Vikki asked
I’m 30 weeks pregnant am I aloud to take pain reliever Tylenol (acetaminophen) 500 mg for my pain?
Answer
Tylenol (acetaminophen) is classified by the FDA as "pregnancy category B" for the 1st, 2nd and 3rd trimesters of pregnancy. The definition of "pregnancy category B" is as follows:
"Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women."
Tylenol Safety During Pregnancy
Tylenol (acetaminophen) is the most commonly used over the counter analgesic during pregnancy. Studies have not reported a clear association with acetaminophen use during pregnancy and teratogenicity (birth defects) or miscarriage. In addition, cases of Tylenol overdose during pregnancy were not associated with early termination of pregnancy or malformations of the fetus.
One large review of data, based on statistics from the National Birth Defects Prevention Study, concluded that Tylenol does not increase the risk of fetal malformations.
Based on the extensive data regarding the relative safety of Tylenol (versus other analgesics), it is the recommended analgesic during pregnancy if medicinal pain relief is required.
Dangers Of Tylenol During Pregnancy
Although Tylenol isn't associated with fetal malformations/defects, it is still advised to only use it during pregnancy if the benefits outweigh the risks.
Studies the evaluate medication risk during pregnancy have methodological limitations. It would be unethical to conduct a placebo controlled trial to evaluate how a certain medication could affect the fetus during pregnancy. As such, it is necessary to review data from a variety of sources and observational studies to draw conclusions.
We do know that Tylenol does cross into the placenta during pregnancy. While Tylenol exposure to the infant isn't associated with defects (as discussed above), recent data suggests a possible association with Tylenol use during pregnancy and certain behavior problems.
One study had results that showed children born to mothers who took Tylenol during pregnancy were more likely to have slower motor development and certain behavior problems at the age of 3 versus mothers who did not take Tylenol. Data from another study indicated an increased risk of behavior problems, such as ADHD by age 7.
It is important to note that the studies above are preliminary and are by no means conclusive. More studies and additional data is needed. There could be other factors at play that need to be considered. For example, many studies have reported that prolonged fever during pregnancy can have negative effects on neonates including:
- Neural tube defects
- Congenital heart defects
- Oral clefts
Tylenol of course, is an effective antipyretic (i.e. fever reducer) and could potentially lessen some of these effects. The main take away is that more information is needed to truly evaluate the safety and risks/benefits of Tylenol during pregnancy.
Summary
Most medical guidelines recommend Tylenol as the first line analgesic during pregnancy in all trimesters if one is needed. It is a pregnancy category B medication, meaning that while no conclusive risks have been found in humans, clinical trial data is lacking. In terms of analgesics, it is recommended over others such as ibuprofen as aspirin.
However, new studies evaluating the safety of Tylenol during pregnancy has found surprisingly results, although again, these aren't conclusive. If you are thinking of using Tylenol during pregnancy, please speak with your doctor to discuss the potential benefits and risks of taking the medication.
