What Cold Medications Can You Take While Pregnant?
Key takeaways:
Some cold medications are generally considered safe to take during pregnancy. They include dextromethorphan (Delsym, Robitussin) and chlorpheniramine. Most steroid nasal sprays (except for Nasacort) are also considered safe.
Some cold medications may be harmful to you or your baby. They include ibuprofen (Advil, Motrin), naproxen (Aleve), and pseudoephedrine (Sudafed). Nasacort nasal spray is also considered unsafe to use during pregnancy.
Ask your healthcare provider or pharmacist before taking any cold medications during pregnancy. If you do need cold medication, take the lowest effective dose for the shortest amount of time possible.
Table of contents
The average adult gets two to four colds per year, and pregnant people are no exception. In fact, you may get sick more easily while you’re pregnant. And if you’re an expectant mother, you need to consider which cold medications are safe for your unborn baby.
Below, we’ll talk about which cold medications you can take during pregnancy, and which to avoid.
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Which cold medications may be safe during pregnancy?
A variety of cough and cold medications are available over the counter (OTC) at your local pharmacy. Different medications target different cold symptoms. So pinpointing your specific symptoms can help you decide which medications to take.
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But when you’re pregnant, it’s not as simple. Research on cough and cold medications during pregnancy is limited. Some research suggests that certain medications should be avoided during the first trimester. This is because the first trimester is an important time of development for your baby. And you don’t want anything to interfere with that process.
When considering whether to take medications during pregnancy, you have to weigh risks versus benefits. Your healthcare provider and pharmacist can help you do this. Always check with them before starting any medication. They may suggest non-medication options, such as a saline rinse, first. If you do need medication, take the lowest dose needed to relieve your symptoms for the shortest period of time possible.
Here are cold medications that are considered safe during pregnancy.
Cough medications
Dextromethorphan (Delsym, Robitussin)
Dextromethorphan (DM) is a cough suppressant. In general, research on pregnant women taking DM has found it safe.
Still, one large study found a possible link between DM and a small number of birth defects. But the authors noted that the mothers in the study almost always used products that contained other medications in addition to DM. So it’s not clear whether DM was truly the cause of these birth defects. The authors also noted that DM is generally still considered safe to take during pregnancy.
Guaifenesin (Mucinex)
Guaifenesin is an “expectorant.” It can help thin mucus to relieve “wet” (productive) coughs.
Research on taking guaifenesin during pregnancy is limited. So it’s not completely clear just how safe it is. It’s possible that your healthcare provider will OK guaifenesin if you need it, especially in the later stages of pregnancy. But this is a medication you should definitely discuss with your healthcare provider before you take it.
Runny nose medications
Older (first-generation) antihistamines like chlorpheniramine
In general, most antihistamines are considered safe in pregnancy. Typically, antihistamines are used for allergies. But older antihistamines have a drying effect that can help with a runny nose from a cold, too. The American College of Obstetricians and Gynecologists (ACOG) considers chlorpheniramine a first-choice option if you need an antihistamine while you’re pregnant.
Keep in mind that older antihistamines tend to have more side effects. Examples include sleepiness, dizziness, and dry mouth. These effects may make it harder to carry out your day-to-day activities. So for many people, these medications may not be the best treatment option.
Newer (second-generation) antihistamines like cetirizine (Zyrtec) and loratadine (Claritin)
Newer antihistamines, such as cetirizine (Zyrtec) and loratadine (Claritin), are less likely to cause bothersome side effects. But they may not be as effective for cold symptoms as older antihistamines. And it’s best to avoid taking them during the first trimester unless your provider OKs it.
Nasal steroid sprays like fluticasone propionate (Flonase) and budesonide (Rhinocort Allergy)
Some steroid nasal sprays are safe to use during pregnancy. They’re usually used for allergies. But they may also help with swelling and runny nose from a cold. Research has shown that OTC budesonide (Rhinocort Allergy), fluticasone (Flonase, Flonase Sensimist), and mometasone (Nasonex) nasal sprays are safe to use while pregnant.
Be aware that these nasal sprays can cause nose-related side effects, such as nosebleeds, dryness, and stinging or burning.
Pain due to headaches or sore throat
Acetaminophen (Tylenol)
Acetaminophen has typically been considered a first-choice option for pain during pregnancy. There’s some conflicting research on just how safe it really is. Still, ACOG recommends it as one of the only safe pain relievers you can take while pregnant.
It’s best to only take acetaminophen while pregnant if you truly need it. And make sure it’s OK with your healthcare provider first.
What cold medicines aren’t safe during pregnancy?
There are a few cough and cold medications that are best to avoid during pregnancy unless your provider tells you otherwise. We’ll cover some of these below. Even if a medication isn’t on this list, always check with your healthcare provider before taking any medication during pregnancy, even OTC products.
Nasal steroid sprays like triamcinolone (Nasacort)
Avoid triamcinolone (Nasacort) during pregnancy. Studies suggest that this nasal spray is linked to birth defects in the respiratory tract (including the throat and windpipe) of the fetus. As discussed above, other nasal steroid sprays are better options during pregnancy.
Oral decongestants like pseudoephedrine (Sudafed)
Studies on oral decongestants during pregnancy are limited. The research we do have shows conflicting results. Some studies show a higher risk of birth defects with pseudoephedrine (Sudafed) during pregnancy. But other research has found no greater risk.
Due to this limited research, ACOG recommends avoiding pseudoephedrine in the first trimester of pregnancy. And if you need a decongestant later in your pregnancy, talk to your provider first. They can help you choose the safest treatment option.
Nasal decongestant sprays like oxymetazoline (Afrin)
Nasal decongestant sprays, such as oxymetazoline (Afrin), deliver medication only where it’s needed: the nose. There isn’t much research on these nasal sprays in pregnancy. One study showed that there might be a link between Afrin and birth defects. But if your congestion is bothersome, your provider may recommend it for a short course (no more than 3 days). Using the spray longer than that can cause congestion to get worse (rebound congestion).
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are common pain relievers. This group of medications includes ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn).
The FDA recommends avoiding NSAIDs at 20 weeks or later in pregnancy. At 20 weeks or later, NSAIDs can decrease the amount of fluid in your belly that protects your baby (amniotic fluid). This can impact the development of your baby’s kidneys, lungs, and other organs. And at 30 weeks of pregnancy or later, NSAIDs can cause problems with your baby’s heart.
NSAIDs might be safe to use in the first half of pregnancy (before 20 weeks), but there are still risks. So they’re not a first-choice option. Acetaminophen is usually preferred for pain relief in pregnancy.
Liquid medications containing alcohol
Some medications come as a syrup that contains alcohol. Ingesting alcohol while pregnant can lead to pregnancy loss, birth defects, and developmental problems in your baby. If you’re looking for a liquid cough or cold medication, read the label to make sure the product is alcohol-free. If you’re not sure, ask your pharmacist before purchasing.
Liquid medications containing natural sugars
Liquid medications may contain sweeteners for flavoring. These sweeteners can increase your blood sugar levels. And this may be a problem if you have gestational diabetes.
In this case, it may be best to use “sugar-free” liquid medications during pregnancy. These typically contain sugar alcohols, like sorbitol, or artificial sweeteners, like sucralose. These may be safer than natural sugar during pregnancy — especially sugar alcohols, which don't affect your blood sugar levels as much.
But keep in mind that artificial sweeteners may not be completely risk free. Consuming a large amount of artificial sweeteners during pregnancy may lead to problems like preterm birth and childhood obesity. So if you’re taking a medication with artificial sweeteners in it, consume the smallest amount needed for the shortest amount of time possible.
Combination medications like DayQuil products
It may be best to avoid combination cold products like DayQuil during pregnancy. These products contain multiple medications, and some may not be safe during pregnancy. It’s also more likely that you’ll take medication you may not need if you choose a combination product.
For example, DayQuil products contain a combination of acetaminophen, dextromethorphan, phenylephrine, and guaifenesin. And Claritin-D contains loratadine and pseudoephedrine. It may be best to avoid phenylephrine and pseudoephedrine during pregnancy.
Always ask your healthcare provider and pharmacist before starting any combination products during pregnancy. They can help make sure each ingredient is safe.
Natural remedies for a cold that are pregnancy-safe
If you’re pregnant and have a cold, it can be tempting to turn to medications so you can go about your daily life. But simply resting is actually one of the best things you can do. And non-medication options may be safer for you and your baby.
Other tips you can try at home to relieve your cold symptoms include:
Use a humidifier in your room to open your nasal passages.
Elevate your upper body on a pillow while resting to help congestion.
Drink plenty of fluids (8 to 12 cups of water a day) to stay hydrated.
Suck on ice chips, gargle with salt water, or drink warm tea to relieve a sore throat.
Make sure you’re getting enough nutrition, even if you have to eat smaller meals.
The bottom line
Certain cold medications are considered safe for most people during pregnancy. They include dextromethorphan (Delsym, Robitussin) for cough and antihistamines such as chlorpheniramine for a runny nose. Acetaminophen (Tylenol) is also generally considered safe, as are most steroid nasal sprays.
Other medications — such as pseudoephedrine (Sudafed), phenylephrine (Sudafed PE), and triamcinolone (Nasocort) — might cause harm to you or your baby. And it’s best to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) unless your provider recommends them.
Keep in mind that combination products, such as DayQuil, contain several ingredients. The best way to be sure each ingredient is safe is to ask your healthcare provider or pharmacist to evaluate the medication. If you do need medication, take the lowest dose for the shortest time possible to minimize any risk.
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