Ibuprofen during pregnancy Safety, Risks, and Alternatives

 

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Pregnant women are advised to avoid ibuprofen during pregnancy, especially if they’re 30 or more weeks pregnant. Taking the medication at 30 weeks and beyond could cause premature closing of a. If a woman takes ibuprofen during the last trimester of pregnancy, she places her child at risk of the following serious consequences: Decrease in the volume of amniotic liquid and, therefore, a delay in birth. Problems with the development of the baby’s lungs.

Cardiac malformations. Ibuprofen can block the arteries of the heart and have serious consequences. Ibuprofen Pregnancy Warnings. Risk Summary: Nonsteroidal anti-inflammatory drug (NSAID) use during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus and therefore should be avoided; prior to 30 weeks gestation, studies are inconclusive regarding potential embryofetal risks.

It’s unlikely that one dose will harm your baby, but taking ibuprofen (Advil and Motrin) is generally not recommended when you’re pregnant, especially during the third trimester. Several studies have been done on the effects of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and naproxen, during pregnancy. The short answer is no, most healthcare providers aren’t comfortable with women taking ibuprofen or Motrin while pregnant.

The same holds true for any medication that has ibuprofen as an active ingredient. It can be especially dangerous to use ibuprofen products like Motrin during the third trimester of pregnancy. According to the study, higher doses of ibuprofen (such as 1,200 to 2,400 milligrams) could mean a “five-fold increased risk” of gastrointestinal bleeding or torn stomach lining.

Before 30 weeks of pregnancy, avoid taking ibuprofen It’s best to avoid taking ibuprofen in the first 30 weeks of pregnancy, unless the benefits outweigh the potential risk to your unborn baby. This is because taking ibuprofen in the first 30 weeks of pregnancy may lead to an increased risk of complications, including miscarriage. Prescription NSAIDs and the risk of miscarriage in the first half of pregnancy.

2-6 Examples of prescription NSAIDs include ibuprofen, naproxen, diclofenac, and celecoxib. Pepto-Bismol may not be safe to use during pregnancy because, as with aspirin, it is a salicylate. This group of medications is anti-inflammatory and known to have effects related to bleeding.

Some research suggests that taking acetaminophen daily for long periods (28 days or longer) could put your baby at greater risk of mild developmental delays or attention deficit hyperactivity.

List of related literature:

Among 578 participants, 86 (15%) took ibuprofen during pregnancy, including 20 during the 3rd trimester buprofen was the fourth most commonly used over-the-counter medication (after acetaminophen, calcium carbonate, and cough drops) (12).

“Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk” by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
from Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk
by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
Lippincott Williams & Wilkins, 2008

Using Drug Facts and Comparisons, AHFS or PubMed, find out if ibuprofen is safe to use in the third trimester of pregnancy.

“The Pharmacy Technician, 7e” by Perspective Press
from The Pharmacy Technician, 7e
by Perspective Press
Morton Publishing Company, 2020

Ibuprofen and naproxen are safer options, but both should be used with caution during pregnancy.

“Sabiston Textbook of Surgery E-Book” by Courtney M. Townsend, R. Daniel Beauchamp, B. Mark Evers, Kenneth L. Mattox
from Sabiston Textbook of Surgery E-Book
by Courtney M. Townsend, R. Daniel Beauchamp, et. al.
Elsevier Health Sciences, 2012

For example, they report that ibuprofen has been known to have detrimental effects when taken during pregnancy such as problems in fetal implantation, childbirth and maternal pulmonary hypertension.

“ADA Dental Drug Handbook: A Quick Reference” by American Dental Association
from ADA Dental Drug Handbook: A Quick Reference
by American Dental Association
American Dental Association, 2018

Nevertheless, it seems likely that many patients will receive ibuprofen during pregnancy either as treatment started before conception was diagnosed or because the drug was considered necessary.

“Ibuprofen: A Critical Bibliographic Review” by Kim D. Rainsford
from Ibuprofen: A Critical Bibliographic Review
by Kim D. Rainsford
Taylor & Francis, 2003

Commonly, pregnant women are counseled that using acetaminophen is safe whereas using a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen is not.

“AWHONN's Perinatal Nursing” by Kathleen R. Simpson
from AWHONN’s Perinatal Nursing
by Kathleen R. Simpson
Wolters Kluwer Health, 2013

Further, a recent case-control study from the National Birth Defects Prevention Study reported an association between ibuprofen use and orofacial clefts, spina bifida, and anophthalmy or microphthalmy (Hernandez 2012).

“Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment” by Christof Schaefer, Paul W.J. Peters, Richard K Miller
from Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment
by Christof Schaefer, Paul W.J. Peters, Richard K Miller
Elsevier Science, 2014

One report stated that the use of ibuprofen in pregnancy occurred in 14.9% of the patients studied, 52% (45 of 86) of whom were exposed in the first trimester (6).

“Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk” by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
from Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk
by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2011

If taken late in pregnancy, ibuprofen may cause premature closure of the ductus arteriosus; therefore ibuprofen use is contraindicated during the third trimester and during labor and delivery.

“Pharmacology E-Book: A Patient-Centered Nursing Process Approach” by Linda E. McCuistion, Jennifer J. Yeager, Mary B. Winton, Kathleen Vuljoin DiMaggio
from Pharmacology E-Book: A Patient-Centered Nursing Process Approach
by Linda E. McCuistion, Jennifer J. Yeager, et. al.
Elsevier Health Sciences, 2020

Adverse effects: ibuprofen should be avoided in pregnancy and its use should be restricted to the management of post-delivery pain.

“Oxford Textbook of Obstetrics and Gynaecology” by Sabaratnam Arulkumaran, William Ledger, Stergios Doumouchtsis, Lynette Denny
from Oxford Textbook of Obstetrics and Gynaecology
by Sabaratnam Arulkumaran, William Ledger, et. al.
Oxford University Press, 2019

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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17 comments

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  • Hi sir is it safe i had drunk 2 tablets of 500 mg Paracetamol Analgesic I’m 5 months pregnant what might be the bad side effects? I’m so worried.

  • Thanks. Yes, I was concerned that I wouldn’t be digesting it as fast at night. Would you also say that taking the vitamin D and probiotics can help cure a chronic inflammatory problem?

  • thank you. have herniated disc c5-c6. had pain in romboid area for 2years. iv recently got shingles in that area. ihave met many people with shingles after herniated disc. is this normal?

  • In general might wanna be careful with NSAIDs. Over 100,000 hospitalizations a year and 16,500 deaths in the US alone. Abramson, S.B. and Weaver, A.L., 2005. Current state of therapy for pain and inflammation. Arthritis research & therapy, 7(S4), p.S1. https://link.springer.com/content/pdf/10.1186/ar1792.pdf

  • Is paracetamol 650mg safe in early pregnancy? Gynac has prescribed Dolo 650 to my wife. Not sure about its tearatogenicity. Need advice.

  • Don’t take painkillers long term. I now have all sorts of stomach problems, cysts on my kidney and liver. Fatty liver disease. I throw up from a few glasses of wine or a nice meal out. Fevering and so many more problems. I wouldn’t wish the damage I have done to myself to anyone else

  • I take ibuprofen for my over active bladder it stops the pain nothing else works I take one 400 mg per day. Is this ok please advise thank you I don’t take any other medicines. The bullet is great I use every day. Like your site you are a great doctor. Thank you

  • Thank you very much.  This is a great companion video to your Acetaminophen video!  Good…  looks like ibuprofen (vs Tylenol) would be better for me:-)

  • I agree to eliminate sugar..but the smoothie you make has a lot of sugar content..pears and pineapple are incredibly high…so, what about the fruits?? Krista

  • Take 2 Advil for pain and then check your blood pressure in the morning.  
     
    I was dealing with really high blood pressure which started years ago. And after keeping a very detailed blood pressure diary I finally put two and two together and stop taking this med which was the recommended dosage and only a couple times a week or whenever I had pain.   Not only did I have high blood pressure, but my heart started beating really hard and I had a very fast pulse shortly after taking Ibuprofen.  I took it for work and exercise related pain.   I’m still very physical since I mow yards with a rotary mower and shovel snow the old fashion way. 
     
    I thought it was my age at 67 and that was the reason I was getting out of breath so quickly and stopping to catch my breath.  But recently when I went out to shovel snow which was heavy and a bit icy, I actually breezed right through without stopping and without becoming short of breath.  But I had been off of Ibuprofen for around 3 months too with my blood pressure staying down, my heart no longer beats hard and my pulse stays down except when I exercise where if anything my blood pressure is below normal the next day and then comes back up to normal later on in the day.    
     
    It seems like my problems started when a doctor prescribed mega doses of Ibuprofen to me to help get rid of this crippling pain I started having after some quack of a chiropractor tried to get rid of it thinking it was the bones.  But it turned out to be sciatica.   Then when I would need a tooth extracted the doctor would prescribe mega doses of Ibuprofen to me.  The last extraction I had I was given a prescription for Vicotin which I heard some bad things about.  So I didn’t take anything and I did just fine with no more pain than if I took pain killers.  And now I see why Ibuprofen isn’t prescribe anymore around here.
     
    Anyhow, getting back to the problems I was having with my heart I ended up in emergency overnight monitoring and taking tests.  And the test results said I wasn’t having  a heart attack but my blood pressure was very high.  I had to make an emergency visit to my doctor because of the same problems with my heart.  He didn’t have a clue as to why my blood pressure was so high; my heart felt like it was pounding out of my chest and a very fast pulse.  So I was sent home and things did improve for me.  
     
     
    Ibuprofen needs to be taken off the market if it is that dangerous, even at recommended doses.   

  • Sir I have ostreogenesis problem (deficiency of calcium ) due to this prob I have severe prob of back pain I can’t walk without taking pain killers I am also 8th month pregnant kindly please suggest me a suitable and effective pain killer

  • Tumeric is a good anti-inflammatory, but I’m not sure if I’m clear about what you mean when you say, would it just be sitting in your stomach at night. Are you referring to the ibuprophen? The body will digest whatever is there, even when you sleep.

  • What about Tumeric? I’ve been drinking a Tumeric tea to reduce inflammation. I keep needing to take ibuprophen at night though…I have a chronic inflammatory condition. and I’m concerned that it might be affecting me negatively… would it just be sitting in my stomach at night?

  • Well, shingles is actually the chicken pox virus that lays dormant in the nervous system and it never goes away. So, what happens is, if the nerve that it is laying dormant in gets irritated, it will flare up and cause shingles to develop. So yes, any problem that can irritate the nerves will cause it, including a herniated disc.

  • Hi sir thank you for your lovely video,I have one doubt can we prescribe aceclofenac and para combination drugs??? Is it safe for pregnancy patient??

  • Excellent explanation doctor. I am 25 weeks pregnant and my gynac had given an injection of Meftal Spas for pain in the pelvis today. Could you kindly let me know if this one dose or “injection of Meftal Spas will affect my baby. I am so nervous and scared it might affect the baby in some way. Kindly advise.

  • Yes Doctor,,,.. noted this for future referrence hopefully not gonna happen since I do not have a physical pain I felt this time,,, very controling my food intake aswell while pandemic were still monitored,. Better be investing health right now before the prophesied second wave will take over,,,,, takegoodcare Doctor Jason too,.��☺