Which Painkillers Can You Safely Take During Pregnancy?

From hormone changes to the body preparing for birth, pregnancy brings on all kinds of aches and pains. When a little discomfort progresses into severe pain, you may wonder which medications are safe to use for relief.

The good news is there are fortunately, painkillers that are safe to take during pregnancy. However, like everything else during pregnancy, you should give special attention to what you are taking and when you are taking it. 

We put together this guide to help you gain a better understanding of  which pain relief medications are OK to take when you are expecting. With that being said, you should always discuss all medicines that you take, including over-the-counter (OTC) drugs, with your OB-GYN or other healthcare providers.

Types of pain medications

There are three main kinds of commonly used analgesics (pain killers):

• Systemic nonopioid analgesics- Acetaminophen, Aspirin, Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Opioid analgesics- Morphine, Codeine, Tramadol

• Adjuvant analgesics- medications not primarily created to control pain but can be used for that purpose. (i.e., Norpramin, Cymbalta, Lyrica)

Which medications are safe to take for pain during pregnancy?

As we stated above, you should always speak to your doctor before taking any medications when you are expecting. 

Acetaminophen

Available over-the-counter, acetaminophen, the main ingredient in Tylenol, is generally considered safe to treat fevers, headaches, joint, or muscle pain during all three trimesters of pregnancy. Your doctor may also prescribe it at higher doses, either alone or combined with other medications. 

If you have liver problems, are allergic to acetaminophen, or your doctor advises against it, you shouldn't take this medication. 

It's always best to take the lowest dose possible for the shortest amount of time, even if your doctor gives you the OK to take acetaminophen. While more research is needed, some studies suggest that babies exposed to high acetaminophen levels in the womb are at greater risk of mild developmental delays or attention deficit hyperactivity disorder (ADHD).

NSAIDs

NSAIDs include aspirin, Advil or Motrin (ibuprofen), and Aleve (naproxen). Usually, up to 20 weeks gestation, ibuprofen, and naproxen are safe to take, while aspirin is never recommended in pregnancy.

During the second half of pregnancy, weeks 21-40, all NSAIDs are not recommended for use. Research shows that oligohydramnios, which refers to low amniotic fluid levels, can occur in as little as two days of taking NSAID after 20 weeks of gestation. Once the issue is identified and the medicine discontinued, amniotic fluid typically returns to normal levels.  

However, if NSAID is continued, it can lead to severe kidney, heart, and other developmental problems and can sometimes even be fatal for the baby. 

Aspirin

Your doctor may prescribe aspirin to treat specific medical problems in pregnancy, such as preeclampsia. Research has shown that women who develop preeclampsia are at a lower risk of preterm labor and other complications when taking a daily low dose of aspirin after the 12th week of pregnancy. Aspirin also decreases the risk of deadly blood clots in these expecting patients.

The active ingredient in aspirin, acetylsalicylic acid, hinders several chemical processes in the body to block pain and inflammation and repress blood clotting.

However, you should only take aspirin if you are at high risk for preeclampsia, AND if your doctor approves of it because it can cause severe problems for both you and your baby. Aspirin slows the ability of your blood to form clots, which can lead to hemorrhaging.  

Prescription Painkillers

Opioids (Percocet, Demerol, Duragesic) are a class of prescription-only medications that are naturally found in the opium poppy plant and work in the brain to produce various effects on the body including pain relief and they can be prescribed to treat pain. Considered narcotics, they are controlled substances and illegal to get or use without a prescription, and are also the most abused prescription drugs in the U.S.

These pain killers are commonly prescribed for intense pain resulting from injuries, surgery, dental work, or migraine headaches.

Studies show that opioid use during pregnancy can increase your odds of having a baby with certain congenital disabilities, like heart problems, as well as increase the chances of premature birth, preterm labor, or even stillbirth.

Opioids during pregnancy can also lead to your baby becoming addicted and experiencing neonatal abstinence syndrome (NAS) after birth. NAS can lead to the baby being too small or having breathing problems. 

If you take opioids for pain relief and become pregnant, your physician may not want you to stop taking them suddenly. Instead, they may recommend you reduce the amount you take gradually to prevent any withdrawal symptoms.

Final thoughts

Managing aches and pain in pregnancy is essential for the health of both mom and baby. While you might be fearful of taking pain killers, there are safe options out there to give you relief. 

Remember, always discuss all prescription and OTC pain medications that you're taking (or considering taking) with your doctor before taking them. Your healthcare provider will be able to help you make informed decisions about treating health conditions during pregnancy.  At CareCard, we are passionate about helping make your prescription payments more affordable, saving members up to 85% on prescription drugs and medications. Learn how CareCard can help make your medication payments more manageable.