Prescription medicine during pregnancy

What is prescription medicine?

Prescription medicine (also called a prescription drug) is medicine your health care provider says you can take to treat a health condition. You need a prescription (an order from your provider) to get the medicine.

Most pregnant people (about 9 in 10 or 90 percent) take medicine during pregnancy. And many pregnant people (about 7 in 10 or 70 percent) take at least one prescription medicine. For example, you may need a medicine to treat a health condition, like diabetes, depression  or high blood pressure. But not all prescription medicine is safe to use during pregnancy.

If you’re pregnant or thinking about getting pregnant, talk to your provider:

• About any medicines you take. This includes prescription medicine, over-the-counter medicine, herbal and dietary supplements, and vitamins.
• Before you stop taking any medicine or start taking any new medicine.
• About the best ways to manage any health conditions you have.

How can you make sure a prescription medicine is safe to take during pregnancy?

Your provider can tell you if a prescription medicine is safe to take during pregnancy. Your provider may want you to stop taking a medicine or switch to one that’s safer for you and your baby. Don’t stop taking a prescription medicine without talking to your provider first. Make sure that any provider who prescribes medicine for you knows that you’re pregnant.

When you get a prescription for medicine, your provider tells you exactly how much to take, how often to take it and how long to take it. When you take any prescription medicine:

• Take it exactly as your provider says to take it.
• Don’t take it with alcohol or other drugs.
• Don’t take someone else’s prescription medicine.

If you’re using a prescription medicine differently than you’re supposed to use it (you take more than was prescribed, you take it with drugs or alcohol or you take someone else’s medicine), tell your provider. Sometimes, you can get dependent on certain prescription medicines, especially if you use them differently than you’re supposed to. If you need help to quit, talk to your provider. You can also find help and treatment resources by visiting the Substance Abuse and Mental Health Services Administration (SAMSHA) or by calling the helpline at 1-800-662-HELP (4357).

Can prescription medicine harm your baby during pregnancy?

How prescription medicine affects your baby during pregnancy depends on many things, including:

• Which medicines you take
• How much medicine you take (the dose)
• When during pregnancy you take the medicine
• Health conditions you may have

That’s why it’s important to talk to your provider about the medicines you take, and take medicine exactly as your provider says.

Some prescription medicines can cause problems for your baby, including:

• Preterm birth. This is when your baby is born before 37 weeks of pregnancy. Babies born too soon may have more health problems at birth and later in life.
• Low birthweight. This is when your baby is born weighing less than 5 pounds, 8 ounces.
• Birth defects. These are structural changes present at birth that can affect almost any part of the body. They may affect how the body looks, works or both. Birth defects can cause problems in overall health, how the body develops or how the body works.
• Learning and behavior problems later in life
• Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
• Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.
• Sudden infant death syndrome (also called SIDS or crib death). This is the unexplained death of a baby younger than 1 year old. SIDS usually happens when a baby is sleeping.

Is it safe to take prescription opioids during pregnancy?

Providers may prescribe opioids to relieve pain, such as after an injury or surgery. They’re also sometimes used to treat a cough or diarrhea. Some people taking prescription opioids can develop a disease called opioid use disorder (also called opioid addiction). Although opioids are most often prescribed by a provider, sometimes they are taken illegally as street drugs.

Opioid use can be harmful to your baby during pregnancy. It can cause neonatal abstinence syndrome (also called NAS) or neonatal opioid withdrawal syndrome (NOWS). NAS is a group of conditions that affects a baby who’s been exposed to certain substances (such as opioids) in the womb. A baby with NAS goes through withdrawal after birth.

Pregnancy shouldn’t be a reason to avoid treating serious pain. The American College of Obstetricians and Gynecologists (ACOG) says that opioids can be safe during pregnancy when taken under a provider’s care, but they may still cause NAS. If you’re pregnant or planning a pregnancy and you have pain, talk to your provider about the safest medicines and treatments for you. Your provider may try to avoid or limit the use of opioids. If you need to be prescribed opioids during pregnancy, your provider may tell you to use them for the shortest time possible. It’s important to follow your provider’s instructions if you need to take these medicines.

These are some of the more common prescription opioids and some of their common brand names. A brand name is the name given to a product by the company that makes it. 

• Codeine
• Fentanyl (Actiq®, Duragesic®, Sublimaze®)
• Hydrocodone (Vicodin®, Norco®)
• Hydromophone (Dalaudid®)
• Meperidine (Demerol®)
• Methadone (Dolophine®, Methadose®)
• Morphine (Avinza®, Kadian®, Duramorph®, MS Contin®)
• Oxycodone (OxyContin®, Percocet®, Percodan®)
• Oxymorphone (Opana®)
• Tapentadol

There are many other brands of opioids, so if you’re taking any medicine you think may be an opioid or combined with an opioid, tell your provider. For example, some cough medicines contain the opioid codeine.

Can taking prescription medicines during pregnancy cause birth defects?

It’s important to talk to your provider if you’re pregnant or planning a pregnancy and you’re taking prescription medicines. Some prescription medicines may increase the risk of or cause birth defects in your baby if you take them during pregnancy. These include but are not limited to:

• Isotretinoin (Absorica®, Amnesteem®, Claravis®, Myorisan®, Zenatane® and formerly Accutane®), which is used to treat acne

• Opioids, such as codeine, hydrocodone (Vicodin®, Norco®), morphine (Avinza®, Kadian®, Duramorph®, MS Contin®) and oxycodone (OxyContin®, Percocet®, Percodan®).

• Thalidomide (Thalomid®). This medicine is used to treat certain skin conditions, infections, certain types of cancer and complications from HIV (human immunodeficiency virus).

• Warfarin (Coumadin®, Jantoven®), which helps prevent blood clots.

• Molnupiravir (Lagevrio^TM), which is used to treat adults with COVID-19 who are at risk for severe disease.

• Certain medicines called ACE inhibitors that are used to treat high blood pressure and other conditions. These include Captopril (Capoten®) and Enalapril (Vasotec®).

• Certain medicines used to treat depression and other mental health issues. These include Paroxetine (Paxil®), Fluoxetine (Prozac®), and lithium.

• Certain anticonvulsant medicines used to treat seizures and other conditions. These include valproic acid (Depacon®, Depakene®, Depakote®, Stavzor®, Valproic®) and carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®).

Some medicines may increase the risk for birth defects when taken by your partner. For example, a diabetes medicine called metformin may cause sperm defects that may increase the risk for birth defects. If you’re planning a pregnancy or you can get pregnant, be sure your partner discusses any medicines they’re taking with their provider.

Don’t stop taking any prescription medicine without talking to your provider first. Stopping suddenly may cause problems for you and your baby.\

To find out more about the safety of prescription medicines during pregnancy, visit:

• mothertobaby.org
• Treating for Two

More information

Behavioral Health Treatment Services Locator

Food and Drug Administration

Mother to Baby

National Council on Alcoholism and Drug Dependence

Treating for Two

Last reviewed: July, 2022

See also: Neonatal abstinence syndrome (NAS), Preventing NAS in your baby infographic, Caring for a baby with NAS infographic