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Ibuprofen When Pregnant: Safety, Effects And Alternatives

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Ibuprofen belongs to a class of medications, non-steroidal anti-inflammatory drugs (NSAIDs). It helps treat mild to moderate pain, inflammation, fever, rheumatoid, and osteoarthritis. To know whether Ibuprofen while pregnant is safe or not, read on the safety profile and alternatives of the medicine.

Aches and pains such as backache, headache, and leg pains are common during pregnancy, and medications including Ibuprofen may not always be the right choice (1) (2). Learn the reasons from this post.

Is It Safe To Take Ibuprofen During Pregnancy?

The US Food and Drug Administration (FDA) states that Ibuprofen should be used in pregnant women only if prescribed by a doctor. Further, you should avoid the drug, especially during the third trimester, unless advised otherwise by a doctor as it may be harmful to the fetus and cause complications during delivery (3).

Why Is It Not Safe To Take Ibuprofen During Pregnancy?

Ibuprofen works by blocking the production of certain chemical substances (prostaglandins) in the body that produce inflammation. The potential pregnancy risk due to prenatal exposure to Ibuprofen is mostly an extension of its mechanism of action.
The FDA instructs to add a warning label on NSAIDs explaining that their use around 20 weeks of pregnancy or later can cause rare but serious problems of the fetal kidney. This can lead to a low volume of amniotic fluid (oligohydramnios) and related pregnancy complications (4). Other possible birth defects or adverse outcomes are:

  • Prenatal exposure to Ibuprofen appears to increase the risk of premature closure of fetal ductus arteriosus and may cause fetal pulmonary hypertension and heart complications (5) (6). The ductus arteriosus is a fetal blood vessel that allows the oxygenated blood from the placenta to bypass the lungs. It is kept open during gestation by prostaglandins secreted by the placenta. At birth, prostaglandin levels decrease naturally, causing the closure of this vessel that establishes heart-lung circulation (7).
  • A study found an association between mid-childhood problems of cognitivefunctions and behavior with prenatal exposure to Ibuprofen (8).
  • Some experts have found an increased risk of asthma in children whose mothers were exposed to Ibuprofen in the second and third trimesters of pregnancy. The same study showed a borderline association between congenital heart defects and first-trimester exposure to the drug (9).
  • Boys born to mothers who have taken NSAIDs during the second trimester may have an increased risk of infertility and testicular cancer due to affected testosterone production (10).
  • Ibuprofen and other NSAIDs may worsen bleeding problems in general. This may contribute to maternal bleeding during pregnancy. NSAIDs may also prolong gestation(11) (12).

What If Ibuprofen Was Used Before Pregnancy?

You should inform your doctor about the duration for which you have taken Ibuprofen. If you have taken it for a longer duration, the doctor may assess the fetal development (13). If you are still on it, he/she may suggest an alternative.

What Are The Safer Alternatives To Ibuprofen During Pregnancy?

You should consult your doctor before taking any pain medication during pregnancy. Acetaminophen or paracetamol may be prescribed to treat pain and fever during pregnancy. It is considered safe in all stages of pregnancy (14).

Frequently Asked Questions

  1. Can I use Ibuprofen gel during pregnancy?

Ibuprofen gel is not recommended if you are more than six months pregnant. Talk to your healthcare provider before using Ibuprofen gel during pregnancy (15).

  1. Does taking Ibuprofen increase the risk of miscarriage?

It is not exactly known whether or not Ibuprofen increases the risk of miscarriage if used early in pregnancy. There are studies that show increased risk while others provide evidence against it (16) (17). More research is needed to establish a conclusive link between Ibuprofen and miscarriage.

OTC painkillers, such as Ibuprofen, may seem a simple solution to the pains and aches during pregnancy, but they may cause substantial harm to your growing fetus. You may try approaches such as physical therapy, exercise, stretches, massages, and alternate treatments, such as acupressure, under expert guidance for pain management in pregnancy (18). Talk to your doctor if you need medications during pregnancy for pain relief.

References:

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  1. Vincent Trung H. Ngo and Tushar Bajaj; (2021); Ibuprofen.
    https://www.ncbi.nlm.nih.gov/books/NBK542299/
  2. Aches and pains during pregnancy.
    https://medlineplus.gov/ency/patientinstructions/000580.htm
  3. Ibuprofen Drug Facts Label.
    https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/ibuprofen-drug-facts-label
  4. FDA Warns that Using a Type of Pain and Fever Medication in Second Half of Pregnancy Could Lead to Complications.
    https://www.fda.gov/news-events/press-announcements/fda-warns-using-type-pain-and-fever-medication-second-half-pregnancy-could-lead-complications
  5. Avinash Patil et al.; (2020); Doppler assessment of the ductus arteriosus with ibuprofen exposure in pregnancy.
    https://www.ajog.org/article/S0002-9378(19)31860-5/fulltext
  6. Ronald A. Black et al.; (2003); Over-the-Counter Medications in Pregnancy.
    https://www.aafp.org/afp/2003/0615/p2517.html
  7. Maria Gillam-Krakauer and Kunal Mahajan; (2021); Patent Ductus Arteriosus.
    https://www.ncbi.nlm.nih.gov/books/NBK430758/
  8. Sheryl L. Rifas-Shiman et al.; (2019); Associations of prenatal or infant exposure to acetaminophen or ibuprofen with mid-childhood executive function and behaviour.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170759/
  9. K. Nezvalová-Henriksen et al.; (2013); Effects of ibuprofen diclofenac naproxen and piroxicam on the course of pregnancy and pregnancy outcome: a prospective cohort study.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683088/
  10. Millissia Ben Maamar et al.; (2017); Ibuprofen results in alterations of human fetal testis development.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345102/
  11. Ibuprofen for adults.
    https://www.nhs.uk/medicines/ibuprofen-for-adults/
  12. Amanda Risser et al.; (2009); NSAID Prescribing Precautions.
    https://www.aafp.org/afp/2009/1215/p1371.html
  13. Ibuprofen.
    https://www.medicinesinpregnancy.org/Medicine–pregnancy/Ibuprofen/
  14. Malaika Babb et al.; (2010); Treating pain during pregnancy.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809170/
  15. Boots Ibuprofen 5% w/w Gel.
    https://www.medicines.org.uk/emc/product/8088/pil#gref
  16. K.D. Rainsford; (2015); Safety and Efficacy of Non-prescription Over-the-Counter (OTC) Ibuprofen.
    https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118743614.ch7
  17. Katarina Dathe et al.; (2018); No evidence of adverse pregnancy outcome after exposure to ibuprofen in the first trimester – Evaluation of the national Embryotox cohort.
    https://www.sciencedirect.com/science/article/abs/pii/S0890623818300431
  18. Shalini Shah et al.; (2015); Pain Management in Pregnancy: Multimodal Approaches.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4584042/
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Dr. Annal Vaidya

(MS)
Dr. Annal Vaidya is a former assistant professor of Obstetrics and Gynecology at the prestigious Seth GS Medical College and KEM Hospital, Mumbai. He currently works as a consultant in various hospitals in the city. Dr. Vaidya specializes in managing high-risk pregnancies, infertility, and complicated pregnancies. He has a special interest in Cosmetic Gynecology and Endoscopy.

Dr. Joyani Das

Dr. Joyani Das is a PhD in Pharmacology with over two years of experience in academics. Previously, she worked as an associate professor, faculty of Pharmacology. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer. Her research work was published in international journals and publications, such as Elsevier, Current... more