Reminder on the contraindication of all NSAIDs from the beginning of the 6th month of pregnancy
Health security & vigilance
updated : January 9, 2004
See also CRAT press release : CYTOTEC ® (misoprostol) in the 1st trimester of pregnancy : a malformative effect ? [Read]
I’m pregnant : what you need to know about nonsteroidal anti-inflammatory drugs (NSAIDs)
- Which drugs are affected by this information ?
All non-steroidal anti-inflammatory drugs are affected by this information, i.e.:
aspirin from 500 mg/d
Be careful, some common drugs are not called « aspirin », but may contain it, whether or not associated with other substances. Read the leaflets carefully and, if in doubt about the nature and use of a medicine, talk to your doctor or pharmacist.
cyclooxygenase 2 inhibitors
All of these NSAIDs (see list below) represent a vast class of drugs, all having the same mode of action.
2. In which cases could an NSAID be prescribed to me ?
NSAIDs are used in a large number of conditions, to relieve and/or treat :
fever,rheumatism, joint pain, lumbar pain,muscle trauma,pain and inflammation of the nose, throat and ears,dental,pain and inflammation, hemorrhoidal pain and inflammation,gynecological pain,headache head, migraines,… and in many other cases.
If you are in one or the other of these cases, never take a medicine without having spoken to your doctor or your pharmacist.
3. Are NSAIDs only available by prescription ?
No, there are NSAIDs, commonly used to treat pain of various origins and fever, which are sold over the counter in pharmacies.
This is the case for aspirin (most medicines containing it are available without a prescription)
and certain medicines containing :
or ibuprofen : (Toprec)
|(Advil, Algifene, Anadvil, Anadvil cold, Antarene, Cliptol, Doctril,
Ergix pain and fever, Expanfen, Gelufene,
|Hemagene Tailor, Ibualgic, Ibuprofen, Ibutop, Intralgis, Nureflex,
|Rhinathiol cold, Rhinureflex, Solufen, Spedifen, Syntofene, Tiburon, Upfen, Vicks Cold).|
Also be careful with NSAIDs which are available as eye drops, ointment, cream or gel for topical application. Although the doses used are generally lower, these drugs must be subject to the same precautions for use as other NSAIDs
Carefully read the instructions for the medicines in your medicine cabinet and, if in doubt, talk to your doctor or pharmacist before using them.
4. What are the risks for my baby with this family of drugs ?
It is the action of these drugs on prostaglandins that is responsible for the effects on the fetus or newborn.
These effects relate to :
the heart with the risk of heart failure,
the kidney with the risk of renal failure,
and can lead to the death of the baby before or after birth.
5. Do these effects occur at any time of pregnancy / at any dose ?
No, this risk appears from the beginning of the 6th month of pregnancy. The risk of occurrence of these effects is then all the more important as the dose is close to the expected date of delivery, even if it is a very occasional dose.
What should I do if I took an NSAID when I started my 6th month of pregnancy ?
1°- You must immediately stop taking the medicine concerned.
2° – Even if you have only taken the medicine once, notify and consult your gynecologist or your attending physician very quickly, because he alone can judge what action to take.
In very specific and very rare situations, your gynecologist, your cardiologist or your doctor may prescribe this type of medicine for you. In this case, strictly follow the prescription (treatment and monitoring) of your doctor.
6. I am less than 5 months pregnant and I have not started my 6th month of pregnancy : is there a risk for the baby if I have taken one of these medicines ?
before 12 weeks of amenorrhea (2 completed months of pregnancy):
There is no risk that these effects will be observed. However, you must refer to the instructions for the medicine you have taken/are taking.
between 12 and 24 weeks of amenorrhea (between 2 months and 5 completed months of pregnancy):
A specific treatment seems without harmful consequences. On the other hand, it is not recommended to take long-term NSAIDs.
However, if you have to use this type of medicine, it is best to talk about it beforehand with your gynecologist, your doctor or your pharmacist, who are able to take into account :the type of NSAID,
the duration of treatment.
They may also offer you other types of medications to relieve your symptoms.
But, in any case, you should no longer take NSAIDs after the end of the 5th month of pregnancy.
NB : The list below is given for information only (medicines marked with an asterisk may be marketed under different brand names) and concerns medicines marketed on December 15, 2003 ; if in doubt about the composition of an older medicine, which has, for example, been kept in your medicine cabinet, ask your pharmacist for advice.