Medicines in pregnancy: what’s safe, and what if I took something before I knew

Finding out you’re pregnant often comes with a mental replay of everything you’ve taken lately. Try not to panic. Here’s how to check a medicine, what to do about ones you already take, and where to find reliable answers.

The general rule: check first

Most medicines pass through the placenta to your baby. Not all affect how a baby develops, but it’s worth checking before taking anything new.

Ask a pharmacist, your midwife or your GP whether a medicine is suitable before you take it. This includes:

painkillers
medicines you buy from a pharmacy or shop, not just ones on prescription
herbal and homeopathic remedies

If you see a doctor, dentist or anyone else who might prescribe something or treat you, tell them you’re pregnant first.

If you take a regular prescribed medicine

Don’t stop it suddenly. The NHS says stopping a prescribed medicine without advice could harm you and your baby. Talk to your doctor as soon as you can.

That includes medicines for epilepsy, asthma, diabetes, an underactive thyroid or a mental health condition. For example:

Epilepsy: keep taking your medicine until you’ve spoken to a specialist. If your pregnancy is unexpected, ask for an urgent appointment with your GP or epilepsy specialist.
Asthma: the NHS advises carrying on with your prescribed treatment and seeing a GP, asthma nurse or specialist as soon as you know you’re pregnant.
Diabetes: your team may change your treatment in pregnancy. If you take tablets, you’ll usually be advised to move to insulin injections, sometimes alongside metformin, so contact your diabetes team as soon as you can.
Antidepressants and other mental health medicines: tell your doctor or specialist as soon as possible, and don’t stop until you’ve spoken to them. See antidepressants in pregnancy.

If you’re planning a pregnancy, the best time to review your medicines with your GP is before you start trying.

If you took something before you knew

What this means depends on the medicine. For some common ones, bumps is reassuring. It says ibuprofen taken before 20 weeks is unlikely to harm the baby, and that paracetamol is the best studied painkiller in pregnancy, with no good evidence that it harms the baby. A few medicines can affect how a baby develops, so it’s always worth looking yours up and telling your GP.

Look the medicine up on bumps. Its leaflets explain what to do if you’ve already taken something.
If you were taking a medicine regularly, tell your GP as soon as possible, and mention it to your midwife.
If bumps has no leaflet for your medicine, your doctor, midwife or pharmacist can ask the UK Teratology Information Service (UKTIS) for advice on your behalf.

Everyday medicines

Painkillers

Paracetamol is usually the first choice. The NHS advises avoiding ibuprofen and painkillers containing codeine unless your doctor prescribes them. See painkillers in pregnancy.

Cold and flu remedies

Rest and fluids help, and paracetamol is fine for pain or a high temperature. Bumps advises avoiding decongestants (tablets, sprays or drops) and ibuprofen. Some combined cold and flu products contain a decongestant or aspirin, so ask a pharmacist. If you think you have flu, speak to your GP, as you may be offered antiviral medicine.

Hay fever tablets

The NHS says cetirizine can be taken in pregnancy: there isn’t much information, but nothing to suggest it will harm your baby. Ask a pharmacist, and avoid products that also contain a decongestant.

Antibiotics

Make sure whoever prescribes one knows you’re pregnant. Some are fine to take: the NHS says amoxicillin is safe in pregnancy, for example.

Creams, gels and patches

Medicines you put on your skin count too. Diclofenac gel and patches, for instance, are anti-inflammatory painkillers (NSAIDs), which the NHS says aren’t usually recommended in pregnancy.

Herbal and natural remedies

“Natural” doesn’t always mean safe. The NHS says some herbal and homeopathic products may be poor quality or contain harmful substances such as lead, and advises against herbal remedies when you’re trying to get pregnant. Tell your midwife, GP or pharmacist about anything you use. See complementary therapies in pregnancy.

Vitamins: what to take and what to avoid

Folic acid: 400 micrograms a day until you’re 12 weeks pregnant. If you didn’t take it before, start as soon as you find out. Some people need a higher 5mg dose on prescription, for example if they have diabetes or take epilepsy medicine.
Vitamin D: 10 micrograms a day, at least from September to March. Some people need it all year, so ask your midwife.
Avoid: supplements containing vitamin A (retinol) and fish liver oils such as cod liver oil, because too much vitamin A could harm your baby. Check any multivitamin doesn’t contain vitamin A or retinol, and avoid eating liver.

How bumps works

Bumps (Best Use of Medicines in Pregnancy) is the website the NHS points to. Its leaflets come from the UK Teratology Information Service (UKTIS), a not-for-profit service funded by the UK Health Security Agency.

Find your medicine in the A to Z list at medicinesinpregnancy.org.
Leaflets explain what’s known, whether extra monitoring is needed, and what to do if you’ve already taken the medicine.
They’re there to help you decide with your doctor, midwife or pharmacist. The bumps team can’t answer personal questions.

Questions people ask

I took medicine before I knew I was pregnant. Is my baby OK?

It depends on the medicine. For some everyday ones, such as paracetamol, bumps is reassuring. Look up the medicine on bumps and tell your GP or midwife, who can check for you and ask UKTIS if needed.

Should I stop my medication now I’m pregnant?

Not without advice. Don’t stop a prescribed medicine before checking with your doctor, and contact them as soon as you can about what’s best for you and your baby. A few medicines, such as isotretinoin for acne, must not be taken in pregnancy, which is another reason to call rather than wait.

Can a pharmacist tell me if a medicine is safe in pregnancy?

Yes. Pharmacists are a good first stop for over-the-counter medicines. Tell them how many weeks pregnant you are.