If you are planning a pregnancy, you may already be thinking about folic acid, diet, exercise and health check-ups.
There is one more conversation worth having before you start trying: your medicine cabinet.
And that means more than prescription medicines.
The painkiller you occasionally take, your thyroid tablet, diabetes medication, acne treatment, vitamins, supplements or even an “all-natural” herbal preparation can all be worth mentioning to your doctor.
The goal isn’t to stop everything.
It is to make sure that what you are taking is appropriate for your health and your pregnancy plans.
Why review medicines before pregnancy?
Some medicines can affect a developing pregnancy, while some medical conditions themselves can make pregnancy riskier if they are not well controlled.
This is why preconception care includes reviewing prescription medicines, non-prescription medicines, nutritional supplements and herbal products. 1 2
The timing matters too. Major fetal development begins very early in pregnancy, sometimes before you know you have conceived. 2
But there is an equally important point:
Stopping a necessary medicine isn’t automatically safer than continuing it.
For conditions such as diabetes, high blood pressure, epilepsy, thyroid disease and some mental-health conditions, good disease control before and during pregnancy can itself be important for a healthy pregnancy. 1 2
So the right question is not simply:
“Is this medicine safe in pregnancy?”
It is:
“What are the benefits of continuing it, what are the possible risks, and is there a safer alternative for me?”
Which medicines deserve particular attention?
You don’t need to memorise a list of medicines to avoid.
Instead, tell your doctor about everything you take regularly or occasionally.
This is particularly important if you take medicines for:
- Diabetes or insulin resistance
- High blood pressure
- Epilepsy or seizures
- Thyroid disease
- Depression or other mental-health conditions
- Asthma
- Autoimmune conditions
- Blood-clotting conditions
- Chronic pain or migraine
Some medicines may need to be changed before conception. Others may be continued because controlling the underlying condition is important. 1
Some medicines also have known or potential effects on fetal development. The actual risk depends on the specific medicine, dose, timing and your individual circumstances — which is why broad internet lists of “safe” and “unsafe” medicines can be misleading. 1 5
What about medicines you buy yourself?
This is an easy one to overlook.
An over-the-counter medicine isn’t automatically pregnancy-safe simply because you can buy it without a prescription.
Think about:
- Painkillers
- Cold and cough medicines
- Allergy medicines
- Laxatives
- Antacids
- Skin treatments
- Vitamins and minerals
Some may be appropriate; others may need caution or an alternative.
ACOG recommends discussing even OTC medicines, vitamins, minerals, herbal products and skin treatments with your healthcare professional when pregnancy is being planned. 5
So don’t wait until you have a positive pregnancy test to mention them.
And what about Ayurvedic or herbal products?
This deserves particular attention in India.
A product may be described as:
- natural
- herbal
- traditional
- organic
- detoxifying
None of those words automatically means pregnancy-safe.
Herbal products can contain multiple active ingredients, and their effects during pregnancy may not always be well established. ACOG specifically includes herbal products and nutritional supplements in the medication review during prepregnancy care. 1 2
So bring those products into the conversation too — even if you only take them occasionally.
What about folic acid?
Folic acid is different because it is specifically recommended before pregnancy.
For most women, folic acid is recommended daily before conception and during early pregnancy to reduce the risk of neural tube defects. 4 6
India’s National Health Mission advises women of reproductive age to take folic acid daily during the preconception period and continue through the first 12 weeks of pregnancy. Its 2024 clinical curriculum describes starting 2–3 months before conception as ideal. 4
Some women need a higher prescribed dose because of their medical or pregnancy history.
Don’t increase the dose yourself. Ask your doctor what is appropriate for you.
What if you have PCOS, insulin resistance or diabetes?
This is a good example of why medication decisions cannot be made from a generic pregnancy checklist.
If you take a prescribed medicine for PCOS, insulin resistance or diabetes, do not stop or change it on your own because you are planning a pregnancy.
For example, metformin is used for type 2 diabetes and may also be used in some women with PCOS or insulin resistance. Whether it should be continued, changed or replaced around pregnancy depends on why you take it, your health and your pregnancy plans. 3
Untreated or poorly controlled medical conditions can also carry pregnancy risks. For example, good blood glucose control before and during early pregnancy is important for reducing pregnancy complications. 1 2
So if you have diabetes or PCOS, your preconception appointment is an opportunity to make an individualised plan — not a reason to stop treatment abruptly.
Your preconception medicine check
Before you start trying, make a simple list.
Include:
- ☐ Prescription medicines
- ☐ Over-the-counter medicines
- ☐ Vitamins and supplements
- ☐ Ayurvedic or herbal products
- ☐ Skin and acne treatments
- ☐ Inhalers
- ☐ Medicines you take only occasionally
- ☐ Medicines you recently stopped
- ☐ The name, strength and frequency of each
Even better, take the actual strips, bottles or photographs of the labels to your appointment.
That way, your doctor can see the exact medicine, strength and ingredients instead of relying on memory.
What should you ask your doctor?
Rather than asking only:
“Can I stop this?”,
Try asking:
- “Is this medicine suitable if I become pregnant?”
- “Should we change it before I start trying?”
- “If it needs to be changed, how far in advance should we do that?”
- “What should I do if I become pregnant unexpectedly while taking it?”
These questions turn a vague worry into an actual plan.
Please don’t stop an important medicine on your own
This may be the most important message in this article.
Finding out that you are pregnant while taking regular medication can be frightening. Your first instinct may be to stop everything immediately.
Please don’t do that without medical advice.
ACOG specifically advises women not to stop prescription medication before speaking with their healthcare professional because, in some situations, the benefits of treating the mother’s condition may outweigh the potential medication risks. 2 5
Some medicines also need to be tapered or replaced carefully.
The safest approach is a planned medication review before conception whenever possible.
And if the pregnancy is unexpected, don’t blame yourself. Contact your doctor or pharmacist promptly and discuss what you have been taking.
When should you speak to a doctor?
A preconception consultation is especially useful if you:
- Take one or more prescription medicines regularly
- Have diabetes, hypertension, epilepsy, thyroid disease or another chronic condition
- Take psychiatric medication
- Use regular pain or migraine medication
- Take herbal or Ayurvedic preparations
- Take multiple supplements
- Have recently stopped a medication
- Are unsure whether something you take is pregnancy-safe
You don’t need to wait until you are actively trying.
If pregnancy is likely in the coming months, this is a good conversation to have now.
Key Takeaways
- Review everything you take before pregnancy — prescription medicines, OTC medicines, supplements and herbal products. 1 2
- Some medicines may need to be changed before conception, while others may be safer to continue because untreated illness also carries risks. 1 2
- Don’t assume that “over-the-counter” or “natural” means pregnancy-safe. 1 5
- Folic acid is an important part of preconception care and should be started before pregnancy. 4 6
- If you take medicines for PCOS, insulin resistance or diabetes, don’t stop them on your own. Make an individual plan with your doctor. 3
- Take your medicine strips, bottles or photographs of the labels to your appointment.
- Preparing for pregnancy isn’t about making your life completely medicine-free.
- It is about making sure you and your doctor have a clear plan before pregnancy begins.
References
[1] American College of Obstetricians and Gynecologists & American Society for Reproductive Medicine. Prepregnancy Counseling. Committee Opinion No. 762. 2019.
[2] American College of Obstetricians and Gynecologists. Good Health Before Pregnancy: Prepregnancy Care. Last reviewed October 2025.
[3] MotherToBaby. Metformin. June 2026.
[4] National Health Mission, Government of India. Comprehensive Emergency Obstetric and Newborn Care Curriculum 2024.
[5] American College of Obstetricians and Gynecologists. Reducing Risks of Birth Defects.
[6] Centers for Disease Control and Prevention. Folic Acid: Facts for Clinicians. Updated July 15, 2026.