (ACOG), the FDA, and the CDC —not hearsay or social media.
Second, timing matters. The first trimester, when the baby’s organs are forming (roughly weeks two through eight after conception), and the third trimester are the most sensitive windows for medication exposure. Some drugs that are fine mid-pregnancy should be avoided at either end.
One consistent piece of advice: Use the smallest effective dose for the shortest time necessary, and try non-medication approaches first for mild symptoms.
Safe, avoid, or ask: a quick overview
Most medications fall into one of three buckets:
- Generally safe when used as directed: Acetaminophen (Tylenol), most prenatal vitamins, many antihistamines, and common antacids.
- Generally avoid: Ibuprofen and other NSAIDs (Advil, Motrin, Aleve), aspirin unless specifically prescribed, and nighttime “PM” cold formulas containing alcohol.
- Use only with provider guidance: Prescription pain medications, muscle relaxants, and many drugs for chronic conditions.
We’ve provided the list below that you can easily check when you’re out shopping, as well as sections that break this down symptom by symptom.
Safe Over-the-Counter Medications For Pregnancy
Talk to your doctor about any medications you take, prescription or over-the-counter. Do not take Aspirin unless directed by your provider. Do not take anti-inflammatory medications such as Advil, Ibuprofen, Aleve, or similar products without your Provider’s instructions.
Remember: This is a general list meant to serve as a guide, NOT medical advice. Always speak with your healthcare provider before starting or stopping any medication during pregnancy.
| Condition | Medication |
| Acne | Benzoyl Peroxide |
| Avoid Accutane®, Retin-A®, Tetracycline, Minocycline, Salicylic Acid | |
| Anemia | Speak with your provider about medications for anemia |
| Allergies | Allegra® |
| Benadryl® | |
| Claritin | |
| Flonase nasal spray | |
| Coricidin D | |
| Flonase/Nasonex/Rhinocort | |
| Zyrtec | |
| Cold/Congestion | Tylenol Cold &Flu |
| Robitussin | |
| Mucinex | |
| Cough lozenges | |
| Netti pot | |
| Claritin | |
| Zyrtec | |
| Chlor-Trimeton allergy tablets | |
| Afrin Nasal spray | |
| Ocean nasal mist or saline | |
| Sudafed-check with provider | |
| Vicks Formula 44 | |
| Benadryl | |
| Cough | Robitussin |
| Guafenesin | |
| Vicks Vapo Rub | |
| Mucinex | |
| Cough drops | |
| Do not take medications that contain alcohol | |
| Constipation | Citrucel Fiber |
| Metamucil | |
| Fibercon | |
| Konsyl | |
| Natural Calm | |
| Colace (stool softener) | |
| Dulcolax (laxative) | |
| Milk of Magnesia | |
| Miralax | |
| Fleet saline enema-check with provider | |
| Senakot | |
| Gas | Phazyme |
| Simethicone | |
| Diarrhea | Immodium AD |
| BRAT diet (bananas, rice, applesauce, toast) | |
| Kaopectate | |
| Fever | Tylenol (Acetaminophen) |
| Flu | Theraflu |
| Head Lice | Nix |
| Rid | |
| Do not use Kwell | |
| Heartburn or indigestion | Tums |
| Rolaids | |
| Mylanta | |
| Pepcid Complete | |
| Maalox | |
| Prilosec OTC | |
| Tagament | |
| Protonix | |
| Prevacid | |
| Gaviscon | |
| Zantac | |
| Do not take Pepto-Bismol | |
| Hemorrhoids | Preparation H |
| Anusol | |
| Tucks Pads | |
| Nausea/Vomiting | Unisom +B6 |
| Emetrol | |
| Ginger (tea, capsule, crystallized candied or lollipops) | |
| Peppermint Tea | |
| Hard candies | |
| Lemonade | |
| Saltines | |
| Sea Bands bracelets | |
| Vitamin B6 | |
| Pain/Muscle aches/Headache | Tylenol (Regular, extra strength, PM, or with codeine) |
| Extra Strength Tylenol | |
| Small amount of caffeine | |
| Rash/Burn | Hydrocortisone cream or ointment |
| Caladryl cream or lotion | |
| Benadryl cream | |
| Aloe | |
| Aveeno Oatmeal bath | |
| Eucerin Cream | |
| Sunscreen | |
| Sleep Aids | Unisom |
| Tylenol PM | |
| Benadryl | |
| Sore Throat | Cepacol |
| Cepastat | |
| Salt water gargle | |
| Throat lozenges | |
| Tooth Pain | Oragel |
| Yeast Infections | Monistat 7 |
| Clotrimazole 7 | |
| Gyne-Lotrimin |
Safe Medications by Symptom
If you’re dealing with a specific symptom, we recommend focusing on remedying that symptom. Prior to taking anything, always confirm with your provider, and watch out for multi-symptom combination products — a single “cold and flu” product might contain an unsafe ingredient alongside others.
Pain, fever, and headache
Generally safe: Acetaminophen (Tylenol) is the first-line choice for pain and fever, used at the lowest effective dose for the shortest time (see the dedicated section below). For migraines specifically, caffeine in limited amounts (keeping total daily caffeine under about 200 mg) and magnesium supplementation are sometimes used under guidance.
Best to avoid: Ibuprofen (Advil, Motrin), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs (NSAIDs), which have been linked to fetal heart and kidney issues — particularly in the first trimester and after 20 weeks. Avoid aspirin as well, unless your provider has prescribed low-dose aspirin for a specific reason.
Colds, flu, and congestion
Generally safe: Guaifenesin (the expectorant in Mucinex) for chest congestion, cough suppressant dextromethorphan (often shortened to “DM” on medicine packages), and saline nasal spray or a Neti pot for congestion. Pseudoephedrine (Sudafed) is generally considered safe after the first trimester, but should be avoided if you have high blood pressure.
Avoid: Phenylephrine, which may not be safe in early pregnancy, and any multi-symptom product that sneaks in an NSAID or alcohol. If you suspect flu or COVID-19, call your provider — prompt treatment can shorten the illness, and fever itself needs attention.
Allergies and asthma
Generally safe: Second-generation antihistamines like cetirizine (Zyrtec) and loratadine (Claritin) are preferred, but diphenhydramine (Benadryl) is also acceptable. Nasal steroid sprays such as fluticasone (Flonase) are safe, as are standard asthma inhalers — including steroid inhalers and albuterol. Managing asthma well during pregnancy protects both you and your baby.
Nausea and vomiting
Generally safe: There’s evidence that vitamin B6 (pyridoxine) is an effective treatment, often paired with doxylamine (the ingredient in Unisom). You can also try ginger (in the form of chews, capsules or tea) for natural morning sickness relief, especially in the first trimester. Dimenhydrinate (Dramamine) can help with motion-related nausea. If you have severe vomiting or can’t keep fluids down, call your provider.
Heartburn and indigestion
Generally safe: Start with calcium carbonate (Tums, Rolaids). If that isn’t enough, famotidine (Pepcid) and, under guidance, proton pump inhibitors like omeprazole (Prilosec) are options. Simethicone (Gas-X) helps with gas.
Avoid: Bismuth subsalicylate (Pepto-Bismol), which contains an aspirin-like ingredient.
Constipation and hemorrhoids
Generally safe: Fiber supplements (Metamucil, Citrucel), the stool softener docusate (Colace), and the gentle osmotic laxative polyethylene glycol (Miralax). For hemorrhoids, witch hazel pads (Tucks), topical hydrocortisone, and Preparation H are generally acceptable. Loperamide (Imodium) may be used for diarrhea that lasts more than a day. Increasing water, fiber, and light activity helps first.
Skin issues and acne
Generally safe: For acne, topical benzoyl peroxide and azelaic acid are considered acceptable. Hydrocortisone cream, calamine lotion, and oatmeal baths (Aveeno) soothe rashes and itching.
Avoid: Topical retinoids such as adapalene (Differin) and oral retinoids, which can be harmful.
Yeast infections
Generally safe: Topical antifungals like miconazole (Monistat) and clotrimazole creams or suppositories. Confirm the diagnosis with your provider before treating.
Sleep
Generally safe: Antihistamines diphenhydramine (Benadryl) and doxylamine (Unisom) are acceptable for occasional use. Good sleep hygiene comes first, and melatonin lacks enough pregnancy data to recommend over antihistamines.
Fevers Are a Different Matter
Fevers are usually not dangerous, but a high fever in pregnancy, especially in the first trimester, may pose problems and has been associated with neural tube defects and other complications, which is why controlling a fever matters more than waiting it out.
If you’re pregnant and running a fever:
- Take acetaminophen (Tylenol) as directed to bring it down.
- Call your provider if the fever doesn’t improve within 48–72 hours, or if it climbs toward 104°F.
- Skip the ice bath — it isn’t an effective way to lower core temperature and can be counterproductive.
The acetaminophen (Tylenol) question, explained
Research and evidence change over time, which may lead to confusing information. In the case of acetaminophen (Tylenol), you may have seen conflicting information from trusted organizations.
In September 2025, the FDA published an opinion about acetaminophen labeling, citing studies that have associated its use in pregnancy with neurodevelopmental disorders. Around the same time, ACOG reaffirmed its position that moderate acetaminophen use is safe and beneficial in pregnancy, pointing to a large cohort study that found no causal link to autism, ADHD, or intellectual disability — and to the fact that there’s no equally safe alternative for pain and fever.
Where does that leave you? The practical, widely shared guidance is that when used thoughtfully, under the care of a healthcare professional, acetaminophen remains the first-line option for pain and fever in pregnancy.
Continuing Medications for Chronic Conditions
For ongoing health conditions, the theme is continuity of care with the right medications — not stopping.
Mental health
Untreated depression, anxiety, and other conditions carry real risks in pregnancy and postpartum, and stopping medication suddenly can be riskier than continuing. Several SSRIs, such as sertraline (Zoloft) and escitalopram (Lexapro), are generally considered relatively safe, and bupropion (Wellbutrin) is also commonly continued.
Other medications, such as paroxetine (Paxil), fluoxetine (Prozac), and mood stabilizers such as lithium, may be less well tolerated, so if you are currently managing a condition with one of those, speak with your provider. Pregnancy doesn’t automatically mean you have to cease your treatment; you’ll just need to work with your provider to find a pregnancy-safe plan that works for you.
Asthma
Standard inhalers, including steroid inhalers and nasal sprays like Flonase, are considered safe. Keeping asthma controlled protects your baby’s oxygen supply.
Diabetes
Insulin is considered very safe in pregnancy and is the mainstay of blood-sugar control for people with diabetes.
High blood pressure and heart conditions
Medications such as labetalol and nifedipine are commonly used and considered safe. ACE inhibitors and ARBs, however, should be avoided in pregnancy — another reason not to simply continue a pre-pregnancy regimen without review.
When a pregnancy is medically complex, maternal-fetal medicine (MFM) specialists work alongside your OB to fine-tune care.
Vaccines During Pregnancy
A common misconception is that pregnant women should avoid vaccines or that they pose a heightened risk. However, that’s not true; in fact, several are recommended because they protect both you and your baby: COVID-19, influenza (flu), Tdap, and RSV vaccines are all considered safe and encouraged as part of routine prenatal care.
Vitamins, Supplements, and Herbal Products
We recommend starting a prenatal vitamin with folic acid as early as possible in your pregnancy, as it lowers the risk of neural tube defects. Some people (for example, those with a history of seizures) may need a higher folic acid dose, which will depend on guidance from their clinician.
However, supplements don’t automatically mean it’s good for you. Here are a few precautions to consider:
- Not everyone needs iron: Take it only when lab testing confirms anemia or iron deficiency.
- More isn’t better: Avoid vitamin megadoses; high-dose vitamin A, in particular, is known to be harmful, and too much vitamin D or K can cause problems.
- Herbal ≠ safe: Herbal supplements are poorly studied in pregnancy, and some carry real risks (for example, you should avoid raspberry leaf and valerian). Ginger is a well-supported exception for nausea. Don’t take herbal products unless your provider confirms they’re appropriate.
Aspirin and Preeclampsia
While NSAIDs and aspirin are generally off the table, there’s an important exception. For people at increased risk of preeclampsia, ACOG and the U.S. Preventive Services Task Force recommend low-dose aspirin (81 mg daily), although low dose aspirin can be started up to 28 weeks, ideally, it should be started between 12 and 16 weeks and continued until delivery. This is a deliberate, prescribed use backed by strong clinical evidence— not the same as reaching for aspirin as a pain reliever. As with all medications, your provider will work with you and your situation.
When to Call a Doctor
Reach out to your OB-GYN or midwife if:
- You have a fever that climbs toward 104°F or doesn’t improve within 48–72 hours
- Symptoms are severe, or aren’t improving with the safe options above
- You’re unsure whether a medication — prescription or OTC — is safe for you
- You’re considering stopping any regular medication
Frequently asked questions
Is Tylenol safe during pregnancy?
Acetaminophen (Tylenol) is considered the first-line option for pain and fever, used at the lowest effective dose for the shortest time and with provider input — especially for frequent or prolonged use. Major obstetric guidance continues to support prudent use.
Can I take ibuprofen or Advil while pregnant?
Generally no. Ibuprofen and other NSAIDs are usually avoided in pregnancy, particularly in the first trimester and after 20 weeks, unless specifically directed by your provider.
What can I take for a cold while pregnant?
Guaifenesin, dextromethorphan, saline sprays, and acetaminophen for aches are generally considered safe. Pseudoephedrine (Sudafed) is usually fine after the first trimester if your blood pressure is normal. Avoid multi-symptom products with NSAIDs or alcohol.
What helps nausea in pregnancy?
Vitamin B6, doxylamine (Unisom), and ginger are common, well-supported options. Call your provider if you can’t keep fluids down.
Are allergy medications safe during pregnancy?
Second-generation antihistamines like cetirizine (Zyrtec) and loratadine (Claritin) are preferred, and nasal steroids like Flonase are considered safe.
Can I keep taking my antidepressant while pregnant?
Often yes — and stopping suddenly can be riskier than continuing. Don’t stop on your own; make a plan with your provider and prescriber.
What if I took something before I knew I was pregnant?
Many everyday medications are unlikely to cause harm, and a single exposure before you knew is rarely cause for panic. If you became pregnant while on birth control, or took emergency contraception (Plan B) before realizing you were pregnant, these do not cause congenital disabilities. Tell your provider about any medications so they can guide you properly.
The Bottom Line
Pregnancy doesn’t mean toughing out every headache, cold, or flare-up on your own — many medications are safe when used thoughtfully, and the ones to avoid have clear, well-established alternatives. The guiding principle is simple: use the least you need for the shortest time, lean on trusted sources like over alarming headlines, and never start or stop a medication without first talking to your provider.
When in doubt, your Women’s Health Connecticut care team is always available to answer questions, so you don’t have to worry alone.
Expecting, or planning to be? Request an appointment with your Women’s Health Connecticut provider today — we’ll help you build a medication plan that keeps both you and your baby healthy at every stage of your pregnancy.