Medication can be a great tool for improving health—but some medicines that are wonderful for you can cause problems for a developing pregnancy. So if you use certain types of medication, it’s extra important to use birth control carefully and consistently. If you've decided you're ready to get pregnant, make sure to talk to a health care provider first about ways to maximize your health—and your baby’s—including reviewing any medicines you’re taking.
The Food and Drug Administration (FDA) —the agency that reviews all medicines in the U.S. for safety and effectiveness—rates medicines with a letter grade for safety in pregnancy. The categories are straightforward:
'A' means studies show no risk
'B' means there’s no evidence of risk in humans
'C' means risk can’t be ruled out
'D' means there is evidence of risk
'X' means do not use during pregnancy
There are quite a few medications that fall in category C, partly because it just isn’t ethical to do medical studies with pregnant women. It can also be a challenge to weigh the importance of a healthy mom versus a healthy baby. Sometimes a medication’s huge benefit for a mom outweighs a small risk to a growing pregnancy.
So what do we know for sure about common medications and pregnancy?
In general, antibiotics are safe, but there are a few known to be dangerous to a growing pregnancy. Tetracyclines (like doxycycline and minocycline), which are commonly used to treat acne, are considered category D. They can cause problems with your liver and your baby’s teeth. If you were taking a tetracycline when you conceived or early in your pregnancy, make sure to tell your health care provider.
Antidepressants come in so many forms, the safest bet is to talk to your provider before trying to get pregnant. Most antidepressants are category C, although bupropion (Wellbutrin) is category B. Paroxetine (Paxil) has been associated with heart defects, so it’s considered category D.
About two-thirds of women who suffer from depression will experience symptoms during pregnancy. In general, a depressed mom is not a healthy mom, so if you're dealing with depression, work with your provider to figure out the best treatment options for you.
High blood pressure medicines
Although high blood pressure can be dangerous in pregnancy, so are certain blood pressure medicines. Luckily, there are many safe medicines you can take during pregnancy to control your blood pressure. If you are taking an ACE-inhibitor (such as lisinopril), talk to your provider before getting pregnant. These medicines are a category D because they have been associated with birth defects when taken early or late in pregnancy.
Many of the drugs used to prevent seizures have been associated with severe birth defects, including neural tube defects. Although supplementing your diet with additional folic acid may help, meeting with your provider before getting pregnant is incredibly important if you're taking anti-seizure medication. You may choose to switch to a safer medicine like lamotrigine to keep you safe and decrease risks for pregnancy.
Severe acne medicine
It may work wonders on your skin, but isotretinoin (Amnesteem, Claravis, Sotret, or Accutane) can wreak havoc on a growing pregnancy. It’s a category X. Health care providers and pharmacists should make sure you are using two forms of birth control before they provide it! It can cause birth defects like hearing and visual impairment, missing or malformed earlobes, a malformed face, and intellectual disability.
If you are taking other medications and want to learn about their possible impact on a pregnancy, check out the FDA’s Medication Guides. If you don’t want to be pregnant right now—whether you are taking medications or not—the safest plan is to find an effective birth control method that works for you. And as always, talk to your health care provider for more information!