Non-Drug Therapies and Over-the-Counter Suggestions for Pregnant Women
  Contributed by: Lisa Barslou, Pharm.D. Candidate
                        UMKC School of Pharmacy

Finding out one is pregnant is a very exciting time for a woman and her family.  Many questions often arise about what over-the-counter medications are safe for the mother and baby.  This article will explore some non-drug therapies and over-the-counter options for common conditions that can occur during a woman's pregnancy.

Allergic Rhinitis
Yours eyes are red and itchy, your nose won't stop running, and you can't stop sneezing.  It is that time of year when allergies often flare up.  Intranasal cromolyn is the drug of choice in pregnancy because of its wide margin of safety.  Intranasal cromolyn is an anti-inflammatory drug that prevents and treats symptoms of allergic rhinitis. Treatment is most effective when started before seasonal symptoms begin.  Chlorpheniramine is the oral anti-histamine drug of choice in pregnancy if the use of intranasal cromolyn fails, but should be avoided during the third trimester (weeks 27-42)

Common Cold
During the winter many people suffer from the common cold.  The cold starts with a sore throat, followed by nasal symptoms, and a cough.  The good news is that most colds are self-limiting which means they

eventually go away on their own.  Non-drug therapy such as increased fluid intake, adequate rest, increased humidification, and nasal irrigation should be tried first.  If over-the-counter treatment must be used, the drug of choice for congestion is intranasal oxymetazoline.  It is important to remember that overuse can cause rebound congestion.  As for pain associated with a sore throat or pain in general for that matter, acetaminophen (Tylenol) is the drug of choice.  Ibuprofen and aspirin are okay in the first trimester ONLY!  These agents must ABSOLUTELY BE AVOIDED in the third trimester.  Best advice, think about the baby and deal with the cold with non-drug therapies.

Constipation/Hemorrhoids
Constipation during pregnancy is very common.  Constipation can further lead to hemorrhoids causing itching, burning, and discomfort in the anorectal area.  Neither conditions are enjoyable.  The goal of treatment of constipation in pregnancy is to achieve soft stools without the use of laxatives.  Increasing dietary fiber by eating whole grain breads, apples, oat bran, and citrus fruits and increasing daily fluid intake have proven effective in relieving constipation.  Bulk-forming laxatives are also safe and effective when used in pregnancy.  Examples include any Metamucil

product or FiberCon tablets.  Remember to drink plenty of fluids with bulk-forming agents or the condition could worsen.  If hemorrhoids occur as a result of constipation, external agents such as any Preparation H products or Tuck's pad are recommended.

Heartburn
Infrequent and mild heartburn in pregnancy can be treated with calcium and magnesium containing antacids if recommended daily dosages are not exceeded.  Tums and Rolaids are 2 examples of available over-the-counter products.

If any of the mentioned conditions become unbearable contact your primary care physician for other treatment options.  If ever in question about the safety or recommended dose of an over-the-counter medication never hesitate to ask your pharmacist.  Your pharmacist can help you find the products you are looking for.

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