Pregnancy and medication

Carrying another life means you need to be careful of what you’re ingesting, especially when it comes to medication.

Dr Leneque Lindeque, an obstetrics and gynaecologist at Mediclinic Highveld in Mpumalanga, talks us through what’s safe to take during pregnancy and what you should avoid. ‘There may come a time when you’re feeling under the weather and are unsure of what medication is safe for your baby,’ says Dr Lindeque. ‘Although many medications don’t affect your pregnancy, there are some over-the-counter medications and even some natural remedies that can cross over the placenta and affect the development and growth of your child. These drugs are called teratogens. ‘Your doctor will always weigh the risks and benefits of taking medication to help you determine what’s safe,’ she continues. ‘Whenever new medication is being prescribed, always ensure that the healthcare worker knows you’re pregnant.’ 

Safe medications

The good news is there’s more than just a Panado available to cure your ailments during pregnancy, says Dr Lindeque. Here are safe treatments for some common conditions: Constipation: It’s always ideal to start with an increase in dietary fibre and fluid intake. Thereafter bulk-forming laxatives can be used, but castor oil and mineral oil should be avoided. Diarrhoea: Management of the acute condition should include general measures such as hydration and an altered diet. Thereafter products such as loperamide can be considered for short periods of time. Sleep disturbance: Healthy sleeping habits should always be tried before considering medication, but for short-term use sedative antihistamines such as doxylamine and zolpidem can be taken. Benzodiazepines should be avoided in pregnancy as they increase your chances of having a preterm labour and a low birth-weight baby. 

Medications to avoid

Although many medications are safe during pregnancy, there are a number that should be avoided, says Dr Lindeque. These are listed ibelow: 

Absolutely contra-indicated

• Chemotherapeutic drugs e.g. methotrexate Used for autoimmune diseases and some cancers
• Vitamin A-containing drugs e.g. Roaccutane Used for acne and other skin conditions
• Cardiac medication Beta-blockers e.g. atenolol Used for hypertension
• Antifungal drugs e.g. fluconazole Most topical creams are safe, such as those used for vaginal thrush
• Anti-worm medication e.g. mebendazole Used for parasitic worm infestations
• Anti-inflammatory drugs non-steroidal anti-inflammatory e.g. Nurofen Should be avoided in the third trimester
• Gout medication e.g. colchicine Should be avoided throughout pregnancy

Relatively contra-indicated medication

• Psychotropic drugs e.g. lithium Used for some mood disorders. Only to be used under the care of a physician
• Anticlotting medication e.g. warfarin Only to be used under the care of a physician
• Cardiac medication Beta-blockers e.g. atenolol Used for high blood pressure and migraine prophylaxis
• Diuretics e.g. Lasix Can be used in acute circumstances
• Some antibiotics e.g. tetracyclines Used for some infections. Causes delayed bone growth of the fetus
• Endocrine medication e.g. carbimazole Used for an overactive thyroid

Chronic medication

If you’re already taking medication for a chronic condition, it’s important to check with your doctor before you fall pregnant if it’s safe, as some medication may need to be stopped as soon as three months before you conceive, says Dr Lindeque. ‘Consult your doctor again when you find out you’re pregnant in case the medication needs to be changed to one that’s safer during pregnancy. In some cases your chronic medication dose may need to be changed during your pregnancy as your needs change, as is the case with diabetes and epilepsy.’