What Are Prenatal Vitamins: Uses, Side Effects, Warnings

Prenatal vitamins, also known as prenatal supplements, are vitamin and mineral supplements intended to be taken before and during pregnancy and during postnatal lactation. Folic acid is the most important vitamin to take when planning a pregnancy. Folic acid is a B vitamin that cells in your body need for growing and developing.

 Taking 400 mcg of folic acid every day for at least 1 month before and during pregnancy can help lower the risk for problems with the baby’s brain and spine — called neural tube defects (NTDs). Some women, like those who have had a pregnancy affected by NTDs or with sickle cell disease, may need more folic acid. Talk to your doctor or nurse about the dose that is right for you.

Most nutrients should come from the foods you eat, but it’s also a good idea to take prenatal vitamins. Your nurse, doctor, or midwife can recommend the best vitamins for you, in addition to folic acid.

When do I need to start taking prenatal vitamins?

Start taking folic acid at least 1 month before you start trying to get pregnant. The first few weeks of pregnancy are a really important time for fetal health and development. Taking folic acid and other prenatal vitamins can help reduce the risk of some birth defects. Keep taking prenatal vitamins throughout your entire pregnancy.

What should I discuss with my healthcare provider before taking prenatal multivitamins?

Many vitamins can cause serious or life-threatening side effects if taken in large doses. Do not take more of this medication than directed on the label or prescribed by your doctor.

Before taking prenatal multivitamins, tell your doctor about all your medical conditions and all medicines you use.

Ask a doctor before using a vitamin or mineral supplement if you are on a low-salt diet.

You may need to continue taking prenatal multivitamins if you breast-feed your baby. Ask your doctor about taking this medication while breast-feeding.

How should I take prenatal multivitamins?

The dose of a prenatal multivitamin depends on which brand you chose. While there are many brands available, you’ll want to choose a prenatal vitamin that includes:

•          folate (folic acid), which helps prevent neural tube irregularities, like spina bifida

•          iron, which delivers oxygen to the baby and helps prevent anemia

•          calcium, which helps with bone health

•          vitamins D, C, A, and E

•          zinc, which helps boost the immune system

•          copper

•          vitamin B12, which may prevent birth defects and support healthy bone development

•          magnesium

Most pregnant people don’t get enough choline, so it’s important to include choline-rich foods like egg yolks in your diet or take a supplement that contains this vital nutrient.

Choline is important for your health and is essential for fetal brain development and placental function.

Some supplements also contain DHA, which is important for your baby’s brain tissue growth and function — especially during the third trimester.

If your multivitamin doesn’t have DHA in it, ask your doctor for DHA. Use exactly as directed on the label, or as prescribed by your doctor.

Never take more than the recommended dose of prenatal multivitamins.

Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.

Take your prenatal multivitamin with a full glass of water.

Swallow the regular tablet or capsule whole. Do not break, chew, crush, or open it.

The chewable tablet must be chewed or allowed to dissolve in your mouth before swallowing. You may also allow the chewable tablet to dissolve in drinking water, fruit juice, or infant formula (but not milk or other dairy products). Drink this mixture right away.

Use prenatal multivitamins regularly to get the most benefit.

Store at room temperature away from moisture and heat. Keep prenatal multivitamins in their original container. Storing vitamins in a glass container can ruin the medication.

What happens if I miss a dose of prenatal vitamins?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose on prenatal vitamins?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects and can also harm your unborn baby. Certain minerals contained in a prenatal multivitamin may also cause serious overdose symptoms or harm to the baby if you take too much.

Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.

What should I avoid while taking prenatal multivitamins?

Avoid taking any other multivitamin product within 2 hours before or after you take your prenatal multivitamins. Taking similar vitamin products together at the same time can result in a vitamin overdose or serious side effects.

Avoid the regular use of salt substitutes in your diet if your multivitamin contains potassium.

Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the prenatal multivitamin.

What are the possible side effects of prenatal multivitamins?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

When taken as directed, prenatal multivitamins are not expected to cause serious side effects. Common side effects may include:

•          upset stomach;

•          headache; or

•          unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect prenatal multivitamins?

Vitamin and mineral supplements can interact with certain medications, or affect how medications work in your body. Ask a doctor or pharmacist before using prenatal multivitamins with any other medications, especially:

•          a diuretic or “water pill”;

•          heart or blood pressure medications;

•          tretinoin or isotretinoin;

•          trimethoprim and sulfamethoxazole (SMX-TMP or SMZ-TMP); or

•          NSAIDs (nonsteroidal anti-inflammatory drugs) –aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect prenatal multivitamins, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about prenatal multivitamins.

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