Australian Birth Defects Society

A Society devoted to the study of birth defects


MotherSafe is a free telephone service for the women of NSW, based at the Royal Hospital for Women, Randwick.

Tis the season for: treating reflux in pregnancy

I am 14 weeks pregnant and have been using my usual liquid antacid for heartburn (reflux) after my midwife said that it is OK. For the last few weeks it doesn’t seem to work as well or for as long as usual. Is there anything else I can use that is not harmful to my pregnancy?

Some women experience significant symptoms of reflux during pregnancy, which they wish to treat. Reflux symptoms commonly appear for the first time in pregnancy, and women who have had heartburn prior to pregnancy are likely to report that the symptoms become worse when pregnant. In the first instance the over the counter liquid and chewable antacids are recommended due to their long history of use among pregnant women without increasing pregnancy risk. If these products are (or become) ineffective, ranitidine is recommended. Ranitidine has been studied in pregnant women throughout pregnancy, and has not been associated with any increase in birth defects, or any other adverse effects on pregnancy outcome. It can be bought over the counter (without a prescription) from pharmacies in Australia.

Two months ago I started rabeprazole for my severe symptoms related to GORD (gastro-oesophageal reflux disease). It has been working really well. This morning I have done a pregnancy urine test which is positive. I think I may be six weeks pregnant. I am worried because the rabeprazole is Pregnancy Category B1. Has it harmed my baby?


Rabeprazole belongs to a class of drugs called proton pump inhibitors, used to treat reflux. None of the medicines in the class are expected to increase the risk of birth defects or miscarriage if used inadvertently in early pregnancy, but by far the best studied proton pump inhibitor in humans in the first trimester is omeprazole. If a proton pump inhibitor is needed to control symptoms in early pregnancy (such as in women using the medicine pre pregnancy), omeprazole is preferred over other drugs in the class on the basis of reassuring human pregnancy follow up data. Omeprazole is only available with a prescription.

For more information about heartburn and reflux in pregnancy, including food and lifestyle advice as well as medicines, follow the link to

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Page updated 7 December 2016

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