Can I take ibuprofen while pregnant?
Ibuprofen and other NSAIDs Before 20 weeks Ask first
From 20 weeks Avoid
Not unless a doctor recommends it, and not at all from 20 weeks. From week 20, ibuprofen can reduce the amniotic fluid around the baby, and later in pregnancy it can narrow a blood vessel in the baby's heart. Before 20 weeks harm is unlikely, so a dose taken early is rarely a cause for worry. Paracetamol is the painkiller to use instead.
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID), sold as Nurofen in the UK and as Advil or Motrin in the US. Naproxen and diclofenac belong to the same group and follow the same rule. The NHS advises avoiding ibuprofen in pregnancy unless a doctor or pharmacist recommends it. This page explains why week 20 is the line, what to do if you have already taken some, and what to use instead.
Why week 20 is the line
From about 20 weeks, most of the amniotic fluid around the baby is the baby's urine. NSAIDs reduce how well the baby's kidneys work, and less urine means less fluid. In October 2020 the US Food and Drug Administration told pregnant women not to use NSAIDs from 20 weeks unless a doctor advises it, after reports of low amniotic fluid (oligohydramnios) that could appear after 48 hours of use.
Low fluid matters because, as UKTIS notes, it can affect how the baby's lungs and kidneys develop. Our page on the amniotic fluid index explains how a scan measures it.
The second risk comes later. The ductus arteriosus is a blood vessel in the baby's heart that carries blood past the lungs until birth. NSAIDs can make it narrow or close early, and the FDA tells doctors to avoid NSAIDs from 30 weeks for this reason. UKTIS adds a rare but serious lung condition in the newborn, persistent pulmonary hypertension.
| Stage of pregnancy | Ibuprofen and other NSAIDs |
|---|---|
| Before 20 weeks | Not advised unless a doctor recommends it. Harm to the baby is unlikely, so a dose already taken is rarely a worry. |
| From 20 weeks | Avoid. Risk of low amniotic fluid through the baby's kidneys. Only on a doctor's advice, with monitoring. |
| From 30 weeks | Avoid. Added risk of early closure of the ductus arteriosus. |
Ibuprofen in the first trimester
UKTIS considers ibuprofen taken before 20 weeks unlikely to harm the baby, and does not call for extra scans because of it. It still advises against it unless a doctor prescribes it. Some studies have suggested a link between ibuprofen in early pregnancy and miscarriage, and others have not; the inflammatory illnesses that ibuprofen treats can themselves raise the chance of miscarriage, which may explain part of the link.
Germany's Embryotox, the Charité's pregnancy medicines service, goes further and lists ibuprofen alongside paracetamol as a painkiller of choice in the first two thirds of pregnancy, then rules out all NSAIDs from week 28. This page follows the stricter UK and US line of avoiding them from 20 weeks, because the FDA's reports of low fluid start there.
What to take instead
Fine to use
- Paracetamol, the first-choice painkiller at every stage of pregnancy
- A warm bath, a hot-water bottle or a cold pack on the sore spot
- Rest, gentle movement and physiotherapy for back and pelvic pain
- Low-dose aspirin if your doctor prescribed it to prevent pre-eclampsia: keep taking it as advised
Avoid unless a doctor says otherwise
- Ibuprofen tablets, capsules and liquid, including children's ibuprofen
- Naproxen, diclofenac and other NSAIDs
- Aspirin as a painkiller
- Cold and flu remedies that combine ibuprofen with a decongestant such as pseudoephedrine
Read the label of anything you buy for pain, a cold or period-type cramps. The FDA points out that many over-the-counter products contain an NSAID. If paracetamol does not control your pain, ask your doctor before taking anything stronger; UKTIS says doctors prescribe ibuprofen in pregnancy only when it is needed, and then monitor the baby.
Ibuprofen gel and other NSAIDs on the skin
Less ibuprofen reaches your bloodstream from a gel than from a tablet, but some does. UKTIS has no leaflet on gels, so the clearest guidance is the UK product information for ibuprofen 10% gel: there are no clinical data on its use in pregnancy, it should not be used in the first and second trimesters unless clearly necessary, and it is contraindicated in the third trimester. Ask a pharmacist before using one, and try heat, cold or rest first for a sore back.
If you have already taken ibuprofen
Before 20 weeks: stop now that you know you are pregnant, switch to paracetamol if you need a painkiller, and mention it at your next appointment. UKTIS says ibuprofen at this stage is unlikely to harm the baby.
From 20 weeks: stop and tell your doctor or midwife, especially if you took it for more than a day or two. UKTIS says your obstetrician may want to scan the baby and check the amniotic fluid. The FDA reports that low fluid caused by NSAIDs often, though not always, recovers once the medicine is stopped, in most reports within three to six days.
When to get help the same day
Call your doctor, midwife or maternity unit the same day if:
- you took ibuprofen or another NSAID for several days after 20 weeks
- your temperature is 38 °C or higher, or you feel shivery and unwell
- a headache does not ease with paracetamol, or comes with blurred vision, flashing lights, pain below the ribs or sudden swelling of your face, hands or feet: these can be signs of pre-eclampsia
- you have pain in your abdomen that does not go away
Call your maternity unit straight away, day or night, if your baby is moving less than usual or the pattern of movements changes. Do not wait until the next day.
Call 999 or 911, or your local emergency number, for severe abdominal pain, heavy bleeding, a seizure, difficulty breathing, or swelling of the lips or tongue.
Frequently Asked Questions
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 narrow a blood vessel in the baby's heart later in pregnancy. Paracetamol is the usual choice for pain and fever.
Why can't you take ibuprofen after 20 weeks of pregnancy?
From about 20 weeks the baby's kidneys make most of the amniotic fluid. Ibuprofen can reduce how well those kidneys work, so the fluid around the baby drops, which the FDA says can happen after 48 hours of use. Later in pregnancy it can also close the ductus arteriosus, a blood vessel in the baby's heart that must stay open until birth.
Is ibuprofen safe in the first trimester?
UKTIS says ibuprofen taken before 20 weeks is unlikely to harm the baby, but still advises against it unless a doctor recommends it. Some studies have linked early use to miscarriage and others have not, and the illnesses ibuprofen treats may explain part of that link. Paracetamol remains the first choice in the first trimester too.
I took ibuprofen before I knew I was pregnant. Is my baby at risk?
Very unlikely. UKTIS says ibuprofen taken before 20 weeks is unlikely to harm the baby, and no extra scans are needed for that reason. Stop taking it now that you know, switch to paracetamol if you need a painkiller, and mention it at your booking appointment.
I took ibuprofen after 20 weeks. What should I do?
Stop taking it and tell your doctor or midwife, especially if you took several doses. UKTIS says your obstetrician may check the baby and the amniotic fluid with an ultrasound scan. The FDA reports that low amniotic fluid caused by NSAIDs often, though not always, recovers after the medicine is stopped. UKTIS singles out several doses taken without a doctor's advice.
Can I use ibuprofen gel while pregnant?
Ask a pharmacist or doctor first. UK product information for ibuprofen gel says there are no clinical data on its use in pregnancy, that it should not be used in the first and second trimesters unless clearly necessary, and that it must not be used in the third trimester. A warm or cold pack is a safer first try for muscle pain.
What can I take instead of ibuprofen while pregnant?
Paracetamol, which is the first-choice painkiller at every stage of pregnancy. Rest, a warm bath, a hot or cold pack and gentle movement help many kinds of pain. If paracetamol is not enough, ask your doctor rather than going back to ibuprofen: they can prescribe something suitable and check the cause of the pain.
Ibuprofen in pregnancy: at a glance
Ibuprofen and other NSAIDs, such as naproxen and diclofenac, are not advised in pregnancy unless a doctor recommends them, and they should be avoided from 20 weeks. From that week the US FDA and UKTIS warn that they can reduce the baby's kidney function and so the amniotic fluid; from 30 weeks they can also close the ductus arteriosus early. Before 20 weeks UKTIS considers harm unlikely, so a dose taken early is rarely a cause for worry, while Germany's Embryotox allows ibuprofen until week 28. Gels carry the same warnings on their UK product information. Paracetamol is the painkiller to use instead, and anyone who took an NSAID after 20 weeks should tell their doctor or midwife.
Inside Baby Novum: the supplement tracker lets you add anything your doctor prescribed, such as low-dose aspirin, alongside your vitamins and tick it off each day. Three items are free; Premium tracks as many as you need, with reminders. The app never suggests a medicine.
Read next
Sources
- UKTIS / bumps — Ibuprofen in pregnancy
- US FDA (2020) — Avoid NSAIDs in pregnancy at 20 weeks or later
- NHS — Ibuprofen for adults
- UKTIS / bumps — Pain relief in pregnancy
- Embryotox (Charité Berlin) — Ibuprofen
- Ibuprofen 10% w/w Gel — Summary of product characteristics, section 4.6 (UK, emc)
- UKTIS / bumps — Paracetamol in pregnancy
- UKTIS / bumps — Low-dose aspirin in pregnancy
- UKTIS / bumps — Aspirin for pain in pregnancy
- UKTIS / bumps — Treatment of colds and flu in pregnancy
- NHS — High temperature (fever) in adults
- NHS — Pre-eclampsia
- NHS — Your baby's movements
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.