The MHRA has issued a reminder that the use of systemic (oral and injectable) NSAIDs such as ibuprofen, naproxen, and diclofenac is contraindicated in the last trimester of pregnancy (after 28 weeks of pregnancy).

A review of data from a 2022 study has identified that prolonged use of NSAIDs from week 20 of pregnancy onwards may be associated with an increased risk of oligohydramnios (low levels of amniotic fluid surrounding the baby) and fatal renal dysfunction.

Some cases of constriction of the ductus arteriosus (a narrowing of a connecting blood vessel in the baby’s heart) have also been identified at this early stage.

If, following consultation between the patient and a healthcare professional, use of a systemic NSAID after week 20 of pregnancy is considered necessary, it should be prescribed for the lowest dose for the shortest time and additional neonatal monitoring considered if used for longer than several days.

This is in addition to giving advice to discontinue use of any NSAID in the last trimester of pregnancy.

• The MHRA has launched a safety campaign to raise awareness of anaphylaxis and provide advice on the use of adrenaline auto-injectors (AAIs). A toolkit of resources is available for health care professionals to support the safe and effective use of AAIs. They are freely available for download from the MHRA’s guidance page on Adrenaline Auto-Injectors (AAIs) and include infographics and videos about the correct use of AAIs.