The only thing you want when you feel a headache coming on is fast relief. But should you still reach for Tylenol (acetaminophen) if you’re expecting?
The short answer is yes, but as with every medication you consider right now, it’s important to speak with your doctor first.
“When my patients have fever or pain, I advise them that Tylenol is the safest medication available,” says Shannon Smith, M.D., a board-certified OB/GYN in Boston, Massachusetts, and a member of the What to Expect Medical Review Board.
For more about taking Tylenol during pregnancy, including dosages, possible risks and some alternatives for pain relief, read on.
Is it safe to take Tylenol (acetaminophen) during pregnancy?
Acetaminophen, known by the brand name Tylenol, is safe for most women during pregnancy, say the experts.[1] Headaches are common, especially in the first trimester, as they may be caused by a surge in hormones and an increase in blood volume.
Still, “it’s best for women take the lowest effective dose for the shortest amount of time” during pregnancy, says Dr. Smith.
What is the controversy around taking Tylenol when you’re pregnant?
The Tylenol controversy relates to recent research suggesting that taking it while pregnant might affect a baby’s development.[2] Acetaminophen is a “Pregnancy Category B” drug in the U.S., which means it’s deemed safe. Class B also indicates that no studies have shown that the medication leads to birth defects in animals, though there is no specific research on pregnant women.
Dr. Smith notes that the data has questioned an association with prenatal acetaminophen use and the development of several childhood conditions, including asthma, lower IQ, autism spectrum disorder, gross motor development and communication problems, and ADHD.
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“But in an analysis of this research, most clinicians felt the data demonstrating a true link is lacking,” she says.
How much Tylenol is safe to take when pregnant?
Before taking any medication, always discuss it with your doctor first and keep in mind that using Tylenol in a limited way for a short period of time is often best.
As for a general dosage during pregnancy, Dr. Smith says she prescribes 325 milligrams to 1,000 milligrams every six hours.
When during my pregnancy can you take Tylenol?
You can take Tylenol at any point during pregnancy.
What can I take Tylenol for when pregnant?
Tylenol can be taken for headaches, pain and fever during pregnancy and is recommended over ibuprofen (Advil) or naproxen (Aleve). And while you might be wary of taking medications now, it may be needed in certain severe cases.
For example, a very high fever during pregnancy could harm your baby-to-be, so acetaminophen may be necessary to bring the thermometer’s number down.
Dr. Smith adds that “fever can cause congenital malformations in the first trimester and other complications in pregnancy in later trimesters, so in certain instances we always recommend treating the fever completely with Tylenol.”
Are Tylenol PM and Extra Strength Tylenol safe to take when pregnant?
Yes, both of these types of Tylenol are okay to take during pregnancy.
“Tylenol PM is just acetaminophen with diphenhydramine, or Benadryl. This is a great option if you have a headache or pains and are looking to get some sleep. But if you're just looking for something to help with insomnia, then skip the Tylenol and take Benadryl,” says Dr. Smith.
Extra Strength Tylenol, on the other hand, comes in 500-milligram tablets, but it’s also safe to take, Dr. Smith says. Her dosing recommendation in pregnancy is one to two tablets every six hours for a maximum dose of 4,000 milligrams in a 24-hour period.
What are the risks of taking Tylenol when you’re pregnant?
Nearly every medication carries some risk in pregnancy, but acetaminophen has been used for many years and is considered safe.
And even in light of the recent news of possible in utero effects of acetaminophen, the recommendations from major medical organizations, including the American College of Obstetricians and Gynecologists (ACOG), haven’t changed.
Alternatives to Tylenol during pregnancy
Tylenol may well be the best course of action for high fevers and other pain. But if yours is on the mild side, you can try the following supportive therapies for pain relief instead,[3] according to Dr. Smith.
- Ice or heat. Try one of these on painful spots (back, neck) to ease the ache.
Massage. This is also a good alternative for nagging physical pain, says Dr. Smith.
Rest up. A lack of Zzzs can lead to a headache, Dr. Smith says.
Keep a diary. This way, you can identify triggers that cause a headache. You might find that the smell of some foods or other particularly strong odors are behind your pain.
Breathe! It might help to sit still and relax, whether you hit up a prenatal yoga class, soak in a warm bathtub, or try a few minutes of quiet, mindful meditation.
Stay hydrated. And eat well too. Regular meals and snacks may stave off a headache.
When to call the doctor
If your fever or pain persists, even though you’ve been taking acetaminophen for several days, call the doctor. And if you experience more severe signs of distress, such as shortness of breath, fatigue, or trouble breathing, get in touch with your physician right away.
Aches and pains are common in pregnancy, but you don’t have to suffer with them. Always speak with your OB/GYN about taking any medication and inquire about Tylenol for a headache, since a low dose of acetaminophen for a short while is considered safe while expecting.
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