Commonly used medicines during pregnancy
1. Analgesics (pain killers)
a) Paracetamol (500mg tablets)
What is it used for? Paracetamol is a commonly used pain killer in pregnancy. Paracetamol works by relieving pain and lowering high temperature. It can provide effective relief from mild to moderate pain, including headache, toothache, sore throat, symptomatic relief of rheumatic aches and pains, influenza symptoms and fever. How do I take it? Paracetamol can be taken regularly or when required for pain. Dosage: Adults and young persons aged 12 and over: take 2 tablets up to 4 times per day, as required. The tablets should be taken with water. Take only as much as you need to relieve symptom and leave at least 4 hours between each dose. Do not take more than 8 tablets in 23 hours. What are the side effects? Paracetamol is generally well-tolerated in most people. Is it safe to use during pregnancy? Paracetamol is commonly used during pregnancy.b) Co-dydramol
What is it used for? Co-dydramol (10/500 10mg dihydrocodeine and 500mg paracetamol) is a combination of paracetamol and dihydrocodeine. Dihydrocodeine is stronger than paracetamol and is used for the relief of mild to moderate pain. How do I take it? Dosage: Co-dydramol 1 to 2 tablets every 6 hours when required up to a maximum of 4 times per day. Do not take more than 8 tablets in 24 hours. We recommend that you step down pain relief and substitute these tablets for paracetamol as soon as possible which is usually after 3-4 days. Since these tablets contain paracetamol you should not take any other paracetamol tablets at the same time. Do not drink alcohol whilst taking co-dydramol. What are the side effects? The most common side effects of dihydrocodeine are drowsiness, constipation, feeling sick or dry mouth. You may be advised to take a gentle laxative if you experience constipation whilst taking co-dydramol. Is it safe to use during pregnancy? Use of dihydrocodeine during pregnancy as a pain killer can be justified where paracetamol has not been effective. Use the minimum effective does for the least amount of time. If you would like any further information regarding the use of dihydrocodeine in pregnancy, please discuss it with your midwife/doctor.2. Ferrous Sulphate (Iron supplements)
What is it used for? Iron supplements are used to treat iron deficiency anaemia. When the body does not get enough iron, it cannot produce the number of normal red blood cells needed to keep you in good health. It is common for women who are pregnant or who have just given birth to have this condition. These medicines work by replacing body iron. Iron is a mineral that the body needs to produce red blood cells. How should I take it? Swallow the tablets who with water. Although iron preparations are best absorbed on an empty stomach, they may be taken after food to reduce the effects on the stomach. Iron supplements should not be taken within one hour before or two hours after eating or drinking the following products: tea, coffee, milk, eggs and wholegrains. These products can reduce the absorption of iron. Dosage: Ferrous sulphate 200 mg tablets Treatment of iron deficiency anaemia: 1 tablet 2-3 times a day. Prevention of iron deficiency anaemia: 1 tablet per day. What are the side effects? Like all medicines, ferrous sulphate tablets may cause side effects, the most common of which are constipation, diarrhoea, stomach pain, feeling sick and blackened stools (faeces). Is it safe to use during pregnancy? Ferrous sulphate tablets are commonly used safely in pregnancy. Ensure that you do not take more than the recommended dose. If you cannot tolerate ferrous sulphate tablets, an alternative is available called ferrous fumarate. This is available as a liquid or tablets. The same side effect and safety information applies as above for ferrous sulphate.3. Laxatives
What are they used for? Laxatives are used to treat constipation. Pregnant women may experience constipation, which can be very uncomfortable. This is because the whole digestive system is influenced by hormonal changes during pregnancy. It is important for pregnancy women to look after their diet and maintain regular bowel habits to avoid unnecessary discomfort. What else can I do to prevent becoming constipated? The following hints are helpful in maintaining regular bowel habits:- Eat fibre-containing foods, e.g. wholegrain bread, fruit and vegetables.
- Drink sufficient liquid, preferably water.
- Take regular exercise.
a) Lactulose
Lactulose is a liquid laxative used to treat and prevent constipation. Lactulose can take 2-3 days to have an effect; it is generally considered to be a gentle laxative. Dosage: Usually 10 mls twice daily. It must be taken regularly to have an effect.b) Fybogel (Ispaghula husk)
Fybogel is a high fibre drink that works to increase the fibre in your diet. Increased fibre in the diet helps to gently relieve constipation. Fybogel is considered to be a gentle laxative. It is important to maintain an adequate intake of fluid whilst using Fybogel. Dosage: The usual dose is one sachet mixed with a glass of water, up to twice daily. Is it safe to use Lactulose or Fybogel during pregnancy? Lactulose and Fybogel are not absorbed into the blood and only have a local effect on the gut. Both drugs are generally considered safe to use in pregnancy and for breastfeeding, under the advice of a midwife or doctor.4. Blood clot prevention
Enoxaparin (also known as Clexane) is used to prevent blood clots. Blood clots usually present as deep vein thrombosis (DVT) usually in a leg vein, or pulmonary embolism (PE), a blood clot in the lung. Blood clots are more common during pregnancy and some women will be more at risk of blood clots than others. Your risk factors for developing a blood clot will be assessed at your booking appointment and if you are admitted to the hospital. As well as prevention, enoxaparin is also used at higher doses for treatment of DVT and PE. How is enoxaparin used during pregnancy? During the antenatal period, your midwife or obstetrician will assess your risk of developing a DVT/PE. They will look at your previous history and other risk factors that may exist. Your obstetrician will then decide if you require enoxaparin during pregnancy, and the dose you are to have. Is it safe to use during pregnancy? Enoxaparin is given as an injection just beneath the skin (subcutaneous). It is usually injected into a skin fold in your abdomen (stomach) or the upper part of your thigh. If this is not suitable, you may be advised to inject into an alternative site. It should not be injected into your muscles. It may be given either once or twice daily. You should administer the dose at the time recommended by your doctor. How to inject Enoxaparin (Clexane) You will be able to inject enoxaparin once you have been shown how to do so by your doctor or midwife, or by following the instruction leaflet that will be given to you upon discharge. It is a simple process and one that you can do at home. Follow these steps:- Wash and dry your hands.
- Clean the injection site. If someone else is doing it for you it is advisable that they wear gloves.
- Choose the injection site either on the outer aspect of your left or right thigh or your stomach if advised to do so. It is important that you change the site each time. If there is any oozing of blood at the injection site, apply gentle pressure. Do not rub as this may cause bruising.
- Dispose of the syringe in the yellow sharps box provided. This box should be kept out of the reach of other people.
