Innumerable websites offer information about medicines that pregnant women can take safely. But because evidence is limited about many of the drugs listed and because the advice about them is inconsistent, the journal Pharmacoepidemiology and Drug Safety conducted a review to see if their guidance is reliable.
Guess what? In many cases, it’s not. And half of the websites examined didn’t include the key message that women should talk to their doctors about using medicine during pregnancy.
The Centers for Disease Control and Prevention (CDC) has summarized the most important elements of the study.
Half of all women of reproductive age look for health information on the Internet. More than 9 in 10 women use at least one medicine during their pregnancy, and about 7 in 10 of them use at least one prescription medicine. But almost none of the medicines had sufficient data to assess the risk for birth defects.
In the journal study, 25 active Internet websites listed medicines reported to be safe for use in pregnancy. The researchers tried to find out if there was scientific evidence to support this conclusion. Of the 245 medicines listed as pregnancy safe on these websites, about 4 in 10 didn’t have enough data to make that claim.
That doesn’t mean a medicine isn’t safe, but it might be. The point is that no pregnant woman should take any medicine, over the counter or prescription, if she doesn’t discuss it first with her doctor. That includes dietary or herbal supplements, which aren’t regulated by the FDA. If you’re planning to become pregnant, discuss the need for any medicine with your doctor before you conceive. And if you’re pregnant and taking medicine, don’t stop without first consulting your doctor.
Some medicines are notorious for causing birth defects. They include thalidomide (Thalamid) and isotretinoin (Accutane). They should be not be taken by anyone who is or might become pregnant.
Although some medications are known to be harmful when taken during pregnancy, according to the CDC, the safety of most medications taken by pregnant women has been difficult to determine because of certain variables:
- how much medication was taken;
- when during the pregnancy the medication was taken;
- other health conditions a woman might have;
- other medications a woman takes.
Some conditions must be treated even if you’re pregnant, such as asthma, epilepsy (seizures), high blood pressure and depression. If they’re not treated, the mother or the fetus could be harmed. But only your doctor can determine which medicine is appropriate, and at what dose. He or she also should discuss the possible side effects, risks and benefits of any medication being considered. That’s true, of course, whether you’re male or female, pregnant or not.
As the CDC notes, part of the problem in determining pregnancy-safe meds is the approval process. When the FDA tests medications to ensure their general safety and effectiveness, it doesn’t usually include pregnant women because of possible risks to the fetus. That’s why websites cannot make safety claims with authority for many medications.
The CDC suggests several resources where you might be able to find out more about the possible effects a medication might have when taken during pregnancy:
The Organization of Teratology Information Specialists (OTIS) has information about the risks and safety of taking medications during pregnancy and while breastfeeding. OTIS also conducts studies of pregnant women who contact them after having taken certain medications.
Drug companies sometimes conduct special studies using pregnancy registries. They enroll pregnant women who have taken a certain medication. After they give birth, the health of their babies is compared with the health of the babies of women who did not take the medication. For a list of current pregnancy registries and how to enroll, link here.
National Birth Defects Prevention Study is sponsored by the CDC. It works to identify possible risk factors for birth defects, including the effects of taking certain medications during pregnancy. For more information, link here.
Drug companies are required to report any problems with medications to the FDA. Health-care providers, researchers and the public also may report problems directly via the FDA’s MedWatch program.