Common symptoms and medication

Below is a list of common symptoms which can be experienced during pregnancy and what medications are safe to use during pregnancy and while breast-feeding.

Blocked nose

Nasal sprays containing xylometazoline or oxymetazoline are safe to use during pregnancy. These drugs relieve a blocked nose by causing blood vessels to contract. It is very important to follow the dosage instructions. Compared to nasal drops, a nasal spray is usually easier to administer in correct doses.

Cough medicines

The effectiveness of cough medicines is doubtful. Cough medicines typically contain several active ingredients. For most of these ingredients, their safety during pregnancy has not been studied.

Over-the-counter cough suppressants including dextromethorphan and expectorant cough medicines including bromhexidine and guaiphenesine can be safely used during pregnancy.

Advice on the use of these medications during pregnancy also applies to breast-feeding.

Fever

According to some studies, high temperature (≥ 38.5°C) during the first trimester might increase the risk of birth defects. If your temperature rises over 38°C, take paracetamol to bring it down.

While breast-feeding, you can take paracetamol or ibuprofen (an anti-inflammatory drug) to lower your fever. Both drugs pass into breast milk but in such small amounts that it does not pose a threat to the child.

Nausea and morning sickness

In most cases, nausea in pregnancy can be alleviated by dietary habits (e.g. eating small, frequent meals) and sufficient rest.

Nausea medications typically offer only limited relief. However, if you do need medication for nausea, meclozine (Postafen) is available over the counter and is considered safe to use during pregnancy. Discuss other options with your physician at the prenatal clinic.

Heartburn

During pregnancy:

  • Eating small, frequent meals and not lying down soon after a meal might provide sufficient relief for heartburn.
  • Over-the-counter antacids and substances protecting the mucous layer that are not absorbed into the bloodstream in significant amounts can be safely used.
  • Ranitidine can be safely used to reduce hydrochloric acid secretion.
  • Discuss other alternatives with your physician at the prenatal clinic.

 

While breast-feeding:

  • Antacids and substances protecting the mucous layer that are not absorbed into the bloodstream in significant amounts can be safely used.
  • A course of famotidine to reduce hydrochloric acid secretion is considered safe while breast-feeding.
  • Discuss long-term use and other alternatives with your physician at the prenatal clinic.  
 

Migraine

During pregnancy: 

  • Paracetamol is the first choice to treat migraine headaches during pregnancy.
  • If paracetamol is not effective, ibuprofen (an anti-inflammatory drug) or combination drug with paracetamol and codeine (prescription drug) may be taken.
  • Avoid taking anti-inflammatory drugs from week 28 onwards, because their recurrent use causes changes in fetal circulation and renal function.
  • Do not take ergotamine when you are pregnant.

 

Although no risk of birth defects has been identified, always discuss taking migraine-specific medications with your physician.

  • During pregnancy, beta-blockers and the second-generation antidepressants amitriptyline and nortriptyline are typically prescribed for migraine prevention.
  • Do not take anti-epileptic drugs for migraine prevention during pregnancy.

 

While breast-feeding

  • Paracetamol can be safely used while breast-feeding. You can also take anti-inflammatory drugs such as ibuprofen and ketoprofen. These drugs pass into breast milk only in very small amounts.
  • While breast-feeding, only take products containing codeine to treat a migraine attack. Codeine is metabolised into morphine, which can cause respiratory distress. Recurring, long-term exposure can pose a threat to the baby. 
  •  Migraine-specific sumatriptan passes into breast milk in very small amounts, and taking sumatriptan to treat a migraine attack is not contraindicated while breast-feeding.

 

As for other migraine-specific medications, their passage to breast milk is not known. Therefore, taking these drugs is not recommended unless there is a very strong indication for their use.

Constipation

During pregnancy:

  • Including high-fibre foods in your diet is the best way to treat constipation. If medication is necessary, take bulk-forming laxatives. 
  • Laxatives that are safe to use during pregnancy include lactulose and macrogols, which are not absorbed into the bloodstream in significant amounts from the intestines. 
  • The use of senna products, which are stimulant laxatives, is not recommended during pregnancy, but short-term use of bisacodyl may be considered.
  • Remember to drink enough water.

 

Advice on how to treat constipation during pregnancy applies to breast-feeding as well.

Piles (haemorrhoids)

When used according to instructions, it is safe to use over-the-counter creams and medicines to treat haemorrhoids during pregnancy and while breast-feeding.

Vaginal yeast infection

Topical products such as anti-thrush pessaries and creams are not absorbed into the bloodstream in significant amounts and are considered safe during pregnancy and while breast-feeding when used according to instructions. Avoid using an applicator during the third trimester of pregnancy.

Oral yeast infection

Nystatin can be safely used during pregnancy and while breast-feeding. This medicine is not absorbed into the bloodstream in significant amounts from the mouth or intestines.