There’s a lengthy list of dos and don’ts regarding what we can put in our bodies while pregnant. And when we would normally pop a Tylenol or Motrin for a pregnancy headache, we have to pause and make sure that it’s safe for the baby. But that’s when we turn to the experts. Doctors can advise on what cold medicine is safe for pregnancy.
Getting a cough and the sniffles right now can be unnerving when so many people are dealing with other viruses. That tickle in your throat may make your heart drop for a second, but finding out it’s just a cold is a welcome relief that you never thought you’d have. Pregnancy does cause our bodies to be more vulnerable. “Your immune system is slightly more compromised or weakened as a result of the pregnancy, so you are more susceptible to catching a cold,” Dr. Navya Mysore, MD, a primary care provider, tells Romper.
Up next is deciding how to treat your symptoms and get some ease. “I usually start out with supportive care measures,” Dr. Kiarra King, MD, FACOG, a board-certified OB-GYN, tells Romper. “This includes ensuring adequate hydration and managing symptoms. Hot teas, salt water gargles, and cough drops/lozenges can be soothing for a sore throat. A steam shower or humidifier may help relieve nasal congestion.”
If you really need the extra help, that’s where cold medicine can come in. Fortunately, “there are many medications that are safe during pregnancy when you have a cold,” Mysore says. Cold cold symptoms typically pass within seven to 10 days, but since your body is already in full create a human mode, the discomfort of not breathing through a stuffy nose is an extra annoyance.
Here’s what the experts advise when it comes to medications that are safe, as well as what you should avoid while pregnant.
Are over-the-counter medications safe to take during pregnancy?
The answer is yes and no, on a case by case basis depending on ingredients. “I think it’s most important to discuss ingredients that are safe for pregnancy,” Dr. King says. Many of the common cold medications, even within brands, “have several formulations, some which include ingredients not recommended during pregnancy.”
Take care to also watch out for the Food and Drug Administration (FDA)-assigned categories for cold medicine. “Many over-the-counter medications are classified by the FDA according to risk in pregnancy,” Dr. Mysore says. “Those falling in categories A, B, and many in C are generally considered safe for use during pregnancy, and the reason is because the benefit of taking these medications outweighs risks demonstrated by human and animal studies.” According to the FDA, assigned risk categories serve the purpose of preventing harmful consumption because 10% of birth defects come from maternal pharmaceutical exposure.
Additionally, Dr. King notes that over-the-counter cold medication should be used thoughtfully — remember, not all of them do the same thing and are necessary for each sickness. “It’s important to note that colds are viruses and will usually run their course in a week or two,” Dr. King says. “The goal of using cold medicine is to help alleviate symptoms during that time. If you only have a sore throat then you don’t need to take a multi-symptom medication. If you have a runny nose, sore throat and cough make sure that the medication you choose is indicated for those symptoms. Sometimes people just buy any cold medicine because they think the medications are all the same. So, this is a case where reading labels is key.”
So, what ingredients in cold medications are considered safe for pregnancy and what ones aren’t?
Which medications can I take for a cold while pregnant?
Here are Dr. King and Dr. Mysore's recommendations of safe ingredients when it comes to cold medicine:
- Dextromethorphan (Robitussin, Delsym), a cough suppressant, is considered safe.
- Guaifenesin (Mucinex, Robitussin DM), an expectorant, is considered safe.
- Acetaminophen (Tylenol), a pain reliever and fever reducer, is considered safe.
- Diphenhydramine (Benadryl), an antihistamine, is considered safe.
- Doxylamine (NyQuil), an antihistamine, is considered safe.
- Chlorpheniramine (ChlorTrimeton), an antihistamine, is considered safe.
- Budesonide nasal spray (Rhinocort), a steroid, is considered safe.
As Dr. Mysore explains, all of the above are either category A, B or C, meaning they are considered safe for use during pregnancy.
In case you would question how much you should take, Mysore says, “Pregnancy does not change dosage amounts for medications, so you can continue to take the same dosage you were prior to being pregnant.”
What medications should I avoid during pregnancy?
Here are the ingredients Dr. King and Dr. Mysore consider unsafe for pregnant people to take as cold medicine:
- Pseudoephedrine (Sudafed), a decongestant, “should be avoided until after the first trimester and in people with high blood pressure,” Dr. King says. In the second and third trimesters, it may be safe to take, but speak with your doctor first.
- Ibuprofen (Advil, Motrin), a pain reliever and fever reducer, should be avoided.
- Other non-steroidal anti-inflammatory drugs, or NSAIDs (Aspirin, Midol, Aleve), pain relievers and fever reducers, should be avoided.
- Phenylephrine (DayQuil, Theraflu, Sudafed PE), a decongestant and vasoconstrictor, should be avoided.
- Benzocaine-containing lozenges and sprays (Cepacol), sore throat and mouth pain relievers, should be avoided.
- Codeine, a narcotic that treats pain and cough, should be avoided.
Based on the FDA category, if a medication is labeled D and X, it isn’t recommended. Dr. Mysore says she would “absolutely avoid in pregnancy unless directed by your OB and generally, I suggest running by your OB medications that fall under category C. With category D and X medications often the risk of taking these medications is not worth the benefit you would see with your symptoms unless your symptoms are more severe. And that would, of course, be discussed with your doctor.” Additionally, in 2015, the FDA replaced the lettering system with more detailed and comprehensible labels, so providers and pregnant and lactating parents equally understand how medications will affect their baby.
It’s also important to note that different products within brand names will have variations in their safety for pregnant people. Different types of DayQuil and NyQuil, for example, will have different formulations, which is why it’s so important to pay attention to ingredients. If you are unsure or have questions, review it with your OB-GYN or primary care doctor before taking the medication for your cold symptoms. “A patient should always consult with their physician or health care provider regarding their specific situation before taking any medications or supplements,” Dr. King says.
And again, going the home remedy route is always a great starting option. “A few other things you can do to help your symptoms are getting plenty of rest, make sure you are hydrated by drinking water and warm liquids, and gargling salt water can help to ease your sore throat,” Dr. Mysore says. “I also always suggest a humidifier by your bed and cough drops to help with a sore throat and a dry cough.”
As a precaution, always read the labels, which should now list specifically if it is safe for folks who are pregnant. And if you still aren’t sure, contact your doctor for additional guidance.
Navya Mysore, MD, primary care provider
Kiarra King, MD, FACOG, board-certified OB-GYN
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