Is Tylenol PM safe during pregnancy?

What does the evidence say about Tylenol PM during pregnancy?

1. Acetaminophen at recommended doses has not been shown to raise the chance of birth defects, and many healthcare providers and organizations still consider it the pain reliever and fever reducer of choice during pregnancy. 1
2. Studies of diphenhydramine show no consistent pattern of birth defects, and antihistamine use in early pregnancy has not been linked to a higher chance of miscarriage. 2
3. Reports of uterine contractions with third-trimester diphenhydramine generally involved amounts higher than the recommended dose, which is why clinicians ask how much and how often rather than just whether. 2
4. Adults should stay under 4,000 mg of acetaminophen in 24 hours and should never use two acetaminophen-containing products at once, since acetaminophen appears in hundreds of over-the-counter and prescription drugs. 3
5. ACOG supports acetaminophen use in pregnancy when taken as needed, in moderation, and after a conversation with a doctor. 4

Is Tylenol PM safe in each trimester?

• First trimester. Sleep gets strange early, often before anyone else knows you are pregnant. Both ingredients have been studied in first-trimester use without a consistent birth defect signal. Occasional use sits differently than every night, so it is worth naming the pattern out loud at your first prenatal visit.
• Second trimester. Sleep often improves here, which makes this a good stretch to see whether you still need a nightly pill. Some people find the antihistamine leaves them foggy the next morning. If you are reaching for it more than a couple of nights a week, that is the number your clinician wants.
• Third trimester. Reports of uterine contractions after diphenhydramine in the third trimester involved doses above what the label allows, so dose and frequency matter more now. Third-trimester insomnia is common and rarely fixed by one product. Ask your provider what to use and what to stop as your due date gets close.