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Medications and exposures in pregnancy

The following is meant to be a guideline for common over the counter medications and exposures. We have limited information on the long-term effects of many of the following substances, so this information is offered with the best information available at this time. It is best practice to minimize any uncertain exposures and only use medications when needed. Mother to Baby is a resource that has compiled summaries based on available research for common exposures.

Over the Counter Medications

Pain Management (pregnancy)

  • Tylenol is considered safe. The maximum dose of 4000mg per 24 hours must not be exceeded.

  • Avoid all Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen (Advil, Motrin) or Naproxen (Aleve)  

    • Do not take Acetylsalicylic Acid (Aspirin) unless advised by your midwife or physician 

Cold & Flu (please read labels carefully on the package for all ingredients and ask your team if questions)

  • Avoid decongestants Pseudoephedrine or Phenylephrine 

  • Dextromethorphan and/or Guaifenesin can be used to reduce cough and phlegm (e.g. Benylin DM, Robitussin) 

  • Saline spray (e.g. Salinex), sinus rinses, nasal strips, use of a humidifier, Vicks rub, throat lozenges are other good options

  • Tylenol for pain and fever 


  • Nasal spray (e.g. Otrivin containing Oxymetazoline) for short term use only or saline spray (e.g. Salinex) 

  • Diphenhydramine (e.g. Benadryl), Loratadine (e.g. Claritin) and Cetirizine (e.g. Reactine) are considered safe ​as needed

  • Topical Hydrocortisone creams for itching (e.g. Polysporin or Life Hydrocortisone1%) 


  • Start with Antacids: calcium carbonate (e.g. Tums), aluminum hydroxide & magnesium hydroxide (e.g. Maalox), or alginic compounds (e.g. Gaviscon)

  • Sometimes a prescription from your family doctor for other options may be suggested based on severity 


  • Do not use commercial laxatives

  • Fibre supplements (e.g. Metamucil)  

  • Docusate Sodium & Docusate Calcium (e.g. Colace and Surfak) are considered safe


  • Hamamelis & Glycerine compresses (e.g. Tucks or witch hazel)

  • Zinc Ointments (e.g. Anusol) are considered safe

  • Your midwife can provide a hydrocortisone prescription (cream and/or suppository) if indicated

Varicose Veins and Swelling in Legs

  • Your midwife may discuss with you the use of maternity compression stockings. Generally, mild compression stockings (15-20mmHg) are sufficient and found over the counter but a higher prescription can be provided. Your team will discuss in more detail signs of blood clots to monitor for if you are at a higher risk. 



  • Small amounts under 300mg per day (average 2 cups a day of tea or coffee) is generally considered safe

  • Green and Black teas are considered safe but do contain caffeine 

Herbal Tea (per Government of Canada Guide)

  • Avoid chamomile, aloe, coltsfoot, juniper berry, pennyroyal, buckthorn bark, comfrey, labrador tea, sassafras, duck root, lobelia, stinging nettle and senna leaves. Also avoid kombucha tea.

  • Other herbal teas, such as mint, citrus peel, ginger, orange peel and rose hip, are considered safe in moderation (two to three cups per day).


  • No amount is considered safe. Alcohol can affect your baby’s development and have life-long physical and developmental effects. Canadian health care providers recommend avoiding any alcohol during pregnancy.

Cigarette Smoking and Vaping

  • Cessation recommended. For reduction strategies please discuss with your midwife as there are increases in the risk of miscarriage, low birth weight babies, and premature delivery.

  • Second hand smoke should also be avoided, and there should be no smoking inside your home or vehicle. This is especially important when there is a newborn and/or other child in the home. 


  • Cessation recommended. For reduction strategies please discuss with midwife. There is increased risk of preterm labour, low birth weight, lower alertness and slow growth. There may be long term impacts on infant and childhood development, sleep patterns, memory, and learning disabilities.

Hair Colour & Perms

  • Styling products, shampoos, conditioners, dyes and perms are considered safe for use in pregnancy. Use in a well-ventilated area.

Creams and Oils

  • Avoid creams containing retinoids, and use substances with essential oils with caution, as there is no evidence of safety in pregnancy.


  • Safe for use in pregnancy and recommended

Electrolysis and Laser Hair Removal

  • Should be avoided in pregnancy

Tanning, Sauna and Hot Tub

  • Should be avoided due to significant elevation in body temperature 

Household Cleaners

  • Most products are safe for use as directed. Use in a well-ventilated area with gloves if indicated.  Do not use industrial strength cleaners in the home.

Household Paints

  • Use latex paints in well-ventilated areas. Low VOC paints are widely available and have minimal odour

  • Avoid oil-based paints and paint removers (as well as paint stripping)

Mosquitos and Ticks

​When possible, avoid exposure to mosquitoes and ticks. The following is recommended:

  • Avoid travel to areas endemic with mosquito-borne illnesses (ie. Zika virus)

  • Wear long clothes and apply repellant to clothing as opposed to directly on skin

  • Use repellant with 20-30% DEET (lower concentrations are less effective)

  • Repellants with citronella or lavender oil should be avoided as they are less effective and there are no studies to say these are safe

  • Remember that insect repellant can decrease the effectiveness of sunscreen


  • Avoid if possible in pregnancy. If used in your home, stay out of the room it was used in for 2 to 3 times longer than the manufacturer recommends. Ventilate the area well by opening windows after spraying. If applied to the lawn, do not walk on the grass for the recommended amount of time.


  • Make sure your practitioner and the x-ray technician know that you are pregnant

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