General Medicine

General Medicine

Most women take some kind of drug, substance or medication during pregnancy, sometimes without realising the potential for harm. Sometimes people find it hard to stop because of their past life experiences and social stress. Drugs or medication taken by the mother may cross the placenta and impact on the developing fetus. The possible effects may include infant withdrawal from substances, developmental delay, intellectual disability, birth defects, miscarriage and stillbirth.

Doctors usually tell women to avoid medicines during pregnancy, if possible, especially during the first 3 months. That is when a baby's organs form. But sometimes you have to take medicine to treat a health problem, such as high blood pressure or asthma.

You should always give your doctor, midwife and pharmacist a full list of all the medications you take, or have recently taken, including:

• prescription medicines
• over-the-counter medicines
• nutrition supplements (such as vitamins)
• complementary therapies (such as herbal medicine).

You should also tell your doctor or midwife if you smoke, drink alcohol or take illegal drugs, even if you only take them occasionally or socially.

So first your doctor or midwife will look at the risk. Is the risk of taking a medicine higher than the risk of not treating your illness? If you or your baby would face worse problems without treatment, then your doctor or midwife will prescribe medicine or recommend an over-the-counter one. He or she will also look at which medicine to give you. For example, some antibiotics are safe for pregnant women. And some are not.

What medicines can you take during pregnancy?

It can be hard to know if a medicine is safe for your baby. Most medicines are not studied in pregnant women. That's because researchers worry about how the medicines might affect the baby. But some medicines have been taken for so long by so many women that doctors have a good idea of how safe they are.

In general, doctors say it is usually safe to take:

1. Acetaminophen (such as Tylenol) for fever and pain.
2. Penicillin and some other antibiotics.
3. HIV medicines.
4. Some allergy medicines, including loratadine (such as Alavert and Claritin) and diphenhydramine (such as Benadryl).
5. Some over-the-counter cold medicines.
6. Some medicines for high blood pressure.
7. Most asthma medicines.
8. Some medicines for depression.

If you are planning a pregnancy, talk to your doctor or midwife about any medicines you take, even over-the-counter ones. Some of them may be safe to take while you're pregnant. But others may not be safe. Your doctor or midwife may have you stop taking a medicine or may switch you to another one. Some medicines that aren't safe in the first trimester may be safe to use later in the pregnancy.

What medicines should you avoid during pregnancy?

Some medicines are known to increase the chance of birth defects or other problems. But sometimes there's more risk for the mother and her baby if she stops taking a medicine (such as one that controls seizures) than if she keeps taking it. Talk to your doctor or midwife about any medicines you take if you are thinking about having a baby or if you are pregnant.

Some of the medicines that increase the chances of birth defects are:

1. The acne medicine isotretinoin (such as Amnesteem and Claravis). This medicine is very likely to cause birth defects. It should not be taken by women who are pregnant or who may become pregnant.
2. ACE inhibitors, such as benazepril and lisinopril. They lower blood pressure.
3. Some medicines to control seizures, such as valproic acid.
4. Some antibiotics, such as doxycycline and tetracycline.
5. Methotrexate. It is sometimes used to treat arthritis.
6. Warfarin (such as Coumadin). It helps prevent blood clots.
7. Lithium. It is used to treat bipolar depression.
8. Alprazolam (such as Xanax), diazepam (such as Valium), and some other medicines used to treat anxiety.
9. Paroxetine (such as Paxil). This medicine is used to treat depression and other conditions.
10. Over-the-counter pain medicines like aspirin and ibuprofen (such as Advil and Motrin) and naproxen (such as Aleve). The risk of birth defects with these medicines is low.

Is it okay to take herbal supplements and vitamins?

Talk to your doctor or midwife about any herbal supplementsthat you take. Don't take any vitamins or herbal or other supplements unless you talk with your doctor or midwife first.

Women who are trying to get pregnant and those who are pregnant should take a multivitamin that has folic acid. Folic acid is most important before and in the first few weeks of pregnancy, because it prevents some birth defects. You can get folic acid in an over-the-counter multivitamin. Or you might get it in a multivitamin that your doctor or midwife prescribes. Talk to your doctor or midwife about which type of vitamin you should take. In some cases, doctors and midwives prescribe extra iron or extra folic acid.

Effects of medication, drugs or substances during pregnancy

Alcohol and other drugs or medication can cause harm by:

• interfering with normal fetal growth and development
• damaging the baby’s organs
• damaging the placenta and putting the baby’s life at risk
• increasing the risk of miscarriage
• bringing on premature labour.

The potential for harm to the pregnancy and unborn baby depends on a range of factors. These include:

• the type of drug or medication taken
• how the drug or medication is taken
• the size of the dose
• how often it is taken
• whether the drug or medication is used alone or in combination with other drugs or medications
• the individual response of the baby to the drug or medication
• the gestational age of the baby
• other factors, such as maternal health and diet.