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Wondering whether it’s safe to take cold medicine during pregnancy? It depends. Some of the ingredients in cold medications have been studied and are generally considered safe for pregnant women. Others haven’t been researched well enough or have been linked to pregnancy complications and are best avoided.
Cold medications that are okay to take during pregnancy
The following drugs have been studied or used relatively often in pregnant women and are generally considered safe to use when you’re expecting:
- Acetaminophin to relieve pain and reduce fevers. It’s best to take the minimum effective dose for only as long as you need it, and to never exceed the recommended maximum dosage per day.
- Antihistamines to relieve nasal congestion. Antihistamines that are considered safe for pregnant women include:
- Diphenhydramine (this common drug may cause uterine contractions, so in the third trimester it should be used only under the direction of your doctor)
- The cough suppressant dextromethorphan is often found in over-the-counter cold medicines like Robitussin and is considered safe for pregnant women.
- Cough drops with benzocaine or menthol are usually approved for use during pregnancy. Benzocaine doesn’t get into the bloodstream, so it’s very unlikely to pose a risk to a developing baby. Menthol is unlikely to cause problems during pregnancy, as long as it’s used as recommended.
- Decongestant corticosteroid nasal sprays are usually considered safe for use over a short period of time. Nasal strips, saline nasal sprays, and Neti pots are the safest options to use during pregnancy, as they don’t contain any medications.
- Decongestant chest rub with camphor oil (such as Vicks) is generally considered safe if used on the skin as directed, though it isn’t an effective decongestant. The ingredients in a chest rub might feel nice and make you feel like you’re breathing easier, though.
Cold medications to avoid or use with caution
Your doctor or midwife will likely suggest avoiding the following medications during pregnancy – or may recommend skipping them in certain trimesters – often because there’s a concern that they could contribute to possible birth defects or pregnancy complications:
- The decongestants pseudoephedrine and phenylephrine are generally not recommended during the first 13 weeks of pregnancy. After the first trimester, occasional use of these medications (for example, once or twice daily for no more than a day or two) may be safe. More frequent use, however, could be problematic, because these drugs constrict blood vessels. This could decrease blood flow to the placenta and raise your blood pressure. So be sure to check with your healthcare provider first if you want to try either type of decongestant, especially if you’ve already been diagnosed with high blood pressure. It’s important to note though, that the FDA recently stated phenylephrine may not even be helpful when it comes to nasal congestion, so these products may start to fall off drugstore shelves anyway.
- The expectorant guaifenesin (Mucinex) thins mucus secretions in the respiratory passages, making it easier to cough them up. While one study found an increased risk of inguinal hernias in babies exposed to this drug, most studies don’t suggest that guaifenesin increases the risk of birth defects. But since there hasn’t been a lot of research on the drug, your provider may recommend avoiding it in the first trimester.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, naproxen, and sodium salicylate, are usually not considered safe to use for pain relief during pregnancy, especially in the third trimester. The Food and Drug Administration (FDA) warns against using NSAIDs after week 20, as they can cause rare but serious kidney problems in unborn babies and lower a mother’s amniotic fluid levels.
Also keep in mind that herbal supplements (such as echinacea) haven’t been well-studied in pregnant women (and some are dangerous), so skip them unless you’ve cleared a specific supplement with your provider.
Be aware that some liquid cold medicines contain alcohol in concentrations as high as 4.75 percent. Look for products that are labeled “alcohol-free.”
Choosing the best cold medicine for pregnancy
Most cold medicines contain two or more drugs to treat several symptoms, making it more likely that they may contain a drug that isn’t safe during pregnancy. To be safe, read labels and choose an option with the least number of active ingredients. During pregnancy, it’s usually best to buy the specific medications you need individually rather than a multi-symptom medication.
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Always talk to your healthcare provider before taking any medication when you’re expecting. That way you can be sure you’re choosing the safest option at the recommended dosage, and that it doesn’t interfere with any other medications or supplements you’re taking.
Learn more about which medications are safe during pregnancy.