Herbal agents and over-the-counter medications in pregnancy

Exposures to over-the-counter and herbal products are frequent in pregnant women. Limited information exists on the effects of many of these agents during pregnancy; it is not safe to assume that because these products are available without a prescription that they are without danger to the pregnant woman and her fetus. The basic principles utilized in deciding whether to employ prescription medications such as dose, embryological timing and potential toxic fetal effects also apply to herbal medications and over-the-counter agents. Conventional reasoning indicates that maternal exposure to poorly studied medications should be limited; therefore, many of these agents should be used sparingly or not at all by pregnant women. This chapter includes a review of selected herbal and over-the-counter agents, including those which are considered to be acceptable for use in pregnancy.