Pregnancy + drugs

Regular readers to this column may have noticed a thread that runs through the articles. No prizes for guessing they have been written to highlight the importance of using your pharmacist for information and assistance in choosing the right over-the -counter products.

More and more products are being released to the market as OTC’s that started life as prescription medicines. After years of safe use, and no reports of any bad effects, the FDA or other bodies will allow these products to achieve OTC status. This is done also to reduce the price of the product.

When this happens, the responsibility that doctors and pharmacists had when dispensing those items is now transferred to the cashier or store clerk. So the buyer must be aware of what they are using.

Whilst researching these articles, a group has emerged as the most vulnerable to OTC mishap — the unborn child. Yes, products that seem so simple have been proven to affect the unborn.

Researchers at the University of California, Riverside are suggesting that pregnant women regularly consume food and beverages containing toxins believed to pose potential risks to developing foetuses, and that more should be done by health care providers to inform and counsel their patients about the dangers of hidden toxins in their food supply.

The July 2013 issue of Nutrition Journal stated under the heading “Consumption habits of pregnant women and implications for developmental biology: a survey of predominantly Hispanic women in California” that a team of psychologists from UC Riverside and UC San Diego found that the diets of pregnant Hispanic women included tuna, salmon, canned foods, tap water, caffeine, alcohol and over-the-counter medications that contain substances known to cause birth defects.

Consumption of tuna, salmon, canned goods, sugary desserts, fast foods, and drinking of tap water, caffeinated beverages, and alcoholic beverages during pregnancy have been deemed unhealthy due to the appearance of environmental toxins found to have harmful effects in the developing offspring,” the researchers wrote.

Tuna contains methylmercury, and prenatal exposure has been associated with numerous developmental deficits involving attention, verbal learning, motor function and delayed performance. “Staggering” levels of polychlorinated biphenyls have been found in farmed salmon. Prenatal exposure to PCBs has been linked to lower birth weights, smaller head circumferences, and abnormal reflex abilities in newborns and to mental impairment in older children.

Metal food cans are lined with a plastic that contains Bisphenol A (BPA), which leaches from the lining in cans into the food. Prenatal exposure to BPA has been associated in animal studies with hyperactivity, aggression and reproductive problems.

Tap water also contains prenatal toxins. In Downey, California, eight pollutants found in drinking water exceed the health guidelines set by federal and state agencies (not a problem in Barbados, I hope).

Some of those contaminants are known to result in central nervous system defects, oral cleft defects, neural tube defects, low birth weight and risk of fetal death, the researchers said. Pregnant women should be encouraged to drink filtered or bottled water in areas where contamination levels are high, they advised.

Also problematic was the level of caffeine consumption, the research team found. Caffeine consumed during pregnancy is associated with fetal mortality, birth defects and decreased birth weights. Animal studies have found developmental delays, abnormal neuromotor activity, and neurochemical disruptions. Caffeine is found not only in cola drinks or coffee or power drinks, but some popular headache pills contain caffeine.

The tuna mentioned is invariably the canned kind and can be avoided during pregnancy. The fresh tuna we get by the market, once it is not too big, should be safe.

Below is a listing of OTC drugs to monitor or avoid when you realise you are pregnant.

10 OTC drugs to avoid when your’re pregnant:

Drug Found in Recommendation Possible Alternative

Aspirin Excedrin Migraine 1st, 2nd, 3rd trimester:

Not recommended Tylenol (Acetaminophen)

Panadol( Paracetamol)

Bismuth subsalicylate Kaopectate; Pepto Bismol 1st, 2nd trimester:

Use with caution

3rd trimester:

Not recommended Imodium (Loperamide)

Brompheniramine Dimetapp Cold and Fever; Dimetapp Elixir 1st, 2nd trimester:

Use with caution

3rd trimester:

Not recommended Claritin (Loratadine); Zyrtec (Cetirizine)

Caffeine Excedrin Aspirin-Free; Excedrin Quicktabs 1st, 2nd. 3rd trimester:

Use with caution

CR Recommends: Do not exceed 200 milligrams per day to reduce risk of miscarriage None

Castor Oil

— 1st, 2nd. 3rd trimester:

Do not take–unacceptable risk None

Chlorpheniramine Chlor-Trimeton; Combination products: Actifed Cold and Allergy; Actifed Cold and Sinus; Alka-Seltzer Plus Cold Medicine; Dristan Cold; Sinutab Sinus Allergy Maximum Strength; Sudafed Cold and Allergy; TheraFlu Flu and Cold Medicine; Triaminic Cold and Allergy; Tylenol Allergy Sinus Maximum Strength; Tylenol Cold Mulit-Symptom Children’s 1st, 2nd trimester:

Use with caution

3rd trimester:

Not recommended Claritin (Loratadine); Histal Zyrtec (Cetirizine)


Advil, Motrin 1st, 2nd trimester:

Use with caution

3rd trimester:

Not recommended Tylenol (Acetaminophen)/ Panadol( Paracetamol)


Aleve 1st, 2nd trimester:

Use with caution

3rd trimester:

Not recommended Tylenol (Acetaminophen)

Panadol( Paracetamol)

Nicotine All cigarettes; Nicorette gum; Nicoderm patches 1st, 2nd, 3rd trimester:

Not recommended None

Pseudoephedrine Actifed Cold and Sinus, Sudafed Nasal Decongestant, Triaminic AM Decongestant 1st trimester:

Not recommended

2nd, 3rd trimester:

Use with caution Nondrug alternatives: Drink plenty of fluids, consider using steam to relieve congestion, avoid irritants like tobacco smoke

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