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If you dread the discomfort and pain that comes with post-mealtime indigestion and heartburn, you’re not alone. As many as 45 percent of people have heartburn during pregnancy.

While clearly this is common and totally normal during pregnancy, you might be wondering if there are safe over-the-counter (OTC) remedies, like Pepcid, that you can take to help ease some of this burning indigestion.

The good news? You can take Pepcid — while keeping certain considerations in mind — during pregnancy. And there are a few other OTC options — plus some home remedies — you can try the next time you feel the burn coming on.

Pepcid is an OTC histamine-2 blocker (H2 blocker) with the active ingredient famotidine. It relieves heartburn by reducing the amount of acid in the stomach.

According to the company’s website, Pepcid comes in three forms:

  • Original Strength Pepcid AC: Comes in a tablet and contains an H2 blocker that starts working in 15 minutes.
  • Maximum Strength Pepcid AC: Comes in a tablet and contains an H2 blocker that starts working in 15 minutes.
  • Pepcid AC Complete: Comes in a chewable tablet and combines an H2 blocker with an antacid that starts working in seconds.

All three types of Pepcid can be purchased without a prescription, though in cases of pregnancy, you always want to check with your OB-GYN or healthcare provider before taking a new medicine.

Pepcid is often a go-to OTC drug for those who have heartburn and indigestion during pregnancy.

“There are many people who experience acid reflux in pregnancy due to high levels of progesterone and the increasing size of the uterus,” says Rachel Gerber, MD, a reproductive endocrinologist and board certified OB-GYN at Reproductive Medicine Associates.

Pregnancy hormones slow down the muscles of the digestive tract, which causes food to move more slowly, leaving you with a sluggish digestive system.

You may also experience indigestion and heartburn when hormones relax the valve that separates the esophagus from the stomach, causing the food and acids to come back up from the stomach to the esophagus. This process is responsible for the burning feeling that comes with heartburn.

When lifestyle and dietary changes don’t help relieve heartburn in pregnancy, Ross says you can take Pepcid AC by mouth once or twice a day with or without food. As always, discuss taking any new medication with your doctor during pregnancy.

Unless your doctor says otherwise, Pepcid is safe to take during pregnancy. “Pepcid AC is relatively safe to take during pregnancy with no true risks unless you’re allergic to this medication,” says Sherry Ross, MD, an OB-GYN and women’s health expert at Providence Saint John’s Health Center.

Additionally, H2 blockers have been used in all trimesters with no known teratogenic effect, according to a 2014 American Family Physician journal article.

One tool many pregnant people formerly relied on for tracking the safety of medication and drugs was the category ranking from the Food and Drug Administration (FDA). This system assigned a letter (A, B, C, D, or X) to each drug based on its safety during pregnancy.

The FDA stopped using this system in 2015. However, many people — including, possibly, your OB — will still refer to this old category system. The FDA gave Pepcid a B category rating during pregnancy. Category B indicated that a drug was routinely and safely used during pregnancy.

“There are no risks to the mother or fetus,” says G. Thomas Ruiz, MD, OB-GYN lead at MemorialCare Orange Coast Medical Center. Even though Pepcid does cross the placenta, Ruiz says there have been no known ill-effects in babies.

Because of the physiologic changes in pregnancy, Ruiz says there may be increased renal clearance of Pepcid. In plain language, this means you may need to take a higher dose. But check with your doctor.

While it’s best to avoid unnecessary medications during pregnancy unless specifically recommended by your doctor, Gerber says the available data is reassuring that Pepcid doesn’t lead to increase risk in pregnant versus nonpregnant people.

However, before you take Pepcid, Ross says to consult with your doctor if you have a history of kidney or liver disease, asthma, COPD, or breathing problems.

Some of the more common side effects of Pepcid include:

  • constipation
  • diarrhea
  • dry mouth
  • headache
  • nausea
  • muscle cramps

Dietary and lifestyle changes can help reduce heartburn, indigestion, and acid reflux during pregnancy. Whenever possible, Gerber recommends trying these interventions before starting a medication.

Remedies that may help reduce heartburn, indigestion, or acid reflux include the following:

  • Eat several small meals a day instead of three large ones.
  • Eat most of your food in the first half of the day and eat less at night.
  • Eat slowly and chew your food thoroughly.
  • Avoid eating or drinking acidic beverages for up to 2 hours before going to sleep.
  • Drink fluids between meals.
  • Avoid citrus fruits and juices.
  • Avoid very fatty foods that slow stomach emptying.
  • Avoid carbonated beverages, tomato sauce, spicy foods, and fried foods.
  • Remain upright after meals for at least 30 minutes
  • Decrease your intake of hot spices or hot sauces.
  • Sleep with the head of the bed at a comfortable incline. (If you don’t have one of those fancy mattresses that does this, use pillows.)

When it comes to OTC medications to try before using Pepcid, Ross says products such as Tums or Maalox help coat the esophagus, which minimizes the burning sensation. Both are safe in pregnancy.

For optimal results, Ross recommends taking these medications 30 minutes before each meal and before bedtime.

Be aware that proton pump inhibitors such as Nexium (pantoprazole) are sometimes recommended to treat acid reflux, according to Gerber. “This class of medications also appears to be safe for use in pregnancy but has not been as widely studies in this population as the H2 receptor blockers such as Pepcid,” she says.

Heartburn and indigestion are common ailments during pregnancy. The good news? You have options for treating this uncomfortable condition.

Lifestyle and diet modifications are your first line of defense, but if those don’t work, doctors often recommend an OTC product like Pepcid, which is safe to take during pregnancy.

As always, consult with your OB-GYN or healthcare provider before taking any drug or medication. If you experience any adverse side effects while taking Pepcid, stop immediately and call your doctor.