Can breastfeeding moms take pills, and which ones?

Throughout the entire pregnancy, there was an almost complete ban on taking any medications for a woman. But then the baby is born, and the next natural stage begins for the mother - the period of breastfeeding. Most often, it lasts not nine months, like pregnancy, but much longer - on average up to one and a half to two years, or even more. Therefore, the next question inevitably affects almost every woman: can nursing mothers take pills, and which ones? After all, the chance of harming the baby during feeding is no lower than during pregnancy? Let's try to understand this difficult topic.

What medications can a nursing mother take?

If you open several instructions for different medications, you will notice that in most of them, in the column “Use during breastfeeding” it says: “no data”, “effect not studied”, “studies not conducted”, etc.

Indeed, it is often easier for a manufacturer to write such a phrase than to pay for additional expensive studies. Therefore, the fact that such drugs are not recommended due to a lack of confidence in their safety does not mean anything.

As a rule, most practicing doctors are aware of how dangerous a particular medication can be. Therefore, the main rule for nursing mothers should be: before taking any medication, consult a doctor. Reading the instructions is great, but you should not take medications on your own and without a prescription.

The undesirable and negative impact of tablets and mixtures on the health and well-being of the infant can be determined by the following number of factors:

• how toxic is this medication for a child’s body;
• in what volume it penetrates into breast milk, and how much of this milk does the baby drink;
• does the medicine interfere with the full development of the child's body;
• if the active substance gets into the child’s hands, how quickly and to what extent is it excreted;
• whether the drug is taken once or whether the mother requires long-term treatment;
• is there an individual reaction of the mother's or child's organism to the medication;
• How high is the risk of developing allergies in a baby?

Among all the medicines, there are always more toxic and less toxic for the human body. Therefore, for a nursing mother, in any case, you can choose pills that will not require you to stop or even stop breastfeeding.

The optimal therapeutic regimen that does not interfere with breastfeeding will be determined by a doctor who will first carefully study the pharmacological properties of the medications.

According to statistics, nursing mothers often resort to taking pills in cases where they can be done without them. There are many methods known to cure, for example, a cough or a sore throat without taking medications internally.

It is recommended that nursing mothers take pills only when they are really needed, and without this, healing becomes impossible.

If the medication is necessary and it may have a negative effect on the baby, the mother is advised to stop breastfeeding; however, it is necessary to continue expressing milk to stimulate its production and resume feeding the baby after the completion of treatment.

What medications can a nursing mother take for a fever?

If a nursing mother has a fever, she should first find out the cause of the problem: it could be a cold, poisoning, mastitis or lactostasis. In case of breast diseases, it is better to consult a doctor immediately, as self-medication is fraught with unpleasant consequences. In case of mild poisoning or a minor cold, you can try to cure yourself. However, if the temperature reaches 39°C, you should visit a doctor.

It is worth noting right away that a rise in temperature is not a reason to stop breastfeeding. If you feel a little unwell, you can do without taking pills, for example, do the following:

• drink plenty of warm liquids throughout the day, such as chamomile or raspberry tea;
• if the baby does not have allergies, then you can add honey and lemon to the tea;
• wipe the body with a damp towel (you can use a vinegar mixture consisting of 50 ml of water and 30 ml of table vinegar, but no more);
• A vinegar compress can be applied to the forehead.

Nursing mothers are allowed to take fever tablets only when the readings reach 38°C or higher.

Many medications are able to "bring down" the temperature quite quickly: for example, we are talking about such tablets as Teraflu, Coldrex, etc. But during breastfeeding, these medications cannot be taken, since they fully penetrate into the milk and even change its structure. The well-known Citramon is also prohibited.

The most recommended tablets for nursing mothers are:

• Paracetamol - this drug gets into breast milk, but in very small quantities. It is allowed to take one tablet three times a day, with an interval between doses of at least four hours. The maximum term of treatment with Paracetamol without a doctor's prescription is three days.
• Children's Nurofen (Ibuprofen) in tablets can be taken if Paracetamol does not have the desired effect. It is optimal to take one tablet no more than four times a day. If there is no significant improvement within three days, then you should visit a doctor for advice.

A nursing mother should avoid exceeding the dosage of even approved tablets, since any medication to one degree or another affects the blood picture and liver, and also changes the taste and structure of breast milk.

What cough medicine can a nursing mother take?

Treating a cough in a nursing mother is not an easy task, because such a symptom can accompany not only a common cold, but also viral diseases. Therefore, it is better to consult a doctor who will listen to breathing, conduct diagnostics and prescribe appropriate treatment with tablets or other drugs approved for breastfeeding. The fact is that an advanced inflammatory process in the respiratory system can quickly become complicated by other pathological conditions, which will subsequently require more complex treatment using stronger and more complex drugs. That is when lactation will really have to be stopped.

In case of a mild productive cough, a nursing mother may be advised to seek help from traditional medicine, if the doctor does not object to this.

What pills can a doctor recommend to a nursing mother (from the category of drugs permitted during the lactation period):

• Ambroxol, Lazolvan - to increase the secretion and removal of mucus and optimize coughing, take one tablet twice a day, after meals, with water. If you adhere to this regimen, then you do not need to stop breastfeeding.
• Mucaltin - as a bronchodilator and secretolytic, to reduce the frequency of coughing attacks and their intensity, take 2 tablets 4 times a day before meals, with plenty of liquid. There is no need to stop breastfeeding for the duration of treatment.

It is not recommended to take tablets such as ACC, as well as preparations with plantain, thyme, licorice, and anise without consulting a doctor.

What medications for flu, acute respiratory viral infections and colds can nursing mothers take?

Viral and microbial infections are dangerous, first of all, because of the high probability of complications. In addition, not all pills are indicated for nursing mothers.

The first thing the doctor will suggest to the woman is to drink plenty of fluids. You can drink herbal tea, breast tea, various fruit drinks (if the baby is not allergic to berries) and just clean warm water.

Symptomatic treatment is allowed. For example, to lower the temperature, you are allowed to take Paracetamol or Nurofen tablets (by the way, you should forget about Acetylsalicylic acid during the period of breastfeeding).

Let's look at other common pills, the use of which raises many questions among nursing mothers:

• Ingavirin - this medication blocks the intracellular introduction of the virus, slows down its reproduction processes. It is usually taken for treatment or prevention. But nursing mothers should not take this medication. The only possible option is to stop breastfeeding for the entire period of treatment. Ingavirin, after penetrating the baby's bloodstream, can cause dizziness, tachycardia and many other extremely undesirable symptoms.
• Arbidol is a drug of an artificially created prototype of human interferon, which accelerates recovery and significantly alleviates the symptoms of a viral disease. However, experts do not have information on whether nursing mothers can take such pills: experiments with Arbidol were conducted only on animals. And, although such experiments showed the relative safety of the drug, no one can answer the question of the possibility of taking it during lactation. What you definitely should not do is treat yourself. Treatment with Arbidol should be discussed with a doctor, and the sooner the better. After all, interferons should be taken at the first symptoms of ARVI. If you are late with taking the first pill, then further treatment with Arbidol will be pointless.
• Anaferon is a tablet containing antibodies to γ-interferon. The drug has a pronounced antiviral effect and is approved for use by nursing mothers: its main capabilities are to prevent complications and speed up recovery. Most nursing women and their babies tolerate Anaferon well. Allergy to the drug is noted only in isolated cases. The main thing is to follow the recommended dosage:
  • immediately after painful symptoms are detected, take one tablet every half hour, and do so for two hours;
  • then take one more tablet every three hours throughout the day;
  • On the following days and thereafter, take one tablet in the morning, at lunch and in the evening – that is, three times a day.

The duration of the treatment course is determined by the doctor individually.

• Antigrippin is a combination drug based on paracetamol, chlorphenamine, ascorbic acid and other components. The tablets have a pronounced anti-inflammatory, antipyretic and antihistamine effect: the main signs of a viral infection disappear in a short time, and recovery is accelerated. However, doctors do not recommend nursing mothers to take Antigrippin, since these tablets are quite toxic for the child's body. If there is an urgent need for treatment with such tablets, then lactation is interrupted.
• Oscillococcinum is a homeopathic remedy that can safely and effectively counteract viral invasion. The composition of the drug is simple and is represented by an extract from the liver and heart tissue of the Barbary duck, as well as sucrose and lactose. It is recommended to take the tablets immediately after the first symptoms of the disease are detected, a quarter of an hour before meals, or between meals. During the first day, three doses of the drug are taken with an interval of six hours between doses. During all subsequent days, one dose should be taken every twelve hours. Preventive administration consists of taking one dose daily at the same time, for one week. The tablets (granules) are kept in the oral cavity until completely dissolved.

Despite the relative safety of Oscillococcinum, nursing mothers are allowed to take the tablets only after talking to a doctor. However, the possibility of an allergic reaction cannot be ruled out - both in the mother and the baby.

What medicine for a sore throat can a nursing mother take?

A sore throat is not a reason to take pills right away. Especially if we are talking about a nursing mother. Of course, a woman wants to get rid of the unpleasant painful sensation as soon as possible, but recovery can be accelerated by other methods, for example:

• gargling with Furacilin solution (take one tablet per glass of warm water, gargle 5-6 times a day);
• rinsing with a saline-soda solution (take ½ teaspoon of baking soda, the same amount of sea salt and a couple of drops of iodine per glass of warm water, rinse 5-6 times a day);
• irrigation of the tonsils with Chlorophyllipt spray, at least three times a day (or lubrication with a similar oil solution);
• irrigation of the tonsils with Ingalipt or Hexoral spray.

Of the tablets, nursing mothers can be offered only the well-known Septefril and Lizobact. Septefril is dissolved in the oral cavity, one tablet 5 times a day. Lizobact is also kept in the mouth until completely dissolved, two tablets three times a day. However, it should be taken into account that of all types of treatment, taking tablets during breastfeeding is less preferable.

What medicine for headaches can a nursing mother take?

Analgesics can be quite dangerous pills for nursing mothers and their babies. Some components of such drugs can cause allergic reactions, diarrhea, or sleep disturbances in children. To avoid trouble, do not choose your pills yourself. Headaches can be caused by many factors, so medications should not be taken "at random". It is important to know how exactly the drug will work and whether it will be safe for the baby.

• Askofen is a combination of acetylsalicylic acid, paracetamol and caffeine, so these tablets help to cope with headaches caused by fatigue and low blood pressure. But, as you know, Aspirin cannot be taken during lactation, and caffeine can negatively affect the baby's condition. Therefore, if a nursing mother wants to take Askofen, she will have to stop breastfeeding for the entire period of therapy (and even for a few days longer). This medication should not be taken for more than five days in a row.
• Analgin is a tablet that is strictly prohibited for nursing mothers. Analgin is a toxic drug, which has already been confirmed by many studies. It can disrupt the structure of milk, interfere with the processes of hematopoiesis, and disrupt the functionality of the urinary system. In addition, Analgin changes the blood picture: it is unsafe to take it even for a relatively healthy person.
• Nimesil, or Nimesulide, according to the instructions should not be used during breastfeeding. But in practice, doctors allow a single pill, although you should stop breastfeeding for one day. Then the process can be resumed.

For headaches associated with cerebral vascular spasm, you can take No-shpa - this will not have any negative impact if the pill is taken by a nursing mother once, in the amount of one piece. If long-term treatment with No-shpa is expected, then the woman will have to temporarily stop the breastfeeding process to avoid the toxic effect of the drug on the child's body. By the way, there is no particular difference between No-shpa and Drotaverine tablets. These drugs are considered analogs of each other.

If a nursing mother's headache is associated with high blood pressure, with spasm of the cerebral vessels, then you can take a relatively safe tablet Papazol, which is a combination of dibazol and papaverine. If Papazol is taken once, then you only need to express the portion of milk that follows taking the tablet - that is, skip one feeding, replacing it with pre-prepared milk or formula. No other changes in feeding the baby need to be made: you can then breastfeed as before. But with long-term and regular use, lactation must be suspended.

What allergy medicine can a nursing mother take?

Itching, rashes on the body, swelling, shortness of breath - these are some of the main signs of allergies. Sometimes the allergic reaction is so strong that it is impossible to do without medication. But - what about lactation? It is clear that external application of antihistamine ointments and creams is acceptable for nursing mothers. But is it possible to take pills with a similar effect?

Antihistamines, the main drugs that can stop an allergic reaction, are divided into three pharmaceutical generations.

Medicines belonging to the first generation are the most well-known and have an additional undesirable effect - some hypnotic effect on the body. The fact is that such drugs overcome the physiological membrane between the circulatory system and the central nervous system, inhibiting its performance. The most popular drugs in this category are:

• Suprastin is not indicated for use by lactating patients due to the high probability of sleep disorders, irritability and capriciousness in the baby. The full spectrum of Suprastin's effect on the child has not been fully studied.
• Clemastine is contraindicated for use by nursing mothers due to the depression of the infant’s psychological state and inhibition of milk secretion.
• Diprazine is an allergy blocking agent that can be taken by a nursing mother only once. Long-term treatment with Diprazine is prohibited during this period.
• Diphenhydramine - this medication is allowed for use by nursing mothers, but under certain conditions:
  • if the baby is older than 3 months;
  • if the baby is not underweight;
  • if a woman takes the minimum possible amount of the drug with a minimum course of treatment.

Antihistamine drugs, which belong to the second generation, do not particularly affect the functioning of the central nervous system and do not form dependence on treatment. However, they can disrupt the heart rate and increase the load on the liver. Of these drugs, the following are allowed for nursing mothers: Cetirizine, Loratadine. Terfenadine is relatively safe - provided it is taken once. Long-term treatment with these tablets is prohibited. The popular drug Ebastine is also prohibited if the patient is breastfeeding.

Antiallergic representatives of the third generation are the most popular and safe. In most cases, they are allowed to be prescribed to nursing mothers, but during the entire therapeutic course, it is necessary to monitor the baby's well-being, and at any suspicious signs, contact a pediatrician. What drugs belong to the third group:

• Levocetirizine - take one tablet once a day.
• Desloratadine - take 5 mg (one tablet) once daily.
• Fexofenadine - take one tablet before meals once a day.

What medicine for diarrhea can a nursing mother take?

Diarrhea, which manifests itself in frequent and loose stools, can be provoked by various reasons. If it is caused by nutritional disorders or stress, then to normalize it, it is enough to simply review your diet and eliminate the source of stress. If the reason is a violation of the intestinal microflora or helminthic invasion, then you should consult a doctor who will prescribe medications appropriate to the problem, approved for use by nursing mothers. It may be necessary to take a stool test beforehand.

The most dangerous causes of loose stools are infectious diseases and poisoning: these painful conditions also require urgent medical attention.

If diarrhea is not accompanied by vomiting or fever, there is no blood in the stool, there is no abdominal pain, then most likely we are talking about stress or alimentary diarrhea. What pills can a nursing mother take to reduce the frequency of urges and soothe an irritated intestine?

• Atoxil is a silicon dioxide preparation, an enterosorbent, which is practically not absorbed in the intestinal cavity and therefore cannot penetrate into breast milk. Atoxil is taken 7 g 2-3 times a day, for 3-5 days.
• Activated carbon is a well-known sorbent, inexpensive, but quite effective for dyspepsia, food poisoning, poisoning. To normalize stool, it may be enough to take three tablets, three in the morning, afternoon and evening. In case of poisoning, the dosage should be increased to 4-8 tablets 3-4 times a day. The tablets are thoroughly crushed and swallowed with plenty of water. For nursing mothers, this drug is absolutely safe.
• Sorbex is a medicine that is a granulated medical carbon that is not absorbed in the intestinal cavity and does not cause disturbances in the microbiocenosis. Sorbex is taken between meals, 2-4 capsules three times a day. The duration of administration is from three days to two weeks. No negative information about the effect of this drug on the condition of a baby who is breastfed has been received.

What medicine for constipation can a nursing mother take?

Constipation is a common symptom that accompanies the postpartum period. Impaired intestinal motility is often the result of several factors at once: changes in hormonal levels, injuries sustained during childbirth, poor nutrition with a predominance of easily digestible foods, sedentary lifestyle, stress and lack of sleep.

Many medications with laxative properties are prohibited for nursing mothers. For example, a woman should not treat constipation with Regulax, Gutalax, etc. However, approved medications do exist, for example:

• Lactulose is a drug that is safe for breastfeeding women. However, the dosage should be selected by the doctor individually (from 10 to 45 ml in the morning with breakfast).
• Duphalac (Dufalac) is a drug based on lactulose. The dosage is also calculated individually - from 10 to 45 ml, once a day.
• Flax seeds are a natural and safe remedy that will quickly eliminate constipation associated with lazy bowel syndrome or a sedentary lifestyle. In the morning on an empty stomach, eat one tablespoon of flax seeds (without a slide), chew well and wash down with a cup of water. The effect will be enhanced if you wash down flax with fresh kefir instead of water.

If the nursing mother's stool does not return to normal with the help of the listed means, then you need to consult a doctor by making an appointment with him for an individual appointment.

What anti-worm medications can nursing mothers take?

If the analysis of the nursing mother's stool indicates the presence of worms, then treatment must follow. Sometimes such an analysis is carried out three times, because parasites are not always detected the first time.

Pills are prescribed to nursing mothers if no other health problems are currently detected. For example, during infections and inflammatory pathologies, helminth removal is not carried out.

Medicines such as Levamisole (in pharmacies it is most often presented as Decaris) and Mebendazole, or Albendazole (better known as Vermox or Vormil), are definitely prohibited for nursing mothers.

And only a few anthelmintic medications can be prescribed to nursing mothers:

• Piperazine - its use is relevant for ascariasis or enterobiasis. The treatment regimen is determined individually, and therapy is carried out under the supervision of a doctor.
• Pyrantel is used for enterobiasis, ascariasis, and ancylostomiasis. The drug is taken once, so this treatment is much more convenient than other similar drugs. To minimize the negative impact of Pyrantel on the baby, it is recommended to express milk in advance and feed from a bottle for 24 hours after taking the tablets.

Can a nursing mother take antibiotics?

Absolutely all antibiotics can penetrate into the mother's milk and, accordingly, into the baby's bloodstream. As a result, the infant may experience intoxication, digestive disorders, diarrhea, allergic reactions, insomnia or drowsiness, etc. But it happens that a nursing mother cannot do without antibiotic therapy. Previously, this required temporarily stopping lactation. Now doctors offer a number of antibiotics that are considered relatively safe for an infant.

Most often, nursing mothers are allowed three groups of antibacterial agents:

• penicillin antibiotics (Amoxicillin, Penicillin - these medications are low-toxic, enter milk in small quantities, but can cause diarrhea and rashes on the baby's skin);
• aminoglycoside antibiotics (Gentamicin enters milk in small quantities, but can provoke changes in the baby’s intestinal flora);
• cephalosporin antibiotics (Cefazolin, Ceftriaxone – appear in small amounts in milk, but can cause diarrhea and increased bleeding).

Other similar medications, such as those belonging to the macrolide group, are rarely prescribed and only when breastfeeding is stopped. Undesirable medications include Erythromycin, Midecamycin, Sumamed: they can cause allergies and digestive problems in infants.

Tetracycline, Metronidazole, Levomycetin, and Clindamycin tablets are absolutely prohibited for nursing mothers.

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How to calm the nervous system of a nursing mother?

Stress in a nursing mother is a common occurrence. A significant role is played by a sharp change in lifestyle, as well as lack of sleep, worries and fears. Some women develop depressive states. How can you calm the nervous system without harming the baby?

• Valerian, valerian tablets - suitable for nursing mothers, stabilize mood, improve sleep, relieve neuroses. As a rule, take one tablet 1-2 times a day: during lactation, this dose is not recommended to be exceeded. The duration of administration is also limited - you should not take tablets for more than ten days in a row.
• Validol is suitable for the treatment of cardiac neuroses, but nursing mothers are advised to drink it with caution. In addition to isovaleric acid, Validol contains menthol, which can lead to depression of the nervous system, nausea, and allergies in the baby. If a woman suffers from angina, she should consult a doctor in advance about what medication to take in case of a possible attack. Most likely, a medical specialist will recommend some effective replacement for tablets such as Validol.
• Glycine is an absolutely safe tablet for nursing mothers and even infants (they can be prescribed by a pediatrician for restless sleep and excessive anxiety of the baby). Glycine has virtually no side effects. A woman is allowed to take 1-2 tablets three times a day, or only at night. The tablet should not be swallowed: it is dissolved in the mouth.

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Can a nursing mother take vitamins?

Most nursing mothers try to enrich their diet as much as possible so that the baby gets all the necessary nutrients and other useful substances. Often, this requires additional vitamin supplements. They are also necessary for the woman herself to recover faster after pregnancy and childbirth.

The baby and his mother especially need B vitamins, ascorbic acid, vitamins A and E. It happens that the doctor recommends taking special vitamin-mineral complexes, which include not only vitamins, but also essential mineral components.

Nursing mothers should avoid choosing vitamin supplements on their own, entrusting this important step to a doctor. This can help prevent an allergic reaction in the baby or other negative consequences.

Which vitamin and mineral supplements raise the most questions among women?

• Iodomarin is prescribed if there is a lack of iodine in the body of a nursing mother, or certain diseases of the thyroid gland. Lactation is not a reason to cancel the drug. On the contrary, many doctors even advise taking such pills if there are appropriate indications for this. Of course, at first, when taking the medication, it is necessary to carefully monitor the baby's condition. He may have such problems as an allergic reaction, changes in stool, etc. Typically, nursing mothers take 200 mcg of Iodomarin immediately after eating.
• Calcium D ₃ Nycomed is a drug that can provide both a nursing mother and her baby with a sufficient amount of calcium. The drug is not contraindicated during lactation if the woman follows the dosage prescribed by the doctor. The fact is that excessive calcium intake can cause increased fatigue, sleep disturbances, loss of attention, and even lead to the development of a depressive state. Doctors advise nursing mothers to take calcium tablets one piece twice a day.
• Elevit Pronatal is a complex drug that is usually recommended for women during pregnancy. This drug is also in demand during breastfeeding: you can find a lot of positive reviews on the Internet from nursing mothers who took this multivitamin. Elevit is taken daily, once a day, in the amount of one tablet. You should not increase the dose on your own: excess vitamins can lead to nausea, headaches, digestive disorders. In addition, the baby sometimes has an adverse reaction to the drug. It is important to monitor the baby during the first few days from the moment you start taking Elevit. If there are any signs of allergy, the drug is canceled.
• Fish oil is a natural food supplement that can be purchased at pharmacies in the form of vials with oily liquid or capsules. Fish oil serves as a preventative measure against osteoporosis, metabolic disorders, anemia, etc. However, nursing mothers should not take this product, as it can significantly affect the structure of milk and change its fat content. As a result, the mother may develop lactostasis. The child may react to the mother taking fish oil with a digestive disorder or an allergic reaction.
• Sorbifer is prescribed for iron deficiency anemia, as well as for its prevention. Sorbifer is allowed to be used by nursing mothers in a dosage of 1 tablet up to 2 times a day. Duration of use - until the hemoglobin content in the bloodstream is normalized.
• Maltofer is often used to correct hemoglobin levels in nursing mothers. If a woman is diagnosed with iron deficiency anemia, then Maltofer should be taken 100-300 mg daily. For preventive purposes, it is enough to take up to 100 mg of the drug per day. The course of treatment can be long - from several months to six months, depending on the indications. A common side effect of Maltofer is darkening of feces. This is a normal reaction that does not require discontinuing the medication.

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Can a nursing mother take a hot bath?

We have sorted out the pills allowed for nursing mothers. In conclusion, I would like to raise another pressing issue: is it allowed for a nursing mother to take a hot bath? After all, sometimes you really want to calm down, relax, relieve tension and fatigue, which especially affects new mothers. By the way, such a bath perfectly eliminates the symptoms of postpartum depression, helps the nervous system and the body as a whole to recover.

Before you start filling the bath, you need to familiarize yourself with some nuances. Thus, the reproductive system does not return to its previous state immediately after the birth of the baby. The reduction of the birth canal is a long process, and if you do not allow it to complete, there is a risk of penetration of microbes and the development of inflammatory processes in the genital area.

It is believed that the cervix closes and its functionality is restored in about 1-2 months. Until this moment, nursing mothers are not recommended to take any bath, including a hot one, otherwise they can "earn" many problems - from inflammation of external injuries and sutures to endometritis, etc.

To get an accurate idea of the time, you can watch your postpartum discharge: as soon as it is completely over, you can think about a water procedure such as a bath. However, the water in it should not be hot - no more than 40°C.

Cool water is also undesirable, as it can lead to a deterioration in the flow of breast milk.

You should not take a bath if you have problems in the nipple area - for example, cracks or other tissue integrity issues. First, you need to heal the skin, and only then think about a water procedure.

We have figured out whether a nursing mother can take pills, and which ones are safer. All that remains is to wish good health to both mother and baby: it is better to stay healthy so that you do not have to take risks and take any, even the most harmless medications.

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