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Which painkillers are safe during pregnancy?

Thursday, 15 April 2004
Answered by: Chandra M. Gulhati
Editor,
MIMS,
New Delhi
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Q. I am about 13 weeks pregnant and I am visiting a gynaecologist for regular checkups. Recently I suffered from severe headache, since I am allergic to paracetamol and develop skin rashes, I tried all possible means other than medication i.e. massage, applying balm, etc. to ease the pain, but all in vain. The headache continued for two and a half days so I called my gynaecologist and he gave me tramadol HCl 50 mg cap-3 capsules to take daily for 2 days. After taking the first dose I felt very drowsy though after the second dose the pain relieved. Later I came to know that it is a pseudo morphine so I discontinued the usage. Will it harm my baby? No study has been conducted on the drug's usage during pregnancy. What other painkillers except paracetamol are considered to be safe during pregnancy? How about nimesulide?

A.  The fact that tramadol is an opiate analgesic is not the reason for its not being recommended for use during pregnancy. Even though animal studies have not shown any adverse effects on foetus, adequate studies have not been conducted in humans. Therefore one should avoid its use during pregnancy. You need not worry about any adverse effect on your unborn baby but do not take any more of tramadol. I do not know why aspirin either alone or in combination with codeine was not prescribed to you. Aspirin should be avoided in the last three months of pregnancy but there is no problem of its being used in early pregnancy. Nimesulide must never be used during any stage of pregnancy. There are serious concerns about its safety. Even though nimesulide was discovered in the United States, it is not approved for use in America and even countries like UK, Australia etc. In any case it is an NSAID and is prohibited for use during pregnancy. It is banned for use in children.

A.  The fact that tramadol is an opiate analgesic is not the reason for its not being recommended for use during pregnancy. Even though animal studies have not shown any adverse effects on foetus, adequate studies have not been conducted in humans. Therefore one should avoid its use during pregnancy. You need not worry about any adverse effect on your unborn baby but do not take any more of tramadol. I do not know why aspirin either alone or in combination with codeine was not prescribed to you. Aspirin should be avoided in the last three months of pregnancy but there is no problem of its being used in early pregnancy. Nimesulide must never be used during any stage of pregnancy. There are serious concerns about its safety. Even though nimesulide was discovered in the United States, it is not approved for use in America and even countries like UK, Australia etc. In any case it is an NSAID and is prohibited for use during pregnancy. It is banned for use in children.

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