The short answer: paracetamol is the first-choice painkiller in pregnancy. Ibuprofen and other NSAIDs are not advised unless a doctor recommends them, and should be avoided from 20 weeks. Antacids, loratadine, cetirizine and most laxatives are generally fine. Avoid decongestants. Never stop a medicine you take for a long-term condition without talking to your doctor first.
Is it safe in pregnancy? The medicines table
Type a medicine to find it. The table gives no doses: check those with a pharmacist, who can also tell you whether a branded product contains something on the "avoid" list.
| Medicine | Verdict | What to know |
|---|---|---|
| Pain and fever | ||
| Paracetamol (acetaminophen) | Generally OK | The first choice for pain and fever in pregnancy. Use the lowest dose that works for the shortest time; an untreated high temperature carries its own risks. |
| Ibuprofen, naproxen, diclofenac (NSAIDs) | Before 20 weeks Ask first From 20 weeks Avoid | Not advised unless a doctor recommends them. From 20 weeks they can reduce the amniotic fluid and narrow a blood vessel in the baby's heart. |
| Aspirin for pain | Before 20 weeks Ask first From 20 weeks Avoid | Not advised as a painkiller unless prescribed, especially from 20 weeks, for the same reasons as ibuprofen. Use paracetamol instead. |
| Low-dose aspirin | Doctor only | Prescribed from 12 weeks to lower the risk of pre-eclampsia in women at higher risk. Take it only if your doctor or midwife has recommended it. |
| Codeine | Doctor only | Only if a doctor recommends it, for a short time. Taken near the birth it can cause breathing and withdrawal problems in the newborn. |
| Heartburn and indigestion | ||
| Antacids and alginates (e.g. Gaviscon) | Generally OK | Usually the first thing to try for heartburn. Do not take them within 2 hours of iron or folic acid tablets. |
| Omeprazole | Ask first | No good evidence of harm; used when antacids are not enough. Check with a pharmacist or doctor first. |
| Famotidine | Ask first | No clear risks found, although doctors usually try omeprazole first. |
| Allergies and hay fever | ||
| Loratadine, cetirizine | Generally OK | No evidence of harm; commonly used for hay fever and allergies in pregnancy. |
| Chlorphenamine | Generally OK | No evidence of harm. It can make you drowsy. |
| Coughs and colds | ||
| Decongestants (pseudoephedrine, phenylephrine, decongestant nasal sprays) | Avoid | Avoid. Check cold and flu remedies too: many combination products contain a decongestant. |
| Pregnancy sickness | ||
| Cyclizine, promethazine, doxylamine with pyridoxine (Xonvea) | Doctor only | First-line treatments for pregnancy sickness that is affecting daily life, prescribed by a doctor. |
| Ondansetron | Doctor only | A second-line option. In the first 12 weeks it carries a very small extra risk of cleft lip or palate, about 3 more babies in 10,000, which your doctor will weigh with you. |
| Metoclopramide | Doctor only | A second-line option, used with care because of side effects such as muscle spasms. |
| Cramps and spasms | ||
| Hyoscine butylbromide (Buscopan) | Doctor only | Too little evidence to call it safe; used only if there is no alternative. |
| Constipation and diarrhoea | ||
| Laxatives: fibre, lactulose, macrogol, senna | Generally OK | Fine to use. Try fibre first, then lactulose or macrogol, then senna. |
| Loperamide | Ask first | Diarrhoea rarely needs a medicine. Use loperamide only if you need it, after checking with a pharmacist. |
| Antibiotics | ||
| Penicillins (amoxicillin) and cephalosporins (cefalexin) | Doctor only | Commonly prescribed in pregnancy, with no concerns found. |
| Nitrofurantoin | Before 28 weeks Doctor only From 28 weeks Avoid | Often the first choice for a urine infection, but usually avoided in the third trimester and especially near the birth. |
| Trimethoprim | Before 13 weeks Avoid From 13 weeks Doctor only | Usually avoided in the first 12 weeks because it lowers folate; if it is needed, extra folic acid is given with it. |
| Doxycycline and other tetracyclines | Before 13 weeks Doctor only From 13 weeks Avoid | Avoided after about 13 weeks because they can stain the baby's teeth, unless there is no other option for a serious infection. |
| Skin and thrush | ||
| Hydrocortisone and other steroid creams | Generally OK | Fine when used as directed; very little reaches your bloodstream. |
| Clotrimazole (thrush) | Generally OK | The preferred treatment for thrush. Ask a pharmacist, as some thrush products are not suitable in pregnancy. |
| Medicines that need a specialist plan | ||
| Isotretinoin (acne) | Avoid | Can cause serious birth defects. If you become pregnant while taking it, stop and contact your doctor straight away. |
| Valproate (epilepsy, bipolar disorder) | Avoid | High risk of birth defects and developmental problems. Do not stop it yourself; contact your specialist urgently. |
| Warfarin | Avoid | Can affect the baby's development and is usually switched to heparin injections. Do not stop it yourself; contact your doctor straight away. |
Before you take anything: four rules
- Tell the pharmacist you are pregnant, every time. The NHS advises checking with a pharmacist, midwife or GP that any medicine, including one bought over the counter, is suitable.
- Use the lowest dose that works, for the shortest time. This is how the UK and EU regulators phrase their advice even for paracetamol.
- Never stop a prescribed medicine on your own. For conditions such as epilepsy, asthma, depression or high blood pressure, stopping suddenly can be more dangerous than the medicine. Talk to your doctor first.
- "Natural" is not the same as safe. Herbal remedies are tested far less than medicines. Our can I eat this guide rates herbal teas one by one, and the prenatal supplements guide covers vitamins.
Is paracetamol safe in pregnancy? The autism question
In September 2025 the US Food and Drug Administration began the process of adding a possible link with autism and ADHD to paracetamol's label. In the same statement it said that a causal relationship has not been established, and it advised doctors to consider minimising paracetamol for routine low-grade fevers while calling it the safest over-the-counter painkiller in pregnancy.
Health bodies elsewhere did not follow. The UK's MHRA, the European Medicines Agency and the World Health Organization said there is no evidence that paracetamol causes autism, and in the US both ACOG and the Society for Maternal-Fetal Medicine kept recommending it. The strongest study, a 2024 Swedish study of 2.48 million children that compared brothers and sisters, found no link with autism, ADHD or intellectual disability once family factors were accounted for. An umbrella review published in September 2026 found that the reported associations shrink towards zero as the quality of the studies rises. As of the US label version published in May 2026, the label had not changed.
The practical advice is the same as before: use paracetamol when you need it, at the lowest dose that works, for the shortest time. The MHRA points out that untreated pain and fever can themselves pose risks to the baby.
Why ibuprofen is avoided from 20 weeks
NSAIDs such as ibuprofen, naproxen and diclofenac work by blocking prostaglandins, which also keep the baby's kidneys and a blood vessel in the heart, the ductus arteriosus, working normally. The FDA warns that from 20 weeks they can reduce the baby's urine output and so the amniotic fluid, and UKTIS adds the risk of the ductus narrowing early. Before 20 weeks UKTIS considers harm unlikely, though some studies have suggested a link with miscarriage that others have not found. Low-dose aspirin prescribed to prevent pre-eclampsia is the exception and should be continued as advised.
In Germany, Embryotox, the Charité's pregnancy medicines service, still lists ibuprofen as a drug of choice up to week 28 and avoids all NSAIDs from week 28. This page follows the stricter UK and US advice of avoiding them from 20 weeks unless a doctor recommends them.
Heartburn, colds and sickness: what to try first
Heartburn: antacids and alginates first, kept 2 hours apart from iron and folic acid, then omeprazole if needed. Our heartburn guide covers the changes that help without medicine.
Colds and flu: paracetamol for aches and fever, and plenty of fluids. Avoid decongestant tablets and sprays, and check the label of combination remedies. A blocked nose in pregnancy is often caused by pregnancy itself and can last for weeks.
Pregnancy sickness: if it is affecting your eating, drinking or daily life, there are effective, well-studied prescription medicines, and the RCOG's 2024 guideline sets out which to try first and which next. Our morning sickness guide explains when to ask for them.
Constipation: fibre, fluids and movement first, then a fibre supplement, then lactulose or macrogol. The constipation guide has the full order.
Medicines for a long-term condition
If you take a regular medicine for epilepsy, a mental health condition, asthma, thyroid disease, high blood pressure or a blood clotting problem, keep taking it and ask your doctor about it as soon as you know you are pregnant, ideally before. A few medicines, such as valproate, isotretinoin and warfarin, can harm a baby and need a specialist plan, often a switch to another medicine. Many others are continued, because stopping suddenly can make the condition worse; your doctor will weigh the medicine against the condition with you.
When to call your doctor or maternity unit the same day
Call your maternity unit, GP or a pharmacist the same day if:
- a headache does not ease with paracetamol, or comes with blurred vision, flashing lights or sudden swelling of your face, hands or feet
- you have a high temperature or feel shivery and unwell
- you have burning when you pee with a fever or pain in your back
- you took a medicine from the "avoid" list and are worried: a pharmacist or your doctor can tell you what, if anything, needs to happen
Call 999 or 911, or your local emergency number, for a severe allergic reaction: swelling of the lips or tongue, difficulty breathing, or collapse.
Inside Baby Novum: the supplement tracker lets you add anything your doctor prescribed alongside your vitamins, with reminders at the times you need them and a daily tick-off. Three items are free; Premium tracks as many as you need. The app never suggests a medicine: it keeps track of what your doctor or midwife has advised.
Related tools and guides
FAQ — medicines in pregnancy
Can I take paracetamol while pregnant?
Yes. Paracetamol is the first-choice painkiller in pregnancy according to the NHS, the UK medicines regulator and the European Medicines Agency. Take the lowest dose that works for the shortest time, and talk to your doctor or midwife if you need it for more than a few days or for a high temperature.
Can I take ibuprofen while pregnant?
It is not advised unless a doctor recommends it, and it should be avoided from 20 weeks. The US FDA warns that NSAIDs such as ibuprofen can lower the amniotic fluid from 20 weeks, and they can also narrow a blood vessel in the baby's heart later in pregnancy. Paracetamol is the usual alternative.
I took ibuprofen before I knew I was pregnant. Is my baby at risk?
Very unlikely. UKTIS, the UK service that reviews medicines in pregnancy, says ibuprofen taken before 20 weeks is unlikely to harm the baby. Stop taking it now that you know, switch to paracetamol if you need a painkiller, and mention it at your booking appointment.
What can I take for a headache while pregnant?
Paracetamol, along with rest, fluids and regular meals. Avoid ibuprofen and aspirin as painkillers. A severe headache that does not ease, especially with blurred vision or sudden swelling of the face or hands after 20 weeks, needs a call to your maternity unit the same day, as it can be a sign of pre-eclampsia.
What can I take for a cold while pregnant?
Paracetamol for aches and fever is fine. Avoid decongestant tablets and nasal sprays, and read the label of any cold or flu remedy, because many combine paracetamol with a decongestant. A pharmacist can tell you which products are suitable in pregnancy.
What can I take for heartburn in pregnancy?
Antacids and alginates such as Gaviscon are usually the first thing to try, taken at least 2 hours apart from iron or folic acid. If they are not enough, omeprazole is generally considered fine; check with a pharmacist or doctor first.
Does taking paracetamol in pregnancy cause autism?
The evidence does not show that it does. The largest study, of 2.48 million Swedish children compared with their own siblings, found no link with autism or ADHD, and the UK, EU and WHO regulators said in 2025 there is no evidence it causes autism. The US FDA has asked doctors to consider using it less for mild fevers; it remains the first-choice painkiller in pregnancy everywhere.
Sources
- NHS — Medicines in pregnancy
- NHS — Paracetamol for adults: pregnancy, breastfeeding and fertility
- UKTIS / bumps — Paracetamol in pregnancy
- MHRA (2025) — Taking paracetamol during pregnancy remains safe
- European Medicines Agency (2025) — Use of paracetamol during pregnancy unchanged in the EU
- Embryotox (Charité Berlin) — Paracetamol
- UKTIS / bumps — Ibuprofen in pregnancy
- US FDA (2020) — Avoid NSAIDs in pregnancy at 20 weeks or later
- Embryotox (Charité Berlin) — Ibuprofen
- UKTIS / bumps — Aspirin for pain in pregnancy
- UKTIS / bumps — Low-dose aspirin in pregnancy
- NICE NG133 — Hypertension in pregnancy: recommendations
- UKTIS / bumps — Codeine in pregnancy
- NHS — Indigestion and heartburn in pregnancy
- UKTIS / bumps — Omeprazole in pregnancy
- UKTIS / bumps — Famotidine in pregnancy
- UKTIS / bumps — Loratadine in pregnancy
- UKTIS / bumps — Cetirizine in pregnancy
- UKTIS / bumps — Chlorphenamine in pregnancy
- UKTIS / bumps — Treatment of colds and flu in pregnancy
- RCOG Green-top Guideline 69 (2024) — Nausea and vomiting of pregnancy and hyperemesis gravidarum
- UKTIS / bumps — Cyclizine in pregnancy
- UKTIS / bumps — Xonvea (doxylamine with pyridoxine) in pregnancy
- MHRA Drug Safety Update (2020) — Ondansetron and oral clefts
- UKTIS / bumps — Ondansetron in pregnancy
- UKTIS / bumps — Metoclopramide in pregnancy
- No-Spa Max 80 mg — Summary of product characteristics (Poland, 2023)
- UKTIS / bumps — Hyoscine in pregnancy
- UKTIS / bumps — Lactulose in pregnancy
- UKTIS / bumps — Senna in pregnancy
- UKTIS / bumps — Loperamide in pregnancy
- UKTIS / bumps — Penicillins in pregnancy
- UKTIS / bumps — Cephalosporins in pregnancy
- UKTIS / bumps — Nitrofurantoin in pregnancy
- UKTIS / bumps — Trimethoprim in pregnancy
- UKTIS / bumps — Doxycycline in pregnancy
- UKTIS / bumps — Topical corticosteroids in pregnancy
- UKTIS / bumps — Clotrimazole in pregnancy
- NHS — Isotretinoin capsules
- MHRA — Valproate use by women and girls
- UKTIS / bumps — Warfarin in pregnancy
- US FDA (22 September 2025) — FDA responds to evidence of possible association between autism and acetaminophen use during pregnancy
- ACOG Practice Advisory (2025) — Acetaminophen use in pregnancy and neurodevelopmental outcomes
- Society for Maternal-Fetal Medicine (2025) — Statement on acetaminophen use during pregnancy and autism
- DailyMed — Tylenol Regular Strength label (US, May 2026)
- WHO (24 September 2025) — Statement on autism-related issues
- Ahlqvist et al., JAMA 2024 — Acetaminophen use during pregnancy and children's risk of autism, ADHD and intellectual disability
- Tayebi-Hillali et al., Developmental Medicine & Child Neurology 2026 — Prenatal paracetamol and autism and ADHD: an umbrella review
- Embryotox (Charité Berlin) — Xylometazolin
Medicines in pregnancy — at a glance
Paracetamol is the first-choice painkiller in pregnancy, used at the lowest dose that works for the shortest time; regulators in the UK, the EU and the WHO found no evidence that it causes autism, and the largest sibling study found no link. Ibuprofen and other NSAIDs are not advised unless a doctor recommends them and should be avoided from 20 weeks. Antacids and alginates, loratadine, cetirizine, chlorphenamine, laxatives, steroid creams and clotrimazole are generally fine. Decongestants are best avoided. Anti-sickness medicines, codeine and antibiotics are for a doctor to prescribe, and some antibiotics are avoided at certain stages. Never stop a long-term medicine without talking to your doctor, and always tell the pharmacist you are pregnant.
Baby Novum is an informational and tracking tool, not a medical device, and does not provide medical diagnosis or treatment. Always consult your doctor or midwife about your pregnancy.