Experts: Pregnant People Should Be Cautious About Taking Tylenol - Verywell Health

Key Takeaways

• In a new paper, researchers are warning pregnant people not to take acetaminophen, a common over-the-counter (OTC) medication used to treat pain and relieve fevers.
• The researchers cite some previous research that linked acetaminophen use in pregnancy to negative health outcomes in babies and children.
• Doctors say that pregnant people should be cautious about taking any medications, including acetaminophen.

For years, acetaminophen (also called paracetamol) has been considered a safe medication to take for pain relief during pregnancy.

Now, researchers warn that the common over-the-counter (OTC) pain reliever may interfere with fetal development, and they are advising pregnant people to be cautious about taking the drug.

Tylenol is a popular brand of acetaminophen.

New Recommendations

In the new consensus statement published in Nature Reviews Endocrinology, the researchers cite a growing body of evidence that suggests acetaminophen use during pregnancy can affect the fetus, and that it may lead to neurodevelopmental, reproductive, and urogenital disorders in children. 

The researchers are not necessarily saying that pregnant people should never use acetaminophen—rather, they advise that it should be used with caution and under the guidance of a doctor.

The authors wrote that acetaminophen is an "important medication" and acknowledged that "alternatives for treatment of high fever and severe pain are limited."

Based on the evidence, the authors made the following recommendations:

• Pregnant people should avoid taking acetaminophen "unless its use is medically indicated."
• Pregnant people should consult with a doctor or pharmacist if they are unsure whether they need to use acetaminophen, as well as before taking it long-term.
• Pregnant people should minimize exposure to acetaminophen by using the lowest effective dose for the shortest possible time.

What Is Acetaminophen?

Acetaminophen is in a class of medications called analgesics (pain relievers) and antipyretics (fever reducers). It works by changing the way the body senses pain, as well as by cooling the body.

Jamie Alan, RPh, PharmD, PhD, associate professor of pharmacology and toxicology at Michigan State University, tells Verywell that in pregnancy, acetaminophen "does help with pain reduction and fever reduction."

Up to 70% of pregnant people in the United States report taking acetaminophen at some point in their pregnancy.

Acetaminophen is an active ingredient in many pain-relieving medications, such as Tylenol. It can relieve mild to moderate pain from headaches, menstrual periods, colds, sore throats, backaches, toothaches, osteoarthritis, muscle aches, and reactions to vaccinations. It is also used to reduce fevers.

Is Acetaminophen Safe?

The Food and Drug Administration (FDA) is aware that the decision to use any medication during pregnancy can be complex. In a 2015 statement on the use of pain medicine in pregnancy, the FDA acknowledged that "severe and persistent pain that is not effectively treated during pregnancy can result in depression, anxiety, and high blood pressure in the mother."

Jennifer Wider, MD

Any medication used during pregnancy has the potential to have side effects.

— Jennifer Wider, MD

The FDA said that medications "including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen can help treat severe and persistent pain" but that it is important "to carefully weigh the benefits and risks of using prescription and OTC pain medicines during pregnancy." \

While some research has suggested that acetaminophen (in both OTC and prescription forms) is linked with a higher risk of attention deficit hyperactivity disorder (ADHD) in children born to people who took the medication during pregnancy, the FDA says that the data is "inconclusive."

Research has also found that taking too much acetaminophen during pregnancy can be difficult for the pregnant person's liver—and the fetus's liver—to process. The authors of the most recent paper say that the drug has also been linked to genital malformations and early-onset puberty.

What Doctors Say

Christine Greves, MD, an OB/GYN at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida, tells Verywell that in general, doctors recommend that that you limit taking any medication during pregnancy, including acetaminophen.

The American College of Obstetricians and Gynecologists (ACOG) recommends the use of acetaminophen to treat conditions like the flu in pregnant people.

Women's health expert Jennifer Wider, MD, tells Verywell that if you're pregnant, it's important to only take medication—including OTC drugs like acetaminophen—under the guidance of a doctor.

"Any medication used during pregnancy has the potential to have side effects," says Wilder. "It's much better to use caution when taking any pharmaceutical and definitely speak to your doctor."

Medication Alternatives

If you have mild aches and pains, Greves recommends trying different supportive measures first, like ice and stretching for back pain. If they don't help, then it might be worth talking to your doctor about medication.

"Ideally, you would only take acetaminophen at the lowest dose possible for the shortest amount of time," says Greves. "If you're going to take it for longer periods of time or if you have chronic pain, it's best to talk to your OB/GYN or pain management doctor about the risk-benefit ratio of that."

What This Means For You

Acetaminophen use in small doses for a short time is generally considered safe in pregnancy. Still, you should always talk to your doctor about any medication that you plan to take—even OTC drugs—while you are pregnant.

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