After 20 weeks of pregnancy, don't take painkillers like ibuprofen on your own

Cost

Free.

What you get

In October 2020 the U.S. Food and Drug Administration (FDA) issued a safety warning. Using nonsteroidal anti-inflammatory drugs after about 20 weeks of pregnancy may cause kidney problems in the baby, leading to too little amniotic fluid. The warning covers both prescription and over-the-counter drugs, including aspirin, ibuprofen, naproxen, diclofenac and celecoxib. The FDA reviewed adverse event reports up to July 2017 and found 35 cases of too little amniotic fluid or newborn kidney impairment, all with serious outcomes. Of these, 5 newborns died, all with newborn kidney failure. In the literature, most cases of too little amniotic fluid recovered within 72 hours to 6 days after stopping the drug. The FDA advises pregnant women not to use these drugs after 20 weeks unless a doctor specifically recommends it. Low-dose 81 mg aspirin prescribed by a doctor for specific problems in pregnancy is not subject to this limit. When pain or fever relief is needed, the FDA mentions that acetaminophen and other drugs can be used; ask a pharmacist or doctor first.

Notes

The FDA reminds people that many over-the-counter drugs for colds, flu and sleeplessness also contain this type of ingredient, so read the ingredient list. U.S. over-the-counter labels used to warn only about the last 3 months of pregnancy, and this move brought the line forward to about 20 weeks. For low-dose aspirin to prevent preeclampsia, see §27.5 (low-dose aspirin). Graded B because the numbers come from adverse event reports, and it is not known how many people took the drug without any problem. The benefit is rated “medium” as a judgment: the outcome is serious, but it happens rarely.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. U.S. Food and Drug Administration (2020-10-15). FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid. Drug Safety Communication. https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-avoiding-use-nsaids-pregnancy-20-weeks-or-later-because-they-can-result-low-amniotic

Translated from the Chinese original. Original book, section 34, tip 5. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer