Introduction
During pregnancy, many women ask themselves the question of which medications may be taken without hesitation. Most pregnant women are primarily concerned about the unborn child, but of course also about their own well-being. In particular the question of suitable painkillers during pregnancy is of primary concern to many women.
Above all, freely available painkillers are important “everyday helpers” for many otherwise healthy people and are taken as needed. But what is the situation during pregnancy with such over-the-counter painkillers? Can they harm the child or the mother?
Especially the use of over-the-counter drugs is rarely discussed with a doctor, so it is very important to know the appropriate medication. Women who suffer from pain that requires therapy with prescription painkillers are also faced with a conflict between taking medication and the well-being of the unborn child. In this case, it is important to inform the treating physician of the existing pregnancy or even a suspected pregnancy.
The doctor can then adjust the medication accordingly so that the welfare of the child and the mother is not endangered. In the following article you will find useful information on the topic of “Painkillers in pregnancy”. Important medicines and clinical pictures around the topic “painkillers” are explained in more detail with regard to an existing pregnancy. Nevertheless, in order to ensure optimal and individual care for you and your child, you should always consult your treating physician.
Selection of different medications
Paracetamol is one of the most frequently taken painkillers in Germany. It is freely available in pharmacies and is often used in everyday life to relieve pain or reduce fever. In principle, paracetamol is well tolerated and has few side effects, which is why it is very popular among the population.
There is a great deal of experience with its use during pregnancy. Paracetamol belongs to the group of painkillers which are recommended during pregnancy and lactation, taking into account the existing contraindications. Especially women with severe liver dysfunction should avoid paracetamol.
There have been repeated case reports that paracetamol in the 1st trimenon has a harmful potential in pregnancy, but these suspicions have not been substantiated. Also recently made claims of some studies that paracetamol would cause undescended testicles in boys could not be confirmed. The results of the studies were contradictory and inconclusive.
Paracetamol is also very well tolerated and recommended in the 2nd and 3rd trimester. Individual case reports and studies made claims that taking paracetamol during this time would promote asthmatic symptoms in the child. These claims could not be substantiated either and the study results were highly contradictory.
Therefore, paracetamol in the usual dosage is still recommended during pregnancy. As an alternative, ibuprofen can be used in the 1st and 2nd trimenon (but not in the 3rd trimenon!). Ibuprofen belongs to the group of so-called non-steroidal anti-inflammatory drugs (NSAIDs) and is used for the treatment of mild to moderate pain as well as for fever reduction.
Ibuprofen is also frequently used in the treatment of migraine. There is a great deal of experience in the use of ibuprofen during pregnancy, so that reliable statements can be made about its effects. Ibuprofen can be used during pregnancy.
However, the intake should be made under strict risk-benefit consideration. In the 1st trimester there is no suspicion that ibuprofen may cause harm to the unborn child. However, it should not be taken carelessly and especially not in high doses.
In the 2nd trimenon, the use of ibuprofen should be carefully considered. Ibuprofen should not be taken in the last trimester of pregnancy as there are several risks of harm to the unborn child. In the last trimester of pregnancy ibuprofen may cause premature closure of the ductus arteriosus Botalli in the child.
This important vascular connection in the circulation of the unborn child closes naturally after birth. However, premature closure can lead to complications in the unborn child. In addition, kidney function can be considerably reduced, resulting in a lack of amniotic fluid (oligohydramnios).The increased incidence of necrotizing enterocolitis is also associated with taking ibuprofen in the last trimester of pregnancy.
This is an inflammation of the newborn’s intestinal wall, which can be fatal in up to 30% of cases. Therefore, ibuprofen should not be taken in the 3rd trimester. Paracetamol is an alternative.
Novalgin® is one of the trade names for the active substance metamizole. It is mainly used to treat severe pain and to reduce high fever. Novalgin® is particularly suitable for the relief of colicky abdominal pain.
However, Novalgin® cannot be used without restrictions during pregnancy. The range of experience is not quite as high as with the active substances ibuprofen and paracetamol. Novalgin® must not be used in the 2nd and 3rd trimester of pregnancy.
During this time Novalgin® can lead to a premature closure of the Ductus Arteriosus Botalli, which is an important vascular connection in the circulation of the unborn child. This vascular connection is naturally closed after birth. However, this premature closure is pathological and leads to damage to the unborn child.
Furthermore, a lack of amniotic fluid (oligohydramnios) can occur if Novalgin® is taken in the 2nd and 3rd trimester of pregnancy. Therefore, it is strongly discouraged from taking it. In the first third of pregnancy Novalgin® may be used under strict risk-benefit consideration.
In total it is not recommended to take Novalgin® during pregnancy. However, should there be pain requiring treatment, it is possible to take Novalgin® in the first third of pregnancy with a strict indication. An increased malformation rate during this period is not to be expected.
In the 2nd and 3rd trimester of pregnancy, however, it is not advisable to take it. If Novalgin® is taken repeatedly during this period, the circulation of the unborn child must be monitored closely – about 1 to 2 times a week – with ultrasound examinations. Paracetamol is preferable as a painkiller, if possible.