Is Aleve safe during pregnancy?

What does the evidence say about Aleve during pregnancy?

1. Aleve and other NSAIDs aren't recommended starting around 20 weeks of pregnancy, since they've been linked to rare but serious kidney problems and low amniotic fluid in the baby. 1
2. Most research on naproxen hasn't found a higher overall rate of birth defects, though a few studies have flagged a small, unexplained increase in heart defects or cleft lip and palate. 2
3. Taking naproxen in the third trimester may raise the risk of birth defects, so acetaminophen is the pain reliever recommended instead during pregnancy. 3
4. First-trimester naproxen exposure hasn't been tied to a clear pattern of birth defects in tracked pregnancies, though researchers still recommend reaching for a better-studied option first when one is available. 4
5. Acetaminophen is still the pain and fever reliever most healthcare providers reach for first in pregnancy, since large studies haven't tied typical use to a higher rate of birth defects. 5

Is Aleve safe in each trimester?

• First trimester. Most studies haven't linked first-trimester naproxen use to a higher overall rate of birth defects. A few have flagged a small, unexplained rise in heart defects or cleft lip and palate, so many providers reach for acetaminophen first and save Aleve for when a provider recommends it.
• Second trimester. Second-trimester use still falls under the FDA's 20-week caution: past that point, Aleve moves from occasional-use territory to ask-your-provider-first territory. Some clinicians will still approve a short course, for example for a migraine that isn't responding to acetaminophen.
• Third trimester. By the third trimester, naproxen is best avoided altogether. It's been linked to early closure of a fetal heart vessel, lower amniotic fluid, and babies measuring smaller than expected, which is why acetaminophen or a provider-approved plan is the safer route this late in pregnancy.