Existing Health Conditions: Do Not Stop Your Medicine

Existing Conditions in pregnancy: how to think about it

NHS guidance on existing health conditions in pregnancy is built around one recurring problem: people stop effective treatment on discovering they are pregnant, and the untreated condition then causes more harm than the medicine would have. Epilepsy is the clearest illustration, where uncontrolled seizures carry serious risks, but the same logic applies to asthma, diabetes, thyroid disease, inflammatory bowel disease, mental health conditions and hypertension. The guidance therefore frames pregnancy as a reason to review treatment, not to abandon it. Some medicines do change: doses often need adjusting because pregnancy alters how drugs are absorbed and cleared, thyroid replacement commonly needs increasing, and a small number of drugs are genuinely switched for alternatives. Those are clinical decisions made with the whole picture. The practical advice is to get reviewed early, ideally before conception, and to keep taking what you are on until someone with your notes in front of them says otherwise.

Existing Conditions: safer choices

• Continuing your prescribed medicine until a clinician who knows your history has reviewed it. Stopping unilaterally is the common mistake this guidance exists to prevent.
• Asking for a medication review as early as possible, ideally before conception, but as soon as you know if not.
• Telling your midwife about every condition and every medicine at booking, including ones you consider minor or unrelated.
• Asking specifically what the plan is: whether the medicine stays, changes dose, or switches, and what monitoring you need. Conditions like thyroid disease and diabetes often need dose changes rather than stopping.
• Keeping specialist appointments. Conditions such as epilepsy, diabetes, thyroid disease, asthma and inflammatory conditions usually need input from the team who manages them.

Existing Conditions: what to avoid or double-check

• Do not stop or reduce medication on your own, and do not halve doses to feel safer. Both are common and both can be more dangerous than continuing.
• Avoid deciding from a leaflet. Patient information leaflets are written conservatively and rarely reflect the specific risk and benefit calculation for your situation.
• Do not assume a medicine is unsafe because a website says so. Evidence quality varies enormously between drugs and between sources.
• Do not wait for your first appointment if you are on something you are worried about. Contact your GP, specialist or pharmacist sooner.

How SafeMama helps

SafeMama can identify the active ingredient in your medicines and show what is in combination products, which is useful preparation for a medication review. It is not a substitute for that review, and it should not be used to decide whether to stop something.

Open the SafeMama app, scan the barcode or search the ingredient, then use the result as a starting point for a conversation with your healthcare provider.

Sources

• NHS existing health conditions in pregnancy
• NHS medicines in pregnancy