What to expect when you're expecting (197 page)

Antidiarrheals
. Most antidiarrheals aren’t recommended for use during pregnancy. Both Kaopectate and Pepto-Bismol contain salicylates—an active ingredient that is considered off-limits when you’re expecting. Ask your practitioner if there is anything you can safely take for diarrhea during pregnancy (staying hydrated will be key, too).

Antibiotics.
If your doctor has prescribed antibiotics for you during pregnancy, it’s because the bacterial infection you have is more dangerous than taking the antibiotics to fight it off (many are considered completely safe). You’ll usually be put on antibiotics that fall into the penicillin or erythromycin families. Certain antibiotics are not recommended (such as tetracyclines), so be sure that any doctor prescribing antibiotics while you’re expecting knows that you’re pregnant.

Keeping Current

The many lists of safe, possibly safe, possibly unsafe, and definitely unsafe drugs and medication during pregnancy change all the time, especially as new medications are introduced, others change from being prescription-only to over-thecounter, and still others are being studied to determine their safety during pregnancy. To stay current on what is or isn’t safe, always ask your practitioner first. You can also turn to the U.S. Food and Drug Administration (contact your regional office, or
visit fda.gov
) for information. Or try the local office of the March of Dimes, or contact the March of Dimes Resource Center at (888) MODIMES (663-4637);
marchofdimes.com
. You can also go to safefetus.com to check on the safety of a certain medication during pregnancy.

Antidepressants.
Untreated depression in an expectant mom can have many adverse effects on her baby. Though the research on the effects of antidepressants on pregnancy and on the fetus is ever changing, it does appear that there are several medications that are safe to use, others that should be completely avoided, and still others that can be considered on a case-by-case basis, their use weighed against the risk of untreated (or undertreated) depression. See
page 518
for more on antidepressants.

Antinausea.
Unisom Sleep Tabs (which contain the antihistamine doxylamine), taken in combination with vitamin B
6
, decrease the symptoms of morning sickness but should only be used when recommended by your practitioner. The downside of taking this remedy during the day: sleepiness.

Topical antibiotics.
Small amounts of topical antibiotics, such as bacitracin or Neosporin, are safe during pregnancy.

Topical steroids.
Small amounts of topical hydrocortisones (such as Cortaid) are safe during pregnancy.

If your practitioner recommends that you take a certain medication while you’re expecting, follow these steps for increased benefit and reduced risk:

Discuss with your practitioner the possibility of taking the medication in the smallest effective doses for the shortest possible time.

Take the medication when it’s going to benefit you the most—a cold medication at night, for instance, so it will help you sleep.

Follow directions carefully. Some medications must be taken on an empty stomach; some should be taken with food or milk. If your physician hasn’t given you any instructions, ask your pharmacist for particulars—most provide handouts with full directions and information (including possible side effects) on each prescription drug they sell. Don’t panic if you see that the drug isn’t recommended during pregnancy—the vast majority of drugs carry that warning, even if they’re considered safe. As long as a practitioner who knows that you’re expecting and is familiar with pregnancy drug safety has prescribed or recommended it, it’s okay to take it.

Explore nondrug remedies, and use them, as appropriate, to supplement the drug therapy. For instance, eliminate as many offending allergens from your home as you can, so your physician can reduce the amount of prescribed antihistamines you take. Keep in mind that herbal remedies are still considered drugs and shouldn’t be taken without a practitioner’s approval.

Make sure the medication gets where it’s supposed to by taking a sip of water before you swallow a capsule or tablet, to make it go down more easily, and by drinking a full glass afterward, to ensure that it is washed speedily down to where it will be absorbed.

For additional safety, try to get all your prescriptions at the same pharmacy. The pharmacist will have you and all your prescriptions on the computer and should be able to warn you of potential drug interactions. Also, be sure you’ve gotten the right prescription (or over-the-counter medication). Check the name and dosage on the bottle to be sure it’s the one specified by your doctor (many drug names and patient names are similar, and pharmacies do occasionally make mistakes). For additional reassurance, ask the pharmacist what the drug is meant to treat or check out the printed material that comes with the drug. If you know you were supposed to get an antihistamine for your allergies and the drug you are handed is for hypertension, you’ve obviously got the wrong medication.

Ask about possible side effects and which ones should be reported to your doctor.

Herbal Cures

Herbal supplements and remedies make the most tempting of promises(better memory! sounder sleep! improved immunity!), especially when pregnancy leaves you with fewer selfmedicating options open and your medicine cabinet at least partially closed. Would it really hurt to pop a couple of ginkgo biloba pills to give your brain cells a fighting chance of remembering to pay this month’s electric bill? Or melatonin to guarantee that you’ll sleep like a baby (even when it’s a baby-to-be who’s keeping you awake)? And what about an echinacea or two to fend off the germs after you were sneezed on (twice) at that afternoon meeting? After all, the bottles say “all-natural,” and you did buy them at the health-food store (what could be healthier than that?).

Actually, it could hurt—particularly now that you’re sharing those pills with a little someone else. “All-natural” doesn’t make herbal preparations “all safe,” and neither does a health-foodstore pedigree. Herbal preparations are not tested or approved by the FDA and are not required to undergo clinicalcal trials, which means that their safety (or lack of) is unknown. Even herbs that you’ve heard could be helpful during pregnancy could be dangerous at different points during those nine months. For example, some herbs purported to help bring on labor can cause premature labor if taken before full term. And many herbs are downright dangerous if taken at any time during pregnancy (such as basil oil, black or blue cohosh, clove oil, comfrey, juniper, mistletoe, pennyroyal, sassafras, wild yam, and many others).

It’s always smart to proceed with caution when you’re self-medicating with herbals, but twice as smart when you’re self-medicating for two. To play it safe, don’t take any herbal preparation—even ones you used freely preconception—unless it’s prescribed by your practitioner for use during pregnancy.