Paracetamol in pregnancy – is it safe?

Expert advice on using paracetamol as a painkiller, how much you can take, and update on latest research

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In a nutshell

Yes, it’s safe – as long as you don’t take it for a prolonged period, and only take the minimum you need to ease your pain.

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Recent headlines (January 2018) reveal that studies on mice and rats (NOT humans) suggest women who take paracetamol while pregnant could lower the fertility of their female offspring.

Other headlines (June 2017) suggesting that taking paracetamol when pregnant ‘makes boys less manly’ sounded alarming but were again based on a small study of mice – and the ‘less masculine behaviour’ was only noted in the male offspring of pregnant mice who were given 3 times the recommended dose for humans.

And, last year, (August 2016), when a study suggested a link between taking paracetamol from 18 weeks and an increased risk of hyperactivity in children, experts agreed that much more research was needed before any changes to the current guidelines is made.

“It is important to highlight that from these results we cannot determine a direct link between paracetamol usage and any behavioural problems,” states Dr Tim Overton of the Royal College of Obstetricians and Gynaecologists.

“We recommend that pregnant women continue to follow current guidance.”

The expert view

“Paracetamol is safe in pregnancy and is often used as a painkiller,” says MFM’s GP Dr Philippa Kaye.

The NHS recommends that when you’re pregnant, paracetamol is the preferred choice of drug to treat mild to moderate pain and high temperatures.

So if all those pregnancy aches and pains are driving you mad,  or if you’ve come down with a cold or other minor ailment, then paracetamol should definitely be your first port of call. But the key is not to over-use it.

So what is the recommended dose?

The maximum general dose is one or two tablets (500mg or 1,000mg in total) taken every four to six hours, up to four times in 24 hours. However, if you’re pregnant experts say you should take the minimum amount needed. Don’t be tempted to top up with another dose, just in case the pain returns.

It’s also worth bearing in mind that some other medicines may actually contain paracetamol as well, so it can be easy to go over the limits. If you’re unsure it’s always best to check with a doctor or midwife.

“Be careful when you buy this over the counter as paracetamol is commonly combined with other medications in over the counter products such as cold and flu remedies and the other components may not be safe in pregnancy,” explains Dr Kaye. “So always check with your pharmacist that what you are buying is just simple paracetamol and is safe in pregnancy.”

It’s worth noting that…

While in the UK, paracetamol is considered perfectly safe, a Norwegian study of almost 50,000 children highlighted there could be a possible link between regular long term use of the drug (‘long term’ being classed as more than a month during pregnancy) and issues with development such as communication and behaviour.

Another recent study (Jan 2016) conducted by the University of Edinburgh has shown that extensive – not occasional – use could cause male reproductive disorders at birth or in early childhood due to low testosterone production.

The testing is still in its early stages and what causes the reduction in testosterone is still unknown. Professor Richard Sharpe, from the University of Edinburgh’s MRC Centre for Reproductive Health, who co-led the study, said: “It’s important to remember that this study was conducted in rats, not humans. However, there are many similarities between the two reproductive systems.”

Dr Martin Ward-Platt from the Royal College of Paediatrics and Child Health adds: “The findings of this study send a clear message – expectant mothers should not prolong paracetamol use during pregnancy, only taking it when necessary,”

There have also been studies linking childhood asthma to taking paracetamol in pregnancy, but the NHS is keen to point out that there is no proven evidence that paracetamol is not safe in the recommended dosages.

Mums on our forum say

“I suffered from terrible headaches in the second trimester..I tried to avoid paracetamol as much as I could but there were times where I had to eventually give in and *touch wood* no harm has been done.” Ferbs

“I took it [paracetamol] when I had bad headaches lasting 2 or 3 days in the second trimester and then again in the final two weeks when my back ache was so bad I could barely walk.” Lindtbunny

Read more…

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