Medicines in Pregnancy: The Complete Guide
Medicine safety in pregnancy
When you are pregnant, it is natural to have questions about what is safe - and that includes everyday lifestyle choices, over-the-counter remedies and prescription medicines. This guide explains the current UK guidance in plain language, so you can make informed decisions for you and your baby.
Why medicine safety matters
Some medicines can cross the placenta and reach your developing baby, and the first trimester is a particularly sensitive window because this is when your baby's major organs are forming. That said, this does not mean medicines should be avoided altogether - many are perfectly safe, and stopping a necessary long-term prescription abruptly can sometimes cause far more harm than continuing it, both to you and your baby. This is why the golden rule is simple: never start, stop or change a medicine during pregnancy without speaking to your GP, midwife or pharmacist first.
General rules for medicines in pregnancy
- Always check with a pharmacist, your GP or your midwife before taking any new medicine, including herbal remedies, supplements and products you might not think of as "medicine".
- Paracetamol is generally considered the safest painkiller for short-term use in pregnancy, but take the lowest effective dose for the shortest possible time and check the packaging.
- Avoid ibuprofen and other NSAIDs (non-steroidal anti-inflammatory drugs), especially from 28 weeks onwards, as they can affect your baby's circulation and kidney development.
- Never stop a long-term prescription - for conditions such as asthma, epilepsy, depression, high blood pressure or thyroid disease - without medical advice, since poorly controlled conditions can carry their own risks in pregnancy.
- Take folic acid (400 micrograms daily until 12 weeks) and vitamin D (10 micrograms daily throughout pregnancy) as recommended, as these are among the few supplements specifically advised for all pregnant women in the UK.
Where to get reliable advice
Your pharmacist is often the quickest and most convenient route to trustworthy, personalised advice, and pharmacists are specifically trained in medicine safety during pregnancy. For evidence-based patient information leaflets on individual medicines, the BUMPS (Best Use of Medicines in Pregnancy) website, run by the UK Teratology Information Service, is one of the most respected UK resources and is often recommended by GPs and midwives. If you take regular medication for a long-term health condition, it is ideal to have your treatment reviewed by your specialist team before conceiving, but they remain a valuable resource at any stage of pregnancy.
Making the most of your appointments
Keep a written or phone-saved list of everything you take, including prescription medicines, over-the-counter products, vitamins and any herbal remedies, and bring it to every appointment. When a new medicine is suggested, it can help to ask three simple questions: Is this considered safe in pregnancy? Are there alternative options? And what are the risks of leaving the underlying condition untreated? A good, open conversation with your healthcare team remains the best safeguard for both you and your baby.
Frequently Asked Questions
Is it ever safe to take medicine in the first trimester?
Yes - many medicines, including paracetamol at the recommended dose, are considered safe throughout pregnancy including the first trimester. The key is always checking with a pharmacist, GP or midwife first rather than assuming, since safety varies by medicine and dose.
What should I do if I took a medicine before I knew I was pregnant?
Try not to panic - many women take medicines before realising they are pregnant, and this alone does not mean there will be a problem. Contact your GP, midwife or pharmacist to discuss what you took, and they can advise or refer you for further reassurance if needed.
Are herbal and "natural" remedies automatically safe in pregnancy?
No - herbal and natural does not automatically mean safe in pregnancy, as some herbal products can have strong effects on the body. Always check with your pharmacist, GP or midwife before taking any herbal remedy or supplement, in the same way you would for a conventional medicine.
This article is for general information only and does not replace advice from your midwife, GP or pharmacist.
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