Use of over-the-counter medicines in pregnancy: Scoping Review
Article Sidebar
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Downloads
Societal impact
Results: Ninety-three articles were identified, of which 21 were included in the review. Eleven (52.4%) of the articles reported the frequency of over-the-counter drugs use during pregnancy, which ranged from 40% to 95%. The most used over-the-counter medications were analgesics, including nonsteroidal anti-inflammatory drugs and acetaminophen, as well as cold drugs, antacids, and antiemetics.
Conclusions: Among the safety outcomes, the use of nonsteroidal anti-inflammatory drugs in the third trimester of pregnancy was associated with an increased risk of hypertension, premature closure of the ductus arteriosus, and fetal renal and pulmonary dysfunction. The available information about the use of over-the-counter drugs during pregnancy was identified and synthesized. The frequency of use of these drugs reaches up to 95% of cases, particularly analgesics, cold drugs, antacids, and antiemetics, mainly for pain relief, common cold symptoms, and gastrointestinal discomfort.
">Main Article Content
Abstract
Objective: To identify and synthesize information on the use of over-the-counter drugs in pregnancy, focusing on frequency of use, commonly used drugs, their indications, and health outcomes.
Methodology: A scoping review of the use of over-the-counter drugs in pregnancy was conducted following PRISMA recommendations, in PubMed/Medline articles published until September 9, 2 024, using the terms Mesh: "Nonprescription Drugs" and "Pregnancy”. The information was grouped into four categories: frequency of use, resolution of mild health problems, effectiveness, and safety outcomes.
Results: Ninety-three articles were identified, of which 21 were included in the review. Eleven (52.4%) of the articles reported the frequency of over-the-counter drugs use during pregnancy, which ranged from 40% to 95%. The most used over-the-counter medications were analgesics, including nonsteroidal anti-inflammatory drugs and acetaminophen, as well as cold drugs, antacids, and antiemetics.
Conclusions: Among the safety outcomes, the use of nonsteroidal anti-inflammatory drugs in the third trimester of pregnancy was associated with an increased risk of hypertension, premature closure of the ductus arteriosus, and fetal renal and pulmonary dysfunction. The available information about the use of over-the-counter drugs during pregnancy was identified and synthesized. The frequency of use of these drugs reaches up to 95% of cases, particularly analgesics, cold drugs, antacids, and antiemetics, mainly for pain relief, common cold symptoms, and gastrointestinal discomfort.
Article Details
References
1. Medicamentos de venta libre – DrugFacts, National Institute on Drug Abuse (NIDA) [Internet]. 2017 [citado 28 de octubre de 2024]. Disponible en: https://nida.nih.gov/es/publicaciones/drugfacts/medicamentos-de-venta-libre
2. Gestión e Innovación en Salud. Informe Final. Propuesta para la implementación de la lista de medicamentos de venta libre en República Dominicana. [Internet]. GIS; 2018. Disponible en: http://grupogis.com/wp-content/uploads/2020/09/Propuesta-Implementacion-MLV-V18_Final-entregada.pdf
3. Cómo usar medicamentos de venta libre de manera segura: MedlinePlus enciclopedia médica [Internet]. [citado 28 de octubre de 2024]. Disponible en: https://medlineplus.gov/spanish/ency/patientinstructions/000882.htm
4. Ramírez Puerta D, Larrubia Muñoz O, Escortell Mayor E, Martínez Martínez R. La automedicación responsable, la publicidad farmacéutica y su marco en la Atención Primaria. Med Fam SEMERGEN. 2006;32:117-24.
5.¿Qué es un medicamento OTC?- Asefarma. Especialistas en Compra Venta, Asesoría, Consultoría y Empleo para Farmacias - Asefarma [Internet]. 2018 [citado 28 de octubre de 2024]. Disponible en: https://www.asefarma.com/blog-farmacia/que-es-un-medicamento-otc
6. Llano-Henao Y, Rivera-Cadavid M, Amariles P. Cumplimiento de la normatividad en la publicidad televisiva de medicamentos de venta libre en Colombia: estudio descriptivo retrospectivo 2018. Médicas UIS. 2022;35:2.
7. Marulanda FA. Estudio sobre automedicación en la Universidad de Antioquia, Medellín, Colombia. Iatreia. 2002;15(4):242-247.
8. Martínez Domínguez GI, Martínez Sanchez LM, Rodríguez Gázquez MA. Características del consumo de medicamentos de venta libre en una población de adultos de la ciudad de Medellín (Colombia). Salud Uninorte. 2013;29:360-367.
9. Chambers C. Over-the-counter medications: Risk and safety in pregnancy. Semin Perinatol. Medications in Pregnancy and Lactation. 2015;39:541-4.
10. Koren G, Pastuszak A, Ito S. Drugs in pregnancy. N Engl J Med. 1998;338:1128-37.
11. Grupo de Trabajo DUP España. Estudio multicéntrico sobre el uso de medicamentos durante el embarazo en España (III): los fármacos utilizados durante el primer trimestre de gestación. Med Clínica. 1991;96:52-7.
12. Marín GH, Cañas M, Homar C, Aimetta C, Orchuela J. Uso de fármacos durante el período de gestación en embarazadas de Buenos Aires, Argentina. Rev Salud Pública. 2010;12:722-31.
13. Lupattelli A, Spigset O, Twigg MJ, Zagorodnikova K, Mårdby AC, Moretti ME, et al. Medication use in pregnancy: A cross-sectional, multinational web-based study. BMJ Open. 2014;4:e004365.
14. Trønnes JN, Lupattelli A, Nordeng H. Safety profile of medication used during pregnancy: Results of a multinational European study. Pharmacoepidemiol Drug Saf. 2017;26:802-11.
15. Zafeiri A, Mitchell RT, Hay DC, Fowler PA. Over-the-counter analgesics during pregnancy: A comprehensive review of global prevalence and offspring safety. Hum Reprod Update. 2021;27:67-95.
16. Sandoval Paredes J, Sandoval Paz C. Uso de fármacos durante el embarazo. Horiz Méd Lima. 2018;18:71-9.
17. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169:467-73.
18. Dickinson JE. Nonprescription and complementary medication in obstetrics. Aust N Z J Obstet Gynaecol. 2015;55:199-200.
19. Haas DM, Marsh DJ, Dang DT, Parker CB, Wing DA, Simhan HN, et al. Prescription and other medication use in pregnancy. Obstet Gynecol. 2018;131:789-98.
20. Casey E, Velez MP, Gaudet L, Brogly SB. The use, perceptions and knowledge of safety of over-the-counter medications during pregnancy in a Canadian population. Womens Health Lond Engl. 2023;19:17455057231199394.
21. Zelner I, Matlow J, Hutson JR, Cera P, Koren G, Brent J, et al. Acute poisoning during pregnancy: Observations from the Toxicology Investigators Consortium. J Med Toxicol Off J Am Coll Med Toxicol. 2015;11(3):301-8.
22. Volqvartz T, Vestergaard AL, Aagaard SK, Andreasen MF, Lesnikova I, Uldbjerg N, et al. Use of stimulants, over-the-counter and prescription drugs among Danish pregnant women. Basic Clin Pharmacol Toxicol. 2020;127:205-10.
23. Bertoldi AD, Rifas-Shiman SL, Boing AC, da Silva Dal Pizzol T, Miranda VIA, Silveira MPT, et al. Associations of acetaminophen use during pregnancy and the first year of life with neurodevelopment in early childhood. Paediatr Perinat Epidemiol. 2020;34:267-77.
24. Aagaard SK, Larsen A, Andreasen MF, Lesnikova I, Telving R, Vestergaard AL, et al. Prevalence of xenobiotic substances in first-trimester blood samples from Danish pregnant women: A cross-sectional study. BMJ Open. 2018;8:e018390.
25. Vignato J, Mehner B, Negrete A, Segre LS. Over-the-counter pain medication use during pregnancy. MCN Am J Matern Child Nurs. 2023;48:209-14.
26. van Gelder MMHJ, Vorstenbosch S, Te Winkel B, van Puijenbroek EP, Roeleveld N. Using web-based questionnaires to assess medication use during pregnancy: A validation study in 2 prospectively enrolled cohorts. Am J Epidemiol. 2018;187:326-36.
27. Rayburn WF. Over-the-counter drugs and pregnancy. Obstet Gynecol Clin North Am. 2023;50:27-37.
28. Odalović M, Milanković S, Holst L, Nordeng H, Heitmann K, Tasić L. Pharmacists counselling of pregnant women: Web-based, comparative study between Serbia and Norway. Midwifery. 2016;40:79-86.
29. Abduelkarem AR, Mustafa H. Use of over-the-counter medication among pregnant women in Sharjah, United Arab Emirates. J Pregnancy. 2017;2017:4503793.
30. Tuha A, Gurbie Y, Hailu HG. Evaluation of knowledge and practice of pharmacy professionals regarding the risk of medication use during pregnancy in Dessie Town, Northeast Ethiopia: A cross-sectional study. J Pregnancy. 2019;2019:2186841.
31. Akkad ZA, Alomar M, Palaian S. An exploratory survey on community pharmacists’ service provision for pregnant and lactating women in Sharjah, United Arab Emirates. Plos One. 2022;17:e0262254.
32. Hagen M, Alchin J. Nonprescription drugs recommended in guidelines for common pain conditions. Pain Manag. 2020;10:117-29.
33. Antonucci R, Zaffanello M, Puxeddu E, Porcella A, Cuzzolin L, Pilloni MD, et al. Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn. Curr Drug Metab. 2012;13:474-90.
34. French-Speaking Society of Oral Medicine and Oral Surgery. Recommendations for prescription of oral anti-inflammatory agents in oral surgery in adults. Medicine. 2008;14:130-59.
35. Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol. 2009;16:968-81.
36. Nkuna SL, Phoswa WN. Interrelationships between migraine over the counter (OTC) painkillers and hypertensive disorders of pregnancy: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2021;100:e28049.
37. Gastrosquisis; tratamientos y procedimientos [Internet]. [citado 14 de diciembre de 2024]. Disponible en: https://www.cincinnatichildrens.org/espanol/temas-de-salud/alpha/g/gastroschisis
38. La pseudoefedrina, el compuesto que revisa Europa, ya fue prohibido en Colombia, El Espectador [Internet]. [citado 14 de diciembre de 2024]. Disponible en: https://www.elespectador.com/salud/la-pseudoefedrina-el-compuesto-que-revisa-europa-ya-fue-prohibido-en-colombia/
39. Lattey K, Quinn S, O’Brien K. Over-the-counter antacids linked to severe hypokalaemia in the context of threatened preterm labour. BMJ Case Rep. 2021;14:e236083.
40. Federspiel J, Bukhari MJ, Hamill MM. Interactions between highly active antiretroviral therapy and over-the-counter agents: A cautionary note. Drug Ther Bull. 2022;60:141-3.
41. Mayo Clinic. Resfriado común [Internet]. Mayo Clinic; 2023 [citado 14 de diciembre de 2024]. Disponible en: https://www.mayoclinic.org/es/diseases-conditions/common-cold/diagnosis-treatment/drc-20351611
42. Eyal S. Use of therapeutics in pregnancy and lactation. Pharm Res. 2018;35:107.
43. Chambers C. Over-the-counter medications: Risk and safety in pregnancy. Semin Perinatol. 2015;39:541-4.