Is it okay to take it? How to take medicines during early pregnancy [Doctor-supervised]

Summary of this article

Over-the-counter medications are often weaker in ingredients than those prescribed in hospitals, and it is extremely unlikely that they will affect the development of the baby after a short period of use. When you visit a hospital and ask for a prescription, do not forget to tell them that you are pregnant or may become pregnant.

First of all, can I take medicine while pregnant?

Many people are probably nervous about taking medicines during pregnancy. First of all, is it even okay to take medicines during pregnancy?

Cold medicine, headache medicine… what about over-the-counter medicines?

Over-the-counter medicines are easily available at drugstores. They are a reliable source of medicine when you have a slight cold or a headache. Many people keep them on hand as medicine. Over-the-counter medicines tend to have weaker ingredients than those prescribed by hospitals, and it is highly unlikely that taking them for a short period of time will affect the development of the baby. However, just because they are over-the-counter medicines does not mean that you can take them without worrying. When taking a medicine, be sure to read the package insert and properly confirm the precautions to take during pregnancy. When pregnant women are taking the medicine, there are stages ranging from “Do not administer (not allowed)” to “Avoid long-term administration.” If you are unsure of what to do, please follow the instructions of your doctor or pharmacist.

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What medications are prescribed at the hospital?

When visiting a hospital and getting a prescription for medicine, don’t forget to tell them that you are pregnant or that you may be pregnant. In most cases, this will be filled out in advance on a medical questionnaire, but it’s a good idea to ask the doctor about how to take the medicine during the examination. It is unclear how much effect medicines prescribed before you knew you were pregnant will have on your baby. Discard the medicine and get a new prescription, or ask your doctor or pharmacist if it is safe to take the medicine while pregnant.

妊娠初期の薬とのつき合い方

Medicines to be especially careful of

Medicines that are contraindicated for pregnant women include:

  • Warfarin (a blood thinner)
  • Etretinate (medication for treating keratosis)
  • Ribavirin (antiviral drug)
  • Triazolam (psychotropic drug)
  • Ergotamine (migraine drug)
  • Hormones
  • Antibiotics (aminoglycosides, tetracyclines, quinolones)

These drugs are known to have a high teratogenicity (potential to cause birth defects) in the baby. If you have declared your pregnancy, medical institutions will not prescribe them, but you should be especially careful not to take them during pregnancy.

During early pregnancy, you need to be especially careful about taking medicines.

The risk that medications may affect the baby varies depending on the number of weeks of pregnancy. In particular, the early stages of pregnancy (up to 13 weeks and 6 days) are a time when you need to be particularly careful.

Unaffected period/less than 4 weeks

At this stage, the baby’s organs have not yet formed, so the risk of the medication causing birth defects is low. There may be cases where a woman has been taking medication without realizing she was pregnant, but as long as the pregnancy continues, there is no need to worry.
However, care should be taken with medications that have a high residual effect. It is possible that the drug’s ingredients remain in the body and may be taken after the fourth week of pregnancy. Drugs that have long-lasting effects include etretinate (a drug used to treat keratosis), ribavirin (an antiviral drug), and leflunomide (an antirheumatic drug). If there is a possibility that you are pregnant, avoid taking these medications.

Absolute hypersensitive period/weeks 4 to 7

The most careful time to take medication is between the 4th and 7th weeks of pregnancy. During this time, important organs such as the baby’s central nervous system and heart are being developed, making them susceptible to the effects of medication. The
aforementioned highly teratogenic medications should be avoided during pregnancy. If you declare that you may be pregnant, medical institutions will not prescribe them.
Also, while it is rare for over-the-counter medications to cause birth defects, be sure to read the package insert carefully to see if it is okay to take the medication during pregnancy.

Relative sensitivity period/weeks 8 to 15

During the 8th to 15th week of pregnancy, the palate, hands, feet, genitals, etc. are being formed. Although important organs have finished forming, it is still a time when caution is needed. Please continue to refrain from using the above medications.

Potential allergic period/below 16 weeks

Since most of the baby’s body is already formed, there is almost no risk of the medicine causing birth defects. However, since the medicines taken by pregnant women can also enter the baby’s body through the placenta, some medicines are known to cause fetal dysfunction. In particular, nonsteroidal anti-inflammatory drugs (NSAIDs) have the effect of constricting the baby’s ductus arteriosus, so it is generally recommended to avoid taking them.

If you are taking medication due to illness

Consult your doctor as soon as you start thinking about pregnancy

Some people may be taking medication for a long time due to chronic illness or while undergoing medical treatment. If you stop taking the medication on your own judgment, thinking “It may not be good for the baby…”, you may end up making yourself sick and affecting the development of the baby. If you find out you are pregnant, please consult with your doctor about whether you should continue taking the medication or switch to a different medication. Also
, even if you are not yet pregnant, if you are hoping to become pregnant in the near future or think there is a possibility that you may be pregnant, it is a good idea to inform your medical institution as early as possible.

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Taking medicines may affect the results of NIPT (non-invasive prenatal testing)

NIPT (New Prenatal Testing) analyzes DNA fragments of the baby contained in the blood of the pregnant woman to check for chromosomal abnormalities. The test results are usually shown as “positive” or “negative”, but depending on the type of medication you are taking, the result may be “indeterminate”. If you are considering taking NIPT (New Prenatal Testing) , be sure to consult with your doctor before taking the test.

Supplements that you should be careful about taking

Although supplements may seem to have less of an effect than medicines, there are some that require caution. The following supplements may have a negative effect on the development of your baby, so you should be careful when taking them.

Vitamin A supplements

Vitamin A is a nutrient that protects the skin, mucous membranes, and eyes. It is divided into carotenoids derived from plants and retinol derived from animals. Retinol in particular is easily accumulated in the body, and it is known that excessive intake during early pregnancy increases the risk of causing birth defects in babies. For the same reason, many people have heard that “it is better to be careful not to eat too much eel or liver, which contain a lot of animal-derived vitamin A, during pregnancy.” Since supplements are easily available at drugstores and online stores, self-management is important. If you are taking vitamin A supplements on a regular basis, try stopping the supplements and getting nutrients from meals such as green and yellow vegetables.

Isoflavone-containing supplements

Isoflavones have a similar effect to female hormones. Although they are thought to be good for beauty, it is not recommended to take more isoflavones in supplements than necessary during pregnancy. During pregnancy, a woman’s body is already in a state where hormone balance is easily disturbed. If you take too much isoflavone, your hormone balance will be further disturbed and it may affect the baby’s reproductive function. Although it is not clear how much is harmful, the Ministry of Health, Labor and Welfare has set the upper limit of the recommended intake of soy isoflavones at 75 mg/day and the upper limit of additional intake in supplements at 30 mg/day. Be careful not to take too much just because it is good for your body.

妊娠初期の薬とのつき合い方

What if I take the medicine before I know I’m pregnant?

There are also cases where the patient has taken the medicine before realizing that she is pregnant. If the medicine is taken during the early stages of pregnancy, when the effects of the medicine are a concern, it is still worrying.

As mentioned above, there is certainly a period when the medicine is more likely to affect the baby. However, taking over-the-counter medicines several times during early pregnancy will not affect the development of the baby in most cases. Medicines that may cause birth defects are often not prescribed to women of childbearing age, so there is no need to worry too much.

If you have taken medicine before realizing that you are pregnant, first consult a doctor. Be sure to tell your doctor exactly what type of medicine you have taken, the amount, and the period of use, and follow their instructions. Instead of worrying alone or getting excited or upset over information on the Internet, learning the correct information from an expert will help you calm down.

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If you have any concerns about your medicines, consult your doctor or pharmacist

Medication can be a reliable way to improve physical and mental health issues, but it can be hard to know how to use it during pregnancy. Don’t make your own judgments, such as “This much should be fine…” or “I’m not feeling well, but I definitely won’t take medication!” If you have any concerns, consult with your obstetrician-gynecologist, family doctor, or pharmacist.

【References】

Article Editorial Supervisor


Dr. Kunihiko Shiraogawa

Dr. Kunihiko Shiraogawa

Head Doctor of Hiro Clinic NIPT Nagoya
Certified Obstetrician and Gynecologist, Japan Society of Obstetrics and Gynecology

As an obstetrician/gynecologist with nearly 40 years of extensive experience, he has worked with many pregnant women.
Currently, as the head doctor of Hiro Clinic NIPT Nagoya , he is in charge of NIPT testing, and also provides consultations to pregnant women online at all Hiro Clinic NIPT clinics in Japan.

Brief History

1982 – Aichi Medical University Hospital
1987 – OB/GYN, Kagoshima University Hospital
1993 – Head Doctor, Shiranogawa Clinic
2011 – Kaba Memorial Hospital
2019 – Okamoto Ishii Hospital
2020 – Head Director, Hiro Clinic NIPT Nagoya

Check his Profile here

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