This drug, known as an osmotic laxative, helps you have bowel movements more often. MiraLAX contains the active ingredient polyethylene glycol Only a small amount of the drug is absorbed by your body, so MiraLAX is considered safe for short-term use during pregnancy. Actually, MiraLAX is often a first choice for doctors for easing constipation during pregnancy, according to one source in American Family Physician. For this reason, some doctors may suggest using other drugs that have more research backing their use during pregnancy.
Before you use any medication for constipation during pregnancy, talk to your doctor, especially if your constipation is severe. Learn more: Other causes of constipation ». When used at regular doses, MiraLAX is considered well-tolerated, safe, and effective.
Still, like other medications, MiraLAX can cause side effects in some people. If you take more MiraLAX than the dosage instructions recommend, it may give you diarrhea and too many bowel movements. This could lead to dehydration low fluid levels in the body. Dehydration can be dangerous for both you and your pregnancy. For more information, read about the importance of hydration during pregnancy.
Be sure to follow the dosage instructions on the package carefully, and if you have questions about dosage, ask your doctor. The expectorant guaifenesin has been weakly associated with neural tube defects and inguinal hernias. However, the evidence is not sufficient to determine its safety in pregnancy.
It may be prudent to avoid this medication in the first trimester unless the potential benefits outweigh the risks. Dextromethorphan is a nonnarcotic antitussive isomer of codeine that was found to be teratogenic in chicken embryos. However, a human epidemiologic study and a smaller controlled study did not demonstrate elevated risks of congenital malformations. There are no prospective randomized controlled trials to determine the safety of acetaminophen, ibuprofen, or naproxen use in pregnancy.
At least two-thirds of women use acetaminophen during pregnancy, and one-half of these women use it in the first trimester. In women using acetaminophen specifically for febrile illness, there were decreased risks of various cranial and facial defects and gastroschisis; acetaminophen may be protective because fever increases the risk of these defects. At six weeks of life, the newborns had no evidence of hepatic or renal disease.
The available information on acetaminophen use does not establish fetal risks; therefore, as a single agent, it is safe for use during any trimester, especially as single dosing without routine use. There can be risks of intrauterine growth retardation and fetal and maternal hemorrhage in the third trimester. Overall, aspirin should be avoided during organogenesis and in the third trimester unless a physician specifically prescribes it and the patient understands the risks and benefits.
In a recent study, neither ibuprofen nor naproxen increased the risk of spontaneous abortion when used in the first six weeks of pregnancy. Prolonged use of NSAIDs, including aspirin, should occur only for specific medical indications during pregnancy. Table 4 summarizes the safety of analgesics and antipyretics in pregnancy. C in the first and second trimesters, D in the third trimester [ corrected ]. During pregnancy, herbal remedies are used for nausea, respiratory symptoms, urinary tract infections, pain, and other nonspecific issues.
The Dietary Supplement Health and Education Act of requires manufacturers to ensure the safety of supplements before marketing. However, there is no registration process with the FDA, which takes action only if a supplement is found to be unsafe after marketing. John's wort is generally not recommended in pregnancy because of a lack of human data. A study with women who used Echinacea in the first trimester showed no increased risk of malformations. It inhibits platelet aggregation and prostaglandin production and is contraindicated in pregnancy.
Multiple herbals, such as mugwort, blue cohosh, black cohosh, goldenseal, juniper berry, chaste berry, rue, and pennyroyal oil, are uterine stimulants or abortifacients and should be avoided in pregnancy.
Glucosamine has been used by pregnant women with painful arthritis and appears to be safe. In a case-control study of 54 women, there was only one major malformation in the glucosamine group, which was comparable to the baseline rate of birth defects, and there was no difference in the risk of stillbirth, abortion, preterm birth, or other maternal morbidity.
Although there have been concerns about ginger increasing the risk of spontaneous abortion or preterm delivery, this has not been demonstrated in animal studies. Two systematic reviews demonstrated that ginger improves pregnancy-related nausea more than placebo and as effectively as vitamin B 6. Its effect on vomiting is less certain. No adverse effects have been noted for the mother or developing fetus.
Topical antifungals are commonly used during pregnancy for treatment of vulvovaginitis. Imidazoles and nystatin are well studied and considered safe during pregnancy. No studies are available for terbinafine cream; however, the oral form is pregnancy category B.
As with all steroid use, the lowest dose used for the shortest time possible is recommended. Smaller studies have not shown an association between use of the topical antimicrobial bacitracin and fetal malformations.
Antacids containing aluminum, calcium, or magnesium are often considered first-line treatment in pregnancy. However, at high doses, antacids containing calcium can cause milk-alkali syndrome, 54 and antacids with aluminum can cause neurotoxicity. Selective histamine H 2 blockers have been used in all trimesters with no known teratogenic effects.
In a meta-analysis of 2, women taking H 2 blockers, the OR for congenital malformations was 1. Proton pump inhibitors recently became available OTC. Although concerns have been raised about the potential teratogenicity of omeprazole Prilosec , multiple large cohort studies have demonstrated its safety when taken before conception and during the first trimester.
Proton pump inhibitors and H 2 blockers are considered safe in pregnancy. Diarrhea and constipation are common during pregnancy. Products containing bismuth, mineral oil, and castor oil should be avoided. Bismuth itself is safe, but it has the same risks as aspirin when combined with salicylate. Although the American Gastroenterological Association considers loperamide to be low risk, it should be avoided when possible until further information is available.
Considered safe in pregnancy; magnesium may cause tocolysis in late pregnancy, but this is not a risk with over-the-counter preparations. Simethicone available as a single agent and contained in multiple combination antacids. Sodium salicylate is not thought to suppress platelet function like the salicylate moiety found in aspirin; however, given the concerns over potential fetal toxicity from chronic salicylate exposure, avoidance in the latter half of pregnancy may be prudent.
Data Sources : We searched PubMed, UpToDate, the National Guideline Clearinghouse, and the Cochrane database using the terms over-the-counter, medicine, and pregnancy; herbals and pregnancy; and individual drug names in combination with pregnancy.
Search dates: February to July , July The authors thank pharmacist Stephanie Owens for querying the Clinical Pharmacology database. The opinions herein are those of the authors. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Reprints are not available from the authors. Medication use during pregnancy, with particular focus on prescription drugs: — Am J Obstet Gynecol.
Labeling and prescription drug advertising; content and format for labeling for human prescription drugs. Federal Register. Food and Drug Administration. Summary of proposed rule on pregnancy and lactation labeling. Accessed June 28, Use of over-the-counter medications during pregnancy. Fetal safety of drugs used in the treatment of allergic rhinitis: a critical review. Drug Saf. The safety of asthma and allergy medications during pregnancy.
J Allergy Clin Immunol. Pregnancy outcome following first trimester exposure to antihistamines: meta-analysis. Am J Perinatol. Use of antihistamine medications during early pregnancy and isolated major malformations.
Weber-Schoendorfer C, Schaefer C. The safety of cetirizine during pregnancy. You should not use this medicine if you are allergic to polyethylene glycol, or if you have a bowel obstruction or intestinal blockage. If you have any of these conditions, you could have dangerous or life-threatening side effects from polyethylene glycol People with eating disorders such as anorexia or bulimia should not use this medication without the advice of a doctor.
To make sure this medicine is safe for you, tell your doctor if you have:. FDA pregnancy category C. It is not known whether polyethylene glycol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether polyethylene glycol passes into breast milk or if it could harm a nursing baby.
Tell your doctor if you are breast-feeding a baby. Get emergency medical help if you have signs of an allergic reaction : hives; difficult breathing; swelling of your face, lips, tongue, or throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. Use Miralax Polyethylene Glycol exactly as directed on the label, or as prescribed by your doctor. It is not known whether polyethylene glycol passes into breast milk or if it could harm a nursing baby.
Tell your doctor if you are breast-feeding a baby. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended. To use the powder form of this medicine, measure your dose with the medicine cap on the bottle. This cap should contain dose marks on the inside of it.
Pour the powder into 4 to 8 ounces of a cold or hot beverage such as water, juice, soda, coffee, or tea. Stir this mixture and drink it right away. Do not save for later use. Polyethylene glycol should produce a bowel movement within 1 to 3 days of using the medication. Polyethylene glycol normally causes loose or even watery stools. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose.
Do not take extra medicine to make up the missed dose. Get emergency medical help if you have signs of an allergic reaction : hives; difficult breathing; swelling of your face, lips, tongue, or throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
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