Pregnancy & Lactation : הריון/הנקה

4.6      Fertility, pregnancy and lactation

Pregnancy
There is insufficient experience about the safety of use of ibuprofen in humans during pregnancy. As the influence of prostaglandin synthesis inhibition is unclear, it is recommended not to use ibuprofen during the first six months of pregnancy.
Rarely, taking NSAIDs after the 20th week of pregnancy may cause impaired renal function of the fetus, which may cause low levels of amniotic fluid (oligohydramnios).
The effects were observed after days to weeks of treatment. However, in rare cases, low levels of amniotic fluid were observed already after 48 hours of taking NSAIDs. In most cases, oligohydramnios passed with the treatment discontinuation.
Using NSAIDs after the 20th week of pregnancy should be limited. If it was decided that the benefit outweighs the risk for the fetus and the treatment with the medicine is essential after the  20th week of pregnancy, the lowest effective dose should be used for the shortest possible period.
Referring the patient to ultrasound scan should be considered, in order to estimate the amount of amniotic fluid when the treatment with therapeutic dosage of these medicines exceeding 5 days and stopping the treatment if low levels of amniotic fluid is detected.
In the last trimester of pregnancy use of ibuprofen is contraindicated. Due to the mechanism of action, inhibition of uterine contractions, premature closure of ductus arteriosus and pulmonary hypertension of the neonate, an increased bleeding tendency in mother and child and increased formation of oedema in the mother could occur.

Breast-feeding

Ibuprofen and its metabolites can pass in very small concentrations (0.0008% of the maternal dose) into the breast milk. No harmful effects to infants are known, so it is not necessary to interrupt breast-feeding for short-term treatment with the recommended dose for mild to moderate pain and fever.

Fertility

See section 4.4 on Special Warnings and Precautions for use regarding female fertility