⚠️ Always consult your doctor or midwife before taking any medication during pregnancy. No medication is 100% risk-free in pregnancy. This tool provides general reference information only and cannot replace personalised clinical advice.

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Pregnancy drug safety checker

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Look up the pregnancy safety profile of any medication. Results include FDA legacy category, risk summary, trimester-specific guidance and key clinical notes. Covers 200+ commonly used medications.

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Medication safety in pregnancy: understanding the evidence

No medication is completely risk-free in pregnancy. The question is always whether the benefit of treating the condition outweighs the risk of the medication to the developing fetus. Many conditions, including depression, epilepsy, hypertension, diabetes and infections, carry their own serious risks to pregnancy if left untreated.

The old FDA pregnancy categories (A, B, C, D, X)

The FDA replaced the A/B/C/D/X category system in 2015 with more detailed narrative labelling (the Pregnancy and Lactation Labeling Rule, PLLR). However, the old categories remain widely referenced in clinical practice and many prescribers still use them as shorthand. Category A means controlled studies show no risk. B means animal studies show no risk but human data is limited. C means animal studies show adverse effects but human data is inadequate. D means human data shows fetal risk but benefits may outweigh risks. X means fetal risk clearly outweighs any possible benefit, contraindicated in pregnancy.

Trimester matters

The first trimester (weeks 1-12) is the period of organogenesis, when the heart, brain, limbs and organs form. This is the period of highest teratogenic risk. NSAIDs are relatively low-risk in the first and second trimester but can cause premature closure of the ductus arteriosus in the third trimester and are generally avoided after 28-30 weeks. SSRIs taken in late pregnancy are associated with neonatal adaptation syndrome. Always check trimester-specific guidance.

When treatment is riskier to withhold

Epilepsy treated with valproate carries significant teratogenic risk, but uncontrolled seizures in pregnancy are life-threatening. Severe depression or anxiety left untreated in pregnancy is associated with poor maternal and fetal outcomes. The decision about any medication in pregnancy should always involve the prescriber who knows the patient's full clinical picture. Use our Breastfeeding Drug Safety Checker for postnatal medication decisions. For checking drug interactions in pregnancy, use the Drug Interaction Checker.

Frequently asked questions

Is paracetamol safe during pregnancy?

Paracetamol has been the analgesic of choice in pregnancy for decades and is generally considered the safest option for pain and fever. Recent observational studies have raised questions about prolonged use potentially affecting fetal development, but the evidence is not conclusive. Current guidance is to use paracetamol at the lowest effective dose for the shortest time, and to avoid prolonged use without medical advice.

Can I take ibuprofen during pregnancy?

Ibuprofen is generally avoided in pregnancy, especially from 20 weeks onwards. In the third trimester it can cause premature closure of the ductus arteriosus and impair fetal renal function, leading to oligohydramnios. The FDA warned against use from 20 weeks in 2020. In the first trimester, some studies show an association with miscarriage. Paracetamol is preferred for pain and fever management in pregnancy.

What does FDA pregnancy category X mean?

Category X means the risks of the medication to the fetus clearly outweigh any possible benefit. It is contraindicated in pregnancy. Examples include isotretinoin (Roaccutane), thalidomide, warfarin in the first trimester, methotrexate, statins and misoprostol. The FDA replaced the A/B/C/D/X system with more detailed narrative labelling in 2015, but these categories remain widely referenced.