Intake Of Painkillers In Pregnancy - Safe or Unsafe

How Safe Are Painkillers in Pregnancy?

Medically Reviewed By
Dr. Sabiha Anjum (Gynecologist/Obstetrician)
View more Gynecologist/Obstetrician Our Panel of Experts

You have a terrible headache, and your instincts tell you to reach out for that painkiller during the first sign of pain. While painkillers are relatively safe to use during the first trimester of pregnancy, regular and frequent use may pose a risk to your baby’s well being and development during the coming weeks. Here’s your go-to-guide for painkillers used in pregnancy.

Is It Safe to Take Painkillers During Pregnancy?

Although Paracetamol is relatively safe for use, it must be noted that it’s not safe to take painkillers during pregnancy on a regular basis since chemical compounds from these medications enter the placenta into the baby’s bloodstream. Although it’s not possible to avoid drugs completely for the entire duration of your pregnancy, it is important to keep in mind that you can take painkillers during your pregnancy weeks, provided you don’t overuse or take them too frequently.

Which Painkillers Are Safe for Pregnant Women

Paracetamol is safe to take at any point in time in your pregnancy, but it is advisable only in low doses for brief periods of time. It is the most reliable drug to turn to for relief from fever or pain which is not too intense.

Which Painkillers Are Safe for Pregnant Women

Painkillers to Avoid When Pregnant

Ibuprofen must be avoided during early pregnancy, as it upsets the stomach of some pregnant mothers. Risks associated with cardiovascular health and reduction in amniotic fluids in the placenta are linked to the use of ibuprofen during the third trimester of pregnancy.

Avoid Aspirin and Non-Steroidal Anti-Inflammatory Drugs like Ibuprofen and Naproxen since studies indicate that taking these medications in early pregnancy may lead to miscarriage and congenital disabilities(birth defects).

Here are 10 OTC (Over-The-Counter) drugs to avoid or painkiller harmful during pregnancy. Please note that this is not a complete list and consult with your healthcare provider for more information.

OTC Drug Present In Our Suggestion Other Alternatives
Bismuth Subsalicylate Kaopectate; Pepto Bismol Use with extreme caution before 20 weeks and do not use after 20 weeks Imodium (Loperamide)
Aspirin Bayer; Excedrin Migraine Consult a healthcare provider before use Tylenol (Acetaminophen)
Brompheniramine Dimetapp Cold and Allergy Use with extreme caution before 36 weeks and do not use after 36 weeks Claritin (loratadine);

Zyrtec (cetirizine)

Caffeine Anacin Regular

Strength; Excedrin

Extra Strength;

Excedrin Migraine

Consume below 200mg daily to reduce risk of miscarriage and congenital disabilities, including caffeine from tea, coffee, and other beverage sources N/A
Castor Oil High risk – avoid consumption Alternatives include psyllium-based supplements. Consider increasing physical activity, eat foods rich in fibre, and consume more fluids.
Nicotine Cigarettes and tobacco-based products High-risk – causes fetal abnormalities Quit smoking and avoid ingesting nicotine during pregnancy
chlorpheniramine Found in Chlor-Trimeton and Alka-Seltzer Plus Cold Formula products Use with caution before 36 weeks and avoid using after that Claritin (loratadine);

Zyrtec (cetirizine)

Ibuprofen Advil, Motrin Not recommended during the 1st and 3rd trimesters. Use with caution during the second trimester. Tylenol


Phenylephrine and pseudo-ephedrine Found in products like Alka-Seltzer Plus Day; Sudafed PE Pressure + Pain; Tylenol Cold Multi-symptom; Vicks Dayquil Cold and Flu Relief Not recommended during the 1st trimester. Use with caution during the 2nd and 3rd trimesters. Consume more fluids and use steam treatment for congestion relief. Avoid exposure to nicotine irritants for alleviating symptoms and getting relief.
Naproxen Aleve Not recommended during the first and third trimesters. Use with caution under medical supervision during the second trimester. Tylenol


Stay away from stronger medications or painkiller harmful in pregnancy since they may affect your baby’s development and always seek your doctor’s advice before taking Tramadol, opiate derivatives, and strong anti-inflammatory drugs like Voltarol.

How Do Medicines Affect the Newborn Baby?

Use of potent medication during early pregnancy affects foetal development and results in low birth weights depending on the types of medicines taken. Medicines with harmful effects cross over into the baby’s placenta directly through the bloodstream and stunts baby’s development. Mothers who take Opioids expose their newborn babies to the risk of having a neural tube birth defect.

During the second and third trimesters, mothers who took OTC Pain Relievers regularly such as Acetaminophen were at a greater risk for birthing babies with Attention Deficit Disorder and Behaviour issues. In general, all women face a risk of 3% to 4% of having babies with congenital disabilities despite the use of medications. For those who take over-the-counter drugs or harmful drugs in high doses, social and emotional development get stunted along with birth deformities surfacing during the second and third trimester weeks of pregnancy since the foetus is said to be very sensitive during this stage due to developing cognitive functions and organs.

How Do Medicines Affect the Newborn Baby?

How Are Medicines Judged Safe or Unsafe?

The FDA conducts clinical trials to study the effects of newly created medications and test them to check if they work the way they are intended. These drugs are tested in clinical trials on pregnant animals but not on pregnant women. Nowadays, nursing institutions and pregnant mothers sign up for studies by research companies which collect and maintain data through a national registry. Here’s how you can deem whether a painkiller used in pregnancy is safe or unsafe:

  • Signing up for FDA-approved registries near your area will give you access to information and clinical trials associated with pregnancy medications.
  • In most cases, medicines are judges safe or unsafe for pregnancies based on their history of use and reported side effects.
  • A website by the Department of Health and Human Services details a list of medications used by pregnant mothers and their effects on babies during pregnancies which expecting mothers can go through for more info.
  • According to WebMD, the effects of most medications on your unborn or newborn baby are unknown.
  • Your doctor will assess how certain medications interact with existing medical conditions and ascertain whether or not you need to be prescribed those medications. At the end of the day, profiles of expecting mothers vary based on family history, genetic makeup, and existing medicinal usage and doctors take these into account before providing an assessment on the types of drugs safe or unsafe for pregnant women.
  • You can consult your healthcare provider or doctor to ask regarding safety and risks associated with taking certain drugs and medications during the various trimesters of your pregnancy.
  • Prescription-free prenatal vitamins are safe to take during pregnancies while herbal preparations and over-the-counter medications are unsafe and should be taken under medical supervision or by doctor’s advice.

Here are some general guidelines for taking medications according to the different trimesters in pregnancy.

1. First Trimester

Paracetamol without any added ingredients is safe to take during the early months of pregnancy. Avoid taking Opioids as these are unsafe and increase risks associated with spina bifida and heart defects during the first trimester of pregnancy.

2. Second Trimester

NSAIDs should be avoided during pregnancies since they are linked to miscarriages and congenital disabilities. The use of Tramadol may be safe during the second trimester of pregnancy.

3. Third Trimester

Avoid medications like Ibuprofen during the third trimester since it causes heart problems and results in high blood pressure in the baby’s lungs, thus leading to a reduction in amniotic fluids in the uterus. Avoid Tramadol during this trimester since it causes respiratory problems and newborn withdrawal symptoms.

Remedies for Relieving Pain Instead of Taking Painkillers

  • Take rests and warm baths for sharp pains and cramps related to your abdominal muscles.
  • Arnica gel is used to relieve back pains and joint aches and is also used for treating varicose veins.
  • Prenatal Yoga involves gentle exercises which promote health and wellbeing for expecting mothers. Practice under medical supervision to prevent preterm labour.
  • Sleep in an inclined position to prevent heartburn.

    Remedies for Relieving Pain Instead of Taking Painkillers

  • Avoid stimulating laxatives to prevent inducing preterm labour.
  • For carpal tunnel syndrome, pelvic pain and joint pain, acupuncture is a great way to get relief. Please ensure to receive acupuncture treatment from a certified specialist who has experience treating pregnant women.
  • For long-term back pain relief, Chiropractic care gives excellent results by using hands-on pressure to fix any misalignments in the spine gently. Pregnant mothers have reported tremendous success with this.
  • You may also use Frankincense Essential Oils for alleviating headaches and sore joints. It contains anti-arthritic and anti-inflammatory properties and can be taken directly through the skin or mixed with baths. Please consult with your doctor before ingesting this essential oil.
  • Your doctor may recommend using Acetaminophen for alleviating headaches during pregnancy. Alternatively, you may apply a cold compress for getting relief.
  • For nasal congestion and stuffiness, use a saline nasal spray for relief. Cold poses no risks during pregnancy, and it is advisable to take flu shots to protect both you and your baby from the risk of pneumonia during pregnancy.
  • Ask your partner to give you a gentle massage for relieving aches and pains
  • To ensure deep sleep and prevent insomnia, have some warm milk and take a warm bath (not hot) before bedtime.
  • Wear support hoses for controlling swelling in the legs and ankles.
  • Minimize stress and enjoy your days during the trimesters of your pregnancy. Eat small frequent meals over large meals and eat a diet high in protein and complex carbohydrates.
  • Avoid alcohol, sugary foods and drinks, spicy meals, and junk or processed foods. These may cause haemorrhoids, affect your health, and in turn, cause discomfort.
  • Use heating pads to relieve backaches during pregnancy. Use pregnancy girdles or elastic rings to support your abdomen.
  • Avoid standing for long periods, sleep on a firm mattress, and place a pillow between the legs.
  • Do not lift heavy loads or objects with a lot of weight.
  • Avoid breast discomfort by wearing bras with proper breast support and nursing pads.
  • Maintain a good posture and keep your weight in check to reduce discomfort, fatigue, and signs of breathlessness.
  • You can relieve bladder infections by drinking a couple of glasses of cranberry juice every day.
  • Sleep when fatigued and slowly stand up and get down when changing positions to avoid dizziness and light-headedness.
  • For regular bowel movements and healthy stools, eat a diet rich in fresh fruits and vegetables, whole grains, slices of bread, and cereals. Avoid over-the-counter laxatives and drink plenty of water to regulate digestive and intestinal tract health.

Tips to Remember While Taking Painkillers During Pregnancy

  • Paracetamol is used for treating mild to moderate pains and is safe to take during any trimester of pregnancy. It is unsafe only when taken regularly and in high doses.
  • Do not drive or do tasks that require a lot of focus after taking Codeine since it slows reaction times and induces sleepiness.
  • Alert your doctor regarding the types of medications you are taking and their dosages to keep things on track and ensure the healthy development of your foetus.
  • Check whether you are regularly taking your folic acid tablets during pregnancy and maintain a healthy diet high in protein and complex carbohydrates during pregnancy.
  • It is most dangerous to take medications during the first trimester of your pregnancy since the fetus is developing quickly and very vulnerable. Consult with your healthcare provider or doctor before taking prescription drugs and over-the-counter medications.
  • Consider your family history and check with your doctor to see whether certain pregnancy medications interact with existing medical conditions like diabetes, hypertension, and high blood pressure in your body.
  • Avoid strong medications, prescription painkillers, and NSAIDs.
  • Over-the-counter medications may be detrimental to the development of your baby even though they have been deemed safe in regular clinical trials since these haven’t been tested on pregnant mothers.
  • Check whether the medicine you pick up from your pharmacy is over-the-counter or prescription-based. Make sure to read dosage instructions, warning labels, and for information about medical conditions and pregnancies. Some medications state in their labels when they are safe or unsafe during the different trimesters of pregnancy.
  • Although herbal supplements may be safe to treat pains and aches in pregnancies, some herbs cause harmful side effects to your unborn baby and adversely affect your health during pregnancy. These herbs may react with the medications you take during pregnancy which is why it’s important to consult your doctor before opting for herbal pain relief treatments.
  • If you feel any pain or discomfort after taking a particular medication, despite it being labelled safe for pregnant mothers, you must stop taking it and consult your doctor immediately.

Whether you are trying to conceive or are expecting, it is essential to be aware of common pregnancy painkillers and whether or not you can take them. Even though not taking any painkiller medications is the way to go, we understand that it cannot be avoided entirely due to unbearable pregnancy pains which call for their use. Be aware of the dosages, read warning labels, and always consult with your doctor or healthcare provider before using painkiller medications and even nutritional supplements before and during the three trimesters of your pregnancy.

Disclaimer: All content mentioned in this post, including medical opinions, is meant for informational purposes only and should not be considered solid medical advice or doctor-approved treatment regimes. Please consult with your doctor or healthcare provider for any questions you have regarding your health or any pregnancy problems.

Also Read: Hot Flashes During Pregnancy

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