Safe Medicines in Pregnancy: An Australian Guide (Always Check First)

Catching a cold, copping a headache or battling heartburn is stressful enough at the best of times. When you are pregnant, the bigger worry is often a small one on the surface: can I take anything for this? It is one of the most searched health questions in Australia, and the honest answer is that it depends — on the medicine, on how far along you are, and on your own health history. This guide is designed to help you feel a little more informed before you do the one thing that matters most: ask your pharmacist, GP or midwife.

We have organised it the way symptoms actually turn up — pain and fever, heartburn, hay fever, constipation, and coughs and colds — and framed each around the way the Therapeutic Goods Administration (TGA) classifies medicines for use in pregnancy. Throughout, we use careful language on purpose: 'generally considered suitable' and 'usually avoided' rather than definitive directives, because only a health professional who knows your situation can make that call for you.

Is paracetamol generally considered suitable during pregnancy in Australia?

Paracetamol is generally considered the preferred option for pain or fever during pregnancy in Australia, taken at the lowest effective dose for the shortest time needed. The TGA classifies paracetamol as Pregnancy Category A and reconfirmed this assessment in September 2025 after a review. This does not mean unlimited use, and it is not a personal recommendation — always check with your pharmacist, GP or midwife before taking it, particularly if you are taking other medicines or have a liver condition.

How the TGA pregnancy categories work (plain English)

In Australia, medicines are sorted into pregnancy categories that describe how much is known about their use during pregnancy. The categories are A, B1, B2, B3, C, D and X. They are a guide for health professionals, not a simple ranking from safest to most dangerous — for example, the letters do not run in a neat order, and a medicine's category reflects the available evidence rather than a guarantee.

Pain and fever

For everyday aches, headaches and fever, paracetamol (sold under brand names such as Panadol, as well as pharmacy own-brands) is generally considered the first-line option in pregnancy and carries a TGA Category A classification. As with anyone, the advice is to use the lowest effective dose for the shortest time and not to exceed the maximum daily dose on the label. Fever itself can be worth getting checked during pregnancy, so it is worth a call to your GP or midwife rather than just managing it at home.

Ibuprofen, diclofenac and other non-steroidal anti-inflammatory drugs (NSAIDs) — including brands such as Nurofen and Voltaren — are a different story. As a general rule they are usually avoided in pregnancy, and they are particularly avoided from around 20 weeks onwards and in the third trimester because of potential effects on the baby. Aspirin taken for pain is also generally avoided (low-dose aspirin is sometimes prescribed by a doctor for specific reasons, which is a separate situation). If paracetamol is not controlling your pain, that is a conversation to have with your pharmacist, GP or midwife rather than reaching for an anti-inflammatory yourself.

Heartburn and reflux

Heartburn is extremely common in pregnancy, especially later on. Many simple antacids — the type that work in the stomach and are not significantly absorbed into the body, including some calcium- and magnesium-based products — are generally considered suitable for occasional use in pregnancy, but it is worth confirming the specific product with your pharmacist because formulations and added ingredients vary.

• radio_button_uncheckedGenerally suitable: many simple antacids for occasional use — confirm the specific product with your pharmacist because formulations and added ingredients vary
• radio_button_uncheckedNon-medicine measures that can help: smaller meals, avoiding lying down soon after eating, and propping yourself up at night
• radio_button_uncheckedBest chosen with professional input: if antacids are not enough, some other reflux medicines (such as certain acid-reducing tablets) may be considered, but availability and suitability differ, and persistent reflux is worth reviewing

Before starting or continuing any reflux medicine in pregnancy, ask your pharmacist, GP or midwife what is appropriate for you.

Hay fever and allergies

For hay fever and allergies, the choice of antihistamine matters. Some non-drowsy (second-generation) oral antihistamines, such as loratadine and cetirizine, are generally considered suitable in pregnancy and are often the ones discussed first — but the right choice for you should still be confirmed with a health professional. Steroid nasal sprays and saline sprays are also commonly discussed options for nasal symptoms; again, check the specific product first.

What is usually avoided is the 'combination' allergy or sinus product that pairs an antihistamine with an oral decongestant such as pseudoephedrine or phenylephrine — these are generally avoided in pregnancy, particularly in the first trimester. Read the label carefully, because decongestants are often tucked into multi-symptom products. If in doubt, take the box to your pharmacist and ask before you buy.

Constipation

Constipation is another very common pregnancy complaint, partly due to hormonal changes and iron supplements. The usual first steps are non-medicine ones: more fibre, more fluids and gentle activity where you can. If a laxative is needed, bulk-forming fibre supplements and certain gentle stool softeners or osmotic laxatives are generally considered suitable for short-term use in pregnancy, but the specific product and how long to use it are worth checking with your pharmacist. Stimulant laxatives are generally used more cautiously and for shorter periods. As always, confirm the right option for you with your pharmacist, GP or midwife.

Coughs and colds

Cold and flu season is tricky in pregnancy because so many products are 'multi-symptom' combinations that bundle several active ingredients together — and some of those ingredients (such as the decongestant pseudoephedrine) are ones you would usually avoid. For this reason, combination cough, cold and flu products are generally best avoided in pregnancy unless a pharmacist or doctor has okayed the specific product.

A safer general approach is to treat one symptom at a time with simple measures: paracetamol for fever or aches (Category A, as above), saline nasal spray or saline drops for a blocked nose, steam inhalation, rest and fluids, and warm drinks with honey to soothe a cough or sore throat. Some single-ingredient cough preparations may be considered, but this is exactly the kind of choice to run past your pharmacist first. If your symptoms are severe, you are short of breath, or a fever is high or persistent, contact your GP or midwife.

Quick reference: everyday complaints in pregnancy

The table below is a general summary only. It is not personal advice, and it does not replace checking with a health professional. Use it as a starting point for the conversation with your pharmacist, GP or midwife.

When to see your doctor or midwife

Self-managing a minor symptom is one thing, but some situations warrant prompt professional input rather than an over-the-counter product. Contact your GP, midwife or maternity unit if any of the following apply.

And for anything urgent — severe abdominal pain, heavy bleeding, reduced baby movements, severe headache with vision changes, or any symptom that frightens you — contact your maternity care provider or hospital straight away, or call 000 in an emergency.

Frequently Asked Questions

Can I take regular paracetamol when pregnant?

Paracetamol is generally considered the preferred option for pain or fever in pregnancy in Australia and is classified as TGA Category A, with the usual advice being to take the lowest effective dose for the shortest time and to stay within the maximum daily dose on the label. That said, it is not a personal recommendation for your situation, so check with your pharmacist, GP or midwife — especially if you take other medicines or have a liver condition.

Is Panadol or Nurofen better when pregnant?

As a general pattern, paracetamol (Panadol) is usually preferred over ibuprofen (Nurofen) in pregnancy, and anti-inflammatories like ibuprofen are generally avoided, particularly after 20 weeks, unless a doctor advises otherwise. If paracetamol is not managing your pain, speak with your pharmacist, GP or midwife rather than switching to an anti-inflammatory yourself.

Can paracetamol affect the baby?

Paracetamol has a long record of use in pregnancy and is classified Category A by the TGA, which reconfirmed its assessment in September 2025. As with any medicine, the general principle is to use only what you need, at the lowest effective dose, for the shortest necessary time. If you have questions about using paracetamol — including how often or how long — your pharmacist, GP or midwife, or MotherSafe on 1800 647 848, can give you advice based on your circumstances.

Which antihistamine is generally considered suitable in pregnancy?

Non-drowsy antihistamines such as loratadine and cetirizine are generally considered suitable options for hay fever or allergies in pregnancy in Australia, while combination products that also contain a decongestant (such as pseudoephedrine) are usually avoided. The right choice for you still depends on your situation, so confirm the specific product with your pharmacist, GP or midwife.

Can I take anything for heartburn during pregnancy?

Many simple antacids are generally considered suitable for occasional heartburn in pregnancy, and lifestyle measures (smaller meals, not lying down after eating, propping yourself up at night) can help too. Because products and added ingredients vary, and because persistent reflux is worth reviewing, it is best to confirm the specific product with your pharmacist, GP or midwife before using it regularly.

Which cold and flu medicines are usually avoided in pregnancy?

Multi-symptom cold and flu products are generally best avoided in pregnancy, largely because many contain an oral decongestant such as pseudoephedrine or phenylephrine, which are usually avoided. Treating individual symptoms with simpler options — for example paracetamol for fever, or saline spray for a blocked nose — is the more cautious general approach. Always check any cough or cold product with your pharmacist, GP or midwife before taking it.