Most of the over-the-counter medications that you usually take are perfectly safe even during pregnancy but because there are some exceptions, you should always talk to your doctor before you take a medication while pregnant, whether it is over-the-counter, prescription or even an herbal remedy. You should also remember that vague symptoms (such as a headache) that are normally fine to ignore may indicate serious complications during pregnancy. Before you take any over-the-counter medications, talk to your doctor and go over your current medications as safe medications may cause complications when interacting with other medicines. One of the concerns of pregnant women is that “Can I take Tylenol PM during pregnancy?”.

What Is Tylenol PM (Acetaminophen and Diphenhydramine)?

The Generic name of Tylenol PM is acetaminophen and diphenhydramine. The acetaminophen in Tylenol PM is a fever reducer as well as a pain reliever. Diphenhydramine, on the other hand, is an antihistamine which will reduce histamine, a natural chemical that can lead to a runny nose, watery eyes, itching, and sneezing. When combined, acetaminophen and diphenhydramine are used for treating headaches, watery eyes, runny noses, pain, and sneezing due to the flu, common cold, or allergies.

Do Tylenol PM and Pregnancy Work Together?

The ingredients in Tylenol PM make it a combination of Benadryl and Tylenol. Each of these medications is safe to use during pregnancy but it isn’t recommended to use Benadryl in the long term as it is possible to build a tolerance for the medication and some reports indicate that it can lead to damage to the stomach and/or brain, depression, and seizures or other withdrawal symptoms.

You should always talk to your doctor or pharmacist before you take any sleep, pain, allergy, or cold medication. Acetaminophen is a common ingredient in many of the combination medications you will find but you should always read the label to check for it (or APAP, its abbreviation). That is because getting too much acetaminophen may lead to overdosing and can be fatal.

Note: Alcohol should always be avoided during pregnancy and that is especially true while taking Tylenol PM as alcohol and acetaminophen can increase the risk of liver damage when used together. You should also avoid driving while taking Tylenol PM as it can impair your reactions or thinking.

Precautions to Take for Taking Tylenol PM

1. Avoid Alcohol

You should always talk to your doctor before taking medicine with acetaminophen if you have more than three alcoholic drinks each day or have a history of liver disease. Avoid drinking alcohol while taking Tylenol PM or any other medication with acetaminophen. Never take more than the recommended amount of Tylenol PM as it can lead to liver damage or death.

2. Watch Out for Skin Reactions and Allergic Reactions

Skin reactions are rare but a possible side effect and if this occurs, stop taking the medication right away and talk to your doctor. Always talk to your pharmacist or doctor before taking additional medication as many will contain acetaminophen and getting it from multiple sources can lead to an overdose.

If you show any signs of an allergic reaction to Tylenol PM, seek emergency medical help. In some cases acetaminophen will lead to a severe skin reaction which may be fatal so stop taking Tylenol PM (and any other medication containing acetaminophen) immediately if you experience this reaction.

3. Know the Side Effects

Other common side effects of Tylenol PM include mild skin rash, feeling excited or restless, trouble concentrating, mild drowsiness or dizziness, dry nose or mouth, blurred vision, dry eyes, and constipation.

When to Call a Doctor

Stop taking the medication and contact your doctor if you experience jaundice, clay-colored stools, dark urine, loss of appetite, itching, upper stomach pain, nausea, lightheadedness, pale skin, unusual bleeding, easy bruising, flu symptoms, little urination, restless muscle movements, changes in breathing, severe drowsiness or dizziness, or heartbeats that are uneven, pounding, or fast.

Possibe Dangers

The combination of Tylenol PM and Pregnancy can have serious results if not taken properly. There have been two cases of pregnant women overdosing on acetaminophen in the late stages of pregnancy and in both cases, the mom and fetus died of hepatic toxicity. Studies have produced conflicting recommendations on the amount of acetaminophen that can be taken during pregnancy. One study showed that the drug will stay in the body of pregnant women longer than those who are not pregnant while another showed that there was no difference.

Another study also suggested that the usual oral dose of acetaminophen in pregnant women leads to a reduction in the production of prostacyclin but doesn’t affect the production of thromboxane.

Experts (including the FDA) believe that acetaminophen is safe during pregnancy as long as it is used for short periods of time and if the need is real. The FDA assigns diphenhydramine with pregnancy category B although animal studies haven’t shown teratogenicity.

More Medication Safety to Consider During Pregnancy

The following is common problems during pregnancy as well as what medications you can take for them and which ones to avoid.

• Allergies. When treating allergy symptoms such as congestion, antihistamines like loratidine (Claritin) and diphenhydramine (Benadryl) are safe. Avoid pseudoephedrine (Sudafed) as it can lead to birth defects. Decongestantsmay affect the flow of blood to the placenta and should be avoided.
• Coughing. The most common ingredients in cough medications, dextromethorphan and guaifenesin both seem safe during pregnancy despite little testing.
• Aches and pains. It is safe to treat aches and pains with acetaminophen but you should avoid NSAIDS such as ibuprofen or naproxen. These have been linked to congenital heart defects if taken in the first trimester as well as heart abnormalities or low levels of amniotic fluids if taken in the third trimester.
• Heartburn. Most medications for heartburn also seem safe to take during pregnancy including antacids and famotidine. If you are unsure about any medicine, always talk to your doctor before taking it.
• Constipation. Stool softeners such as Colaceappear as well as Metamucil should also be fine during pregnancy. Avoid rectal suppositories, mineral oils, and laxatives as they may stimulate labor.