There is not a great deal of information available about the safety of oral antifungal medicines to treat thrush, such as fluconazole (Diflucan one or Canesten oral) during pregnancy, so we would advise you not to take them. • Antifungal cream or pessaries in pregnancy Metabolism of opioid analgesics is inhibited by cimetidine leading to increased plasma concentration. Anti-arrhythmics: May delay the gastro-intestinal absorption of mexiletine or quinidine (which may also reduce the efficacy of codeine).

Codeine should not be used during breastfeeding (see section 4.3). At normal therapeutic doses codeine and its active metabolite may be present in breast milk at very low doses and is unlikely to adversely affect the breast fed infant. However, if the patient is an ultrarapid metaboliser of codeine higher levels of the active metabolite, morphine, may be present in breast milk and on very rare occasions may result in symptoms of opioid toxicity in the infant, which may be fatal. The infant itself may be a CYP2D6 ultra-rapid metaboliser. In either case on very rare occasions this may result in symptoms of opioid toxicity in the infant. (See also section 4.4).A reduced dose is recommended in elderly or debilitated patients, in hepatic and renal impairment (but avoid if severe), in hypothyroidism, and in adrenocortical insufficiency. Repeated use of opioid analgesics is associated with the development of psychological and physical dependence; although this is rarely a problem with therapeutic use, caution is advised if prescribing for patients with a history of drug dependence or in acute alcoholism. Products such as Imodium which contain loperamide to stop diarrhoea should be avoided, as there is insufficient information available to decide if loperamide is safe or not during pregnancy. If you experience persistent diarrhoea during pregnancy make an urgent appointment with your doctor. Vaginal thrush during pregnancy Drowsiness, dizziness, blurred vision, nausea, vomiting, trouble sleeping, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Taking certain MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking isocarboxazid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

Alkof Syrup is a combination medicine used in the treatment of dry cough. It narrows the small blood vessels and provides relief from congestion or stuffiness in the nose. It also relieves allergy symptoms like watery eyes, sneezing, runny nose, and throat irritation. Anti-emetics: The reduction in intestinal motility caused by codeine may delay the absorption or antagonise the gastrointestinal effects of other drugs e.g. metoclopramide and domperidone. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are not recommended during pregnancy, as there are safer alternatives available. They should particularly be avoided in the last trimester, because they can delay labour, increase the length of labour and cause complications in the newborn baby. Painkilling doses of aspirin can also increase the risk of bleeding in the mother and baby if taken in the third trimester. Possible CNS excitation or depression (hypertension or hypotension) can occur when opioid analgesics are given with antidepressants such as moclobemide (a reversible MAO-A inhibitor). The sedative effects of codeine can possibly be increased when given with tricyclic antidepressants, with anxiolytics or hypnotics, or with sedating antihistamines. Antipsychotic medicines can enhance hypotensive and sedative effects when opioid analgesics are given with antipsychotics.

Take the tablet, capsule, or liquid form by mouth with or without food. This medication may be taken with food or milk if stomach upset occurs.

Heartburn, also known as indigestion or acid reflux, is common during pregnancy for a number of reasons including hormonal changes. To treat heartburn during pregnancy try the following: Tell your doctor right away if you have any serious side effects, including: fast/irregular/pounding heartbeat, mental/mood changes (such as confusion, hallucinations, nervousness), seizures, shaking (tremors), trouble urinating. Use with caution in the elderly, as codeine may induce faecal impaction, producing incontinence, spurious diarrhoea, abdominal pain and, rarely, colonic obstruction. Prolonged use could aggravate irritable bowel syndrome. Children may also be more sensitive to the side effects of antihistamines. In young children, antihistamines may cause agitation/excitement instead of drowsiness. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Patient concerns

The safest medicinal option for treating heartburn during pregnancy is calcium carbonate containing preparations such as TUMS. • Antacids during pregnancy