Ibuprofen and Tylenol in early pregnancy?

[mmfurness]

Hello, my wife is at just under 3 weeks after conception and had a major dental procedure today (removal of infected tooth/tissue + bone graft). She is experiencing pain and the dentist prescribed an alternating course of 600mg of Ibuprofen and 500mg of Extra Strength Tylenol. She took 600mg of Ibuprofen immediately, but our OBGYN advised against taking any more beyond that. Instead, she recommended that my wife stick to Tylenol as needed. This brings up a few questions:
1. What risk (if any is there from the 1 dose of ibuprofen) at this stage of her pregnancy?
2. We've heard that Tylenol increases the risk of Autism, ADHD, and other behavior conditions. Therefore, is it safe for her to take Tylenol in this scenario? If so, how much and how long?
3. Are there safer options than either of these drugs for her pain management?

Thank you.

[kaytlin]

Hi there!

1. NSAIDs like ibuprofen are usually avoided in pregnancy, but really the risk is for people who are 20 or more weeks pregnant. Your OBGYN knows more about her medical history, and would be a better source of information than my blind recommendation. However, if you called in for help and talked to a nurse, you might consider calling back to talk to the provider rather than getting the triage nurse's standard scripted answer. See more here: [url]https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-avoiding-use-nsaids-pregnancy-20-weeks-or-later-because-they-can-result-low-amniotic[/url]

2. There are studies that suggest there is a link between Tylenol/Autism/ADHD, but it is NOT strong research and in my opinion, should not prevent your wife from using Tylenol when she is in pain. Medication should always (pregnancy and lactation included) be a risk-benefit decision about what is best for your situation at that time. Keep in mind that there can also be detrimental effects from untreated pain - higher heart rate, blood pressure, and more. We see moms commonly choose to sacrifice their own health in exchange for their baby's...but withholding maternal treatment itself is a risk!

See more from the Society from Maternal-Fetal Medicine here: [url]https://www.ajog.org/article/S0002-9378(17)30128-X/fulltext[/url]

3. Other than non-pharmacologic options - massages, hot baths, etc., ibuprofen and acetaminophen are the most common options because they have the most data to support safe use. Any way you can support her in a distraction and self-care are a great addition to the plan you're already working on.

Dr. Krutsch