Some medicines are safe when trying for pregnancy, while others may need to be changed before conception. Review prescriptions, over-the-counter medicines, supplements and herbal products—but do not stop essential treatment on your own.
Educational only — not medical advice. If you have urgent symptoms, seek medical care.
You have decided to start trying for a baby.
Then you look at the medicines you take and wonder:
“Should I stop these before I get pregnant?”
That is an important question.
But the answer is not automatically yes.
Some medicines can be continued during pregnancy.
Some need a different dose.
Some should be replaced before conception.
And stopping some medicines suddenly can be dangerous.
Before trying for pregnancy, review everything you take, including:
prescription medicines
over-the-counter medicines
painkillers
vitamins
supplements
herbal products
traditional medicines
skin treatments
injections
But:
Do not stop essential prescribed medicines on your own.
Instead, ask a doctor, pharmacist or other qualified healthcare professional to review them.
Pregnancy may happen before you realize it.
By the time your period is late and you take a pregnancy test, early development has already begun.
So if a medicine needs changing, it is often better to make that decision before conception.
Not necessarily.
Medication decisions require comparing two risks:
the risk of the medicine
versus:
the risk of leaving the medical condition untreated.
Sometimes untreated illness is more dangerous than the medicine.
Imagine someone with epilepsy stops her anti-seizure medicine because she wants to protect her future baby.
She then develops severe seizures.
That can put both her and a pregnancy at risk.
The safer approach may be:
review the medicine → choose the safest effective option → control the epilepsy → then try for pregnancy.
Before your pre-pregnancy appointment, write down everything you use.
Include:
Medicine name
Dose
How often you take it
Why you take it
Do not forget medicines you use only occasionally.
Examples include medicines for:
diabetes
high blood pressure
epilepsy
depression
anxiety
bipolar disorder
asthma
thyroid disease
autoimmune conditions
acne
infections
pain
Some may require special consideration before pregnancy.
People sometimes think:
“I bought it without a prescription, so it must be safe.”
That is not always true.
Over-the-counter medicines still contain active drugs.
This includes some:
painkillers
cold and flu medicines
antihistamines
stomach medicines
topical preparations
Ask if you are unsure.
The appropriate painkiller can depend on:
the specific medicine
dose
how frequently you use it
whether you are already pregnant
your health conditions
If you regularly need pain medication, discuss this before pregnancy rather than relying on repeated self-medication.
This is an important group to review.
Some medicines commonly used for hypertension outside pregnancy are not preferred during pregnancy and may need to be changed before conception.
But:
Do not stop your blood pressure medicine and leave your hypertension untreated.
Your clinician can choose an appropriate alternative when needed.
Good blood glucose control is extremely important before and during pregnancy.
Your diabetes treatment should therefore be reviewed before conception.
Some treatments may be continued.
Others may need adjustment.
The goal is not simply:
“remove the medicine.”
It is:
“achieve safe, effective glucose control.”
Anti-seizure medicines require careful review.
Some have greater pregnancy-related risks than others.
The medicine, dose and number of anti-seizure medicines may all matter.
If you have epilepsy:
do not stop treatment suddenly.
Seek preconception advice from the clinician managing your epilepsy.
You may also need a different folic acid dose.
These decisions should be individualized.
Untreated severe depression, bipolar disorder and other mental health conditions can carry significant risks.
Stopping medicines abruptly may cause:
relapse
withdrawal
worsening symptoms
Discuss pregnancy plans with the clinician managing your treatment.
The goal is to protect both mental health and pregnancy health.
Do not automatically stop your inhaler.
Poorly controlled asthma can reduce oxygen levels and create risks.
Many asthma medicines can be used when needed during pregnancy.
Your asthma should ideally be well controlled before conception.
If you have hypothyroidism and take thyroid replacement, you will usually need to continue treatment.
Thyroid control is important for pregnancy.
Your dose may need monitoring and adjustment.
Tell your healthcare professional as soon as you are planning pregnancy and again when pregnancy is confirmed.
This is particularly important.
Some acne treatments can be harmful during pregnancy and require strict pregnancy prevention while being used.
For example, oral isotretinoin can cause severe fetal abnormalities and must not be used during pregnancy.
If you use prescription acne treatments and want to become pregnant, speak with the prescribing clinician before trying.
Do not assume topical medicines are irrelevant because they are applied to the skin.
Some ingredients can still require review.
Tell your healthcare professional about prescription creams, gels and other skin treatments.
Different antibiotics have different pregnancy safety profiles.
If you need treatment for an infection, tell the prescriber:
“I am trying to become pregnant.”
Do not avoid necessary treatment because you are trying.
Untreated infections can also cause harm.
This is an area where caution is especially important.
People may tell you:
“It's natural, so it cannot harm pregnancy.”
That is not true.
Herbal products can:
contain active chemicals
interact with medicines
affect hormones
affect the liver or kidneys
vary considerably in strength
contain undeclared ingredients or contaminants
Many have not been adequately studied in pregnancy.
Be particularly careful with products claiming to:
clean the womb
regulate hormones
boost ovulation
strengthen the uterus
increase fertility
prepare the body for pregnancy
A marketing claim is not evidence of safety or effectiveness.
Some products may even interfere with treatment or expose an early pregnancy to substances with unknown effects.
Supplements are also biologically active.
Tell your healthcare professional about:
multivitamins
fertility supplements
iron
herbal mixtures
high-dose vitamins
protein or gym supplements
More vitamins are not automatically better.
Yes.
High amounts of preformed vitamin A (retinol) can be harmful during pregnancy.
This is one reason you should avoid taking multiple vitamin products without checking their ingredients.
A pregnancy or preconception supplement should be chosen appropriately.
Folic acid.
For many people planning pregnancy, 400 micrograms (0.4 mg) daily is recommended before conception and during early pregnancy.
Some people require a higher dose based on medical history or medicines.
Ask your healthcare professional which dose applies to you.
Yes.
Some medicines can affect:
ovulation
hormones
sperm production
sexual function
If you have been taking a medicine long-term and are having difficulty conceiving, include it in your fertility review.
Do not stop it without medical advice.
Yes, particularly if there are fertility concerns.
Some medicines can affect:
sperm production
sperm quality
erections
ejaculation
Anabolic steroids and externally supplied testosterone are particularly important because they can suppress sperm production.
A man using testosterone who wants children should discuss this with a qualified clinician rather than stopping or changing treatment independently.
Anabolic steroid use can significantly reduce sperm production.
Some men may even develop very low or absent sperm counts while using them.
If your partner uses anabolic steroids and you are planning pregnancy, medical assessment is advisable.
Do not panic.
Exposure does not automatically mean harm occurred.
Do not make decisions based only on internet searches or frightening stories.
Instead:
identify the exact medicine
identify the dose
determine when you took it
contact a healthcare professional
Risk depends heavily on the specific drug, dose and timing.
Medicine information leaflets can be useful but may use cautious language because evidence during pregnancy is limited.
A statement such as:
“Consult your doctor if pregnant”
does not automatically mean the medicine causes birth defects.
Medication decisions should use appropriate clinical evidence.
Your friend may say:
“My doctor gave me this when I was pregnant, so you can take it.”
Do not do this.
Your:
medical history
pregnancy stage
allergies
other medicines
diagnosis
may be different.
When you are trying for pregnancy, tell healthcare professionals:
“I am actively trying to become pregnant. Is this medicine appropriate if I conceive this month?”
That one sentence provides important context.
For each medicine, the healthcare professional can ask:
If not, it may be stopped appropriately.
Poorly controlled disease may require treatment adjustment.
If yes, continue when needed.
If so, switching before conception may be appropriate.
Sometimes the medicine is appropriate but the dose requires review.
This is one of the most important ideas in this article.
A healthy pregnancy does not necessarily mean:
taking no medicines.
For someone with a serious chronic condition, the safest pregnancy may require regular treatment.
The goal is:
the right medicine + the right dose + the right reason.
Before trying, ask:
What prescription medicines do I take?
What do I buy from the pharmacy myself?
What supplements do I use?
Do I take herbal or traditional products?
Do I use skin treatments?
Have I told my healthcare professional that I want pregnancy?
Do any medicines need changing before I stop contraception?
If you discover you are pregnant while taking a medicine known or suspected to carry significant pregnancy risks, contact the prescribing clinician promptly.
But do not abruptly stop essential treatment unless specifically advised.
The next step should be an individual risk assessment.
When preparing for pregnancy:
Do not assume every medicine is dangerous.
And:
Do not assume every medicine is safe.
Review:
prescriptions + pharmacy medicines + vitamins + supplements + herbal products.
Most importantly:
Never stop essential treatment on your own simply because you want to become pregnant.
Good preconception care is not about removing every medicine.
It is about making sure every medicine you use has a good reason to be there and is the safest effective option for you and a future pregnancy.
PREP-006: What Should I Do Before I Start Trying for a Baby?
PREP-007: Why Should I Have a Pre-Pregnancy Health Check?
PREP-008: Which Health Conditions Should Be Controlled Before Pregnancy?
PREP-010: Which Vaccines Should I Check Before Pregnancy?
PREP-012: Why Should I Take Folic Acid Before Pregnancy?