Pain Relievers

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Question

Are there any over-the-counter pain relievers that are safe to take during pregnancy?

Answer

There are some over-the-counter pain relievers you can take during pregnancy, and you can find them based on the FDA category. The over-the-counter pain reliever of choice during pregnancy is acetaminophen (Tylenol®) (category B). It does transfer from the mother to the fetus. However, it does not seem to harm the fetus in animal studies, but there have not been any human studies done. It has been the pain reliever of choice based on the wide use by pregnant women and the lack of adverse events.

Over-the-Counter pain relievers to avoid during pregnancy

The over-the-counter pain reliever to avoid the entire pregnancy is aspirin (category D) and any drug with aspirin in it since it may cause harm to the fetus. It should only be used in pregnancy under the direct supervision of a physician. There is a class of drugs whose risk in pregnancy depends what trimester you are in. The class is called nonsteroidal anti-inflammatory drugs (NSAIDs) which over-the-counter includes ibuprofen (Motrin®, Advil®) and naproxen (Aleve®). With these drugs, it is category B in the first and second trimesters, but category D in the third trimester. It should be used with caution and avoided in the third trimester. Use of NSAIDs in the third trimester has been associated with harm to the baby. Although these adverse effects are from a study with the NSAID indomethacin, it is still thought to be applicable to the rest of the class because of the potential for adverse effects.

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