NSAIDs should be avoided after 20th week of pregnancy, FDA warns

Taking a common type of pain medication, specifically nonsteroidal anti-inflammatory drugs (NSAIDs), in the second half of a pregnancy — at about 20 weeks and beyond — could cause serious problems for the developing baby, according to a new warning from the Food and Drug Administration. NSAIDs, available over-the-counter and by prescription, include aspirin, ibuprofen (such as Advil, Motrin), naproxen (Aleve) and celecoxib (Celebrex). The warning, however, does not apply to low-dose aspirin (81 milligrams). The FDA is now mandating that labels on the drugs explain that NSAIDs taken at 20 weeks or later could cause rare but serious kidney problems for the fetus, leading to a low level of the vital amniotic fluid that surrounds and protects the fetus as it grows. By this point in a pregnancy, the developing baby’s kidneys produce most of the amniotic fluid, so kidney problems can result in a fluid level that is too low. The FDA already requires a warning on NSAIDs that taking the medication after 30 weeks in a pregnancy carries a risk for fetal heart problems. Women generally are advised to be extra careful about all drugs, herbs and supplements taken when they are pregnant — including medicines they regularly take when not pregnant for pain and existing conditions, such as diabetes or asthma. Women are urged to work closely with their doctors to determine their specific risks and benefits. In its new drug safety warning, the FDA says that “if deemed necessary by a health care professional, use of NSAIDs between 20 and 30 weeks of pregnancy should be limited to the lowest effective dose for the shortest duration.”