Paracetamol During Pregnancy: Is There A Risk For Your Child?

Paracetamol in pregnancy is safe. At least, that is the general recommendation. In recent years, however, there have also been warning voices. Pregnant women are unsure. Which painkillers can you take without risk to your child?

This Article Will Provide You With Clarity

Paracetamol As A Painkiller

It’s amazing, but true: paracetamol has been on the market for over 50 years. But to this day, medicine cannot explain exactly how the active ingredient combats pain. Of course, there are well-founded theories.

Effect Of Paracetamol

Paracetamol has an analgesic and antipyretic effect. An anti-inflammatory effect is hardly detectable. It does not inhibit blood clotting (platelet aggregation).

Mechanism Of Action Theories

The drug inhibits an enzyme (cyclooxygenase) needed for the assembly of a specific group of prostaglandins. Prostaglandins are tissue hormones. Some of these hormones are important for “repairs” of all kinds.

They help in the perception of pain and initiate processes such as blood clotting, fever and inflammation. The synthetic drug paracetamol selectively inhibits a specific variety of cyclooxygenases (COX). As a result, it has little anti-inflammatory effect and no effect on blood clotting.

A second explanation assumes that the active ingredient acts mainly via the nervous system on temperature regulation and pain sensation. Medicine suspects an interplay of both mechanisms and possibly another, as yet unknown, factor.

Paracetamol has a half-life of two to three hours in the body. It is considered easy on the stomach and is broken down by the liver. Therefore, an overdose can be very dangerous. People with a pre-damaged liver should refrain from taking it altogether.

What Symptoms Does Paracetamol Help With?

According to the drug description, paracetamol helps against mild to moderate pain and reduces fever. In cases of severe inflammation, the pain-relieving effect is reduced. Therefore, it does not work as well for rheumatic and arthritic pain, for example.

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Possible Indications For Use Are Stated As:

  • Pain from colds, flu-like infections.
  • Migraine, headache.
  • Toothache.
  • Pain from injuries or after operations.
  • Joint and muscle pain.

Dosage Of Paracetamol In Pregnancy: How Much Can You Take?

The tablets come in dosages of 500 mg and 1,000 mg. After taking, the maximum concentration of active ingredient is reached after one hour. In the form of effervescent tablets approximately after 20 minutes. The effect lasts for four to six hours.

The dosage recommendation for adults is a maximum of one tablet of 500 or 1,000 mg three to four times a day. There should be approximately six hours between doses. Do not exceed the active ingredient limit of 4,000 mg daily! Paracetamol is available without prescription in pharmacies.

However, it should still never be taken long-term without a doctor’s instructions. If the pain does not subside after one or two days, a visit to the doctor should be made. Then the causes of the discomfort must be sought.

The dosage of paracetamol in pregnancy is given as a maximum of three intakes a day (500 – 1,000 mg). No more than ten days in a month.

Embryotox: Information On Medication Use In Pregnancy

Embryotoxicology deals with the effects of drugs on unborn life. It is a subfield of pharmacovigilance. This deals with drug safety.

What Is Embryotox?

Embryotox is the Institute for Clinical Pharmacology and Toxicology. It has been in existence since 1988. In 2012, it was incorporated into Charité-Universitätsmedizin Berlin. The focal points of Embryotox are:

  • Advice on existing risks when taking medicines during pregnancy.
  • Reporting of adverse drug reactions to the responsible federal institute.
  • Scientific work on the clarification of drug therapies in pregnancy.
  • Provision of independent information on the tolerability of drugs during pregnancy and breastfeeding.

Embryotox, A Guide To Drugs In Pregnancy

Embryotox now has the largest European database in the field of “effects of medication in pregnancy”. Midwives, doctors and pharmacists use it as an indispensable reference tool.

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The information is compiled from international reference books, articles, studies and databases. What makes it special, however, is the database that it compiles itself. Because every inquiry is documented.

When contacting Embryotox you will be asked if you are willing to answer a questionnaire after pregnancy. For ethical reasons it is not allowed to conduct studies with pregnant women.

Therefore, these questionnaires provide valuable information to the institute. The institute works independently of the pharmaceutical industry. Its sponsors are the State of Berlin and the Federal Institute for Drugs and Medical Devices (BfArM).

Paracetamol In Pregnancy: Safe Or Dangerous?

Even if it should be sufficiently known: During pregnancy, the rule is to take as few medicines as necessary! Nevertheless, every second pregnant woman finds herself in the situation of having to decide for or against a painkiller. The most common reasons for this are:

  • Headache.
  • Migraine.
  • Back pain.
  • Muscle and joint pain.
  • Cold symptoms.

The use of paracetamol during pregnancy has been considered safe for 50 years. It is an analgesic that is officially approved for use in all three trimesters.

For a short duration of use (up to two days) and in a low dosage, the use of paracetamol in pregnancy is certainly safe. But in reality, longer periods of intake and also higher dosages often result. What then?

Sometimes Harmless, Sometimes Risky: Paracetamol During Pregnancy

Recently, there have been repeated warnings regarding the use of paracetamol during pregnancy. It is about the suspicion of the following health damage in the child:

  • Testicular abnormalities with later risk of inability to conceive or testicular tumors.
  • Higher probability of asthma in the child.
  • Attention deficit hyperactivity disorder(ADHD).
  • Hyperactivity syndrome (HAS).

In recent years, it has been mainly studied from Scandinavia, North America, and England that have caused this uproar. The European Medicines Agency (EMA) is now investigating these suspicions in more detail. For the time being, there will be no change to the official recommendations for use of paracetamol in pregnancy.

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Paracetamol And Ibuprofen 600: Differences And Possible Risks

If you are now unsure and would rather not take paracetamol in pregnancy, are there alternative painkillers? The first thing that comes to your mind might be ibuprofen. Also, a painkiller, which is available over the counter in pharmacies.

However, Ibuprofen 600 is only available by prescription, over-the-counter is the low dosage of 400 mg. With one and a half tablets, however, you have already reached the 600 mg.

Different Effects Of Paracetamol And Ibuprofen 600

Ibuprofen belongs to the drug group of non-steroidal anti-inflammatory drugs, or NSAIDs for short. They act primarily by inhibiting cyclooxygenases. However, they are not as selective as paracetamol. Therefore, the effect of ibuprofen is also anti-inflammatory.

This makes it effective in the treatment of rheumatic pain. It also inhibits blood clotting as well as, unfortunately, the formation of the protective gastric juice mucus. The latter makes ibuprofen intolerable for people with sensitive stomachs. The active ingredient is broken down by the kidneys. Ibuprofen is recommended against the following complaints:

  • Joint inflammation, rheumatic pain.
  • Severe headaches.
  • Back and neck pain.
  • Toothache.
  • Inflammatory diseases.
  • Swelling, pain from an injury.

The Main Differences Between Paracetamol And Ibuprofen

Ibuprofen has an anti-inflammatory effect and inhibits blood clotting; it is broken down by the kidneys and primarily affects the stomach. Paracetamol is somewhat weaker in its effect against pain; does not have an anti-inflammatory effect and inhibits blood clotting; is easy on the stomach; is broken down via the liver and therefore burdens it when taken in high doses or for a long time.

Which Pain Relievers Are Suitable For Pregnant Women?

According to Embryotox, ibuprofen and acetaminophen can be taken during pregnancy. The dosage should be kept as high as necessary, but also as low as possible. However, ibuprofen 600 (also 400) should not be taken in the third trimester.

Only until the 28th SSW. After that, there is a risk of kidney damage in the baby as well as blockage of vital vessels.

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Alternative Painkillers For Pregnant Women

Whether for joint pain, migraine attacks or colds, every second woman resorts to painkillers during pregnancy. Taking paracetamol for a short time, as directed for pregnant or nursing women, is certainly harmless.

Recent studies have not only caused uncertainty with regard to possible effects on the child. It was also found that a pain-relieving effect was hardly perceived, if at all, by many subjects.

In short, paracetamol does not always help and for every type of pain. If pain needs to be relieved over a longer period of time, it is definitely worth looking for alternatives.

Depending on the type and cause of the pain, there are many natural methods, some of which may even work much better than drugs.

Exercise And Relaxation

Especially in the case of muscle or joint pain, exercise is the first choice. Regular exercise under the guidance of a physiotherapist can prevent and relieve pain in the musculoskeletal system. On the other hand, relaxation is important, both physically and mentally. Stressful situations upset the hormonal system and cause tension in the muscles.

Nutrition And Intestinal Health

Pain can also be prevented or even alleviated with the right diet. In addition to all the other micronutrients needed, magnesium and natural pre- and probiotics are especially important. Incorporating appropriate foods into the daily diet provides benefits in pain situations.

Physical Applications

Hot or cold compresses can relieve pain in muscles and joints. So can warm baths and massages. Those with an approach also find promising approaches in kinesiology, acupressure or acupuncture.

Natural Remedies

Nature also has valuable ingredients in store. Among other things, they have analgesic, anti-inflammatory or antibacterial effects. But be careful, natural remedies also have strong effects in some cases. Before prolonged use, please seek medical advice.

Many herbs are grown against pain, for example: devil’s claw, willow bark, turmeric, arnica, frankincense, cannabis, cloves, onions, garlic, sage or peppermint.

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