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Antenatal Supplements

Medication Information Leaflet

This leaflet describes some of the common supplements prescribed by your healthcare professional during your pregnancy.

Folic Acid (usually taken from preconception till the 12th week of pregnancy)
What is this for	To reduce the risk of birth defects, e.g. abnormal development of the spinal cord in the baby during the early stages of pregnancy.
How to take	Take one tablet once a day, usually in the morning, with or without food.
Side effects	Generally, well tolerated without any significant side effects.

Prenatal multivitamins (E.g. Obimin / Prenaforte / Ganilia) (usually taken from the 12th week of pregnancy onwards until delivery)
What is this for	Most prenatal vitamins contain a higher content of micronutrients to meet the increased demand during pregnancy. For example, most prenatal vitamins will contain iron, calcium and folic acid to meet the needs of the baby and mother. Iron helps with the formation of red blood cells, which carry oxygen to the baby. Calcium will help strengthen the baby’s bone development. Not all multivitamins are safe in pregnancy as they may contain higher than necessary contents e.g. some multivitamins may contain higher doses of Vitamin A that may not be safe in pregnancy. Check with your healthcare professional before buying any multivitamins on your own.
How to take	Dose is usually one tablet/capsule after breakfast or lunch. Follow the instructions stated on the medication label / packaging.
Side effects	Generally well tolerated in most patients. Some patients may experience ● Dark-coloured stools – due to the iron content. This is harmless. ● Constipation (due to the calcium and iron contents). You can drink more water and take plenty of fruits and vegetables to prevent it. Alertness if taken close to bedtime as it contains Vitamin B.
Other considerations	For supplements containing iron, space at least 2 hours apart from coffee, tea, milk, dairy products, and calcium supplements for better absorption. Some preparations may contain fish oil (e.g. Ganilia), hence, additional fish oil supplementation is not required.

Fish Oil Supplements (E.g. DHA / Natal Care Plus / Neurogain / Qualibrain/Baby’s First DHA) (usually taken from the 12th week of pregnancy onwards until delivery)
What is this for	Omega-3 fatty acids help with the baby’s brain and eye development.
How to take	Take one capsule once a day with or without food. Follow the instructions stated on the medication label / packaging.
Side effects	Flatulence (passing gas), belching (burping), and fishy aftertaste.

Calcium (E.g. Calcit Ultra / Caltrate / Calcium Carbonate) (usually taken from the 12th week of pregnancy onwards until delivery)
What is this for	For maintenance of mother’s bones and development of the baby’s bones.
How to take	Take one to two tablets once daily with or after food. Follow the instructions stated on the medication label / packaging.
Side effects	Constipation – drink more water and take plenty of fruits and vegetables to prevent it.
Other considerations	Space at least 2 hours apart from milk, dairy products, and supplements that contain iron to improve absorption. Some preparations may contain Vitamin D to enhance calcium absorption.

Iron (E.g. Sangobion / Hemoplex / Maltofer / Floron / Maltofer Drops) (usually taken when your hemoglobin levels are low)
What is this for	For the production of red blood cells to treat anemia (low red blood cell count) and to meet the increased iron needs of both mother and baby.
How to take	Take one to two tablets/capsules a day with or after food. Sometimes, your doctor may prescribe a liquid preparation for you if you are unable to swallow tablets. Follow the instructions as stated on the medication label / packaging.
Side effects	Side effects Generally well tolerated in most patients. Some patients may experience ● Dark-coloured stools. This is harmless. ● Constipation. You can drink more water and take plenty of fruits and vegetables to prevent it.
Other considerations	Most iron supplements may need to be spaced at least 2 hours apart from coffee, tea, milk, dairy products, and calcium or other iron-containing supplements to improve absorption (Exception: iron polymaltose e.g. Maltofer / Floron).

Vitamin D (only required when determined by your doctor)
What is this for	Helps to increase the absorption of calcium and reduce the risk of high blood pressure in pregnancy (pre-eclampsia)
How to take	Follow the instructions as stated on the medication label / packaging.
Side effects	Generally, well tolerated without any significant side effects.

What should I do if I forget to take/use this medication?

Take it as soon as you remember, then continue to take it as you normally would.
If it is too near to the time of your next dose, skip the missed dose and take the next dose at the usual time. There is no need to double or increase the dose.

What precautions should I take?

Inform your healthcare professional if:

You are allergic to these supplements or any of the other ingredients of this medication
You are taking any other medications, including supplements, traditional medications and herbal remedies.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.

Disclaimer

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on May 2022

This article was last reviewed on Tuesday, November 29, 2022