Which Cold Medications Are Safe to Take While Pregnant?
Key takeaways:
It’s best to try nonmedicated treatments if you get a cold during pregnancy. If needed, some cold medications are safe to take while pregnant. But you should always ask your prenatal team or pharmacist before taking any medication while pregnant.
Safe cold medications you can take while pregnant include dextromethorphan (Delsym) for cough, chlorpheniramine for runny nose, and acetaminophen (Tylenol) for sore throat or headache. Most steroid nasal sprays, such as budesonide (Rhinocort Allergy), are also considered safe.
Some cold medications may be harmful to you or your baby. These include nonsteroidal anti-inflammatory drugs (NSAIDs), pseudoephedrine (Sudafed), and triamcinolone nasal spray (Nasacort).
Be sure to avoid liquid cold medications that contain alcohol or sugar. It’s also a good idea to avoid combination cough and cold products during pregnancy. They can increase the risk of taking extra medication you don’t need or that could be harmful.
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Table of contents
On average, adults get two to three colds per year, and pregnant people are no exception. In fact, you may get sick more easily while you’re pregnant.
If you get a cold, a variety of cough and cold medications are available over the counter (OTC). Different medications target different cold symptoms. In most cases, pinpointing your symptoms can help you decide which medications to take.
But when you’re pregnant, it’s not as simple. If you’re expecting, you need to consider which cold medications are safe for both you and your fetus. Below, we’ll talk about which cold medications are safe during pregnancy and which to avoid.
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Which cold medicines are safe during pregnancy?
Research on cough and cold medications during pregnancy is limited. So in most cases, it’s a matter of weighing the risks versus the benefits. Your prescriber and pharmacist can help you do this. So it’s best to check in with them before starting any medication during pregnancy.
In general, nonmedication options, such as a nasal saline rinse, are considered the safest during pregnancy. But if you need medication, take the lowest dose needed to relieve your symptoms for the shortest period of time possible. This helps minimize any risk.
Here are cold medications considered safe during pregnancy, according to the symptom they treat.
1. Cough medications
Dextromethorphan (Delsym) and guaifenesin (Mucinex) are the two main OTC cough medications. They are generally considered safe during pregnancy if your prenatal team OKs them for you. Here’s what the research says.
Dextromethorphan (Delsym)
Dextromethorphan — DM for short — is a cough suppressant. In general, research has found it safe for pregnant women.
One large study found a possible link between DM and a small number of birth defects. But the mothers in the study almost always used products that contained other medications in addition to DM. So it’s not clear whether DM caused these birth defects. The authors also noted that DM is generally still considered safe to take during pregnancy.
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Guaifenesin (Mucinex)
Guaifenesin is an expectorant. It can help thin mucus to relieve “wet” (productive) coughs. It’s often included with DM in combination cough medications, such as Robitussin DM or Mucinex DM.
Research on taking guaifenesin during pregnancy is limited. Some studies suggest it may raise the risk of birth defects, but the overall risk remains low. So it’s generally considered safe to take after the first trimester (12 weeks) of pregnancy.
Good to know: Some OTC cough medications, especially liquids, may also contain alcohol. You should avoid alcohol during pregnancy, so be sure to read the product label carefully to help identify these products.
2. Runny nose medications
When it comes to runny nose medications, there are several options considered safe to take during pregnancy.
Antihistamines, such as chlorpheniramine and loratadine (Claritin)
In general, most antihistamines are considered safe to take while pregnant.
Typically, antihistamines are taken to treat allergy symptoms. But older, first-generation antihistamines have a drying effect that can also help with a runny nose from a cold. 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 constipation. 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 antihistamines, such as loratadine (Claritin), are also considered safe during pregnancy and are less likely to cause side effects. But they’re unlikely to help with cold symptoms the way older antihistamines do. They’re typically effective only for allergy-related symptoms.
Some nasal steroid sprays, such as fluticasone (Flonase) and budesonide (Rhinocort Allergy)
Some (but not all) steroid nasal sprays are safe to use during pregnancy. They’re most effective for chronic allergy symptoms since they can take up to 2 weeks to reach their full effect. But nasal steroids may also help with a runny or stuffy nose from a cold.
Research shows 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.
3. Headache or sore throat medication
Acetaminophen (Tylenol) is typically considered a first-choice option for pain during pregnancy. There’s some conflicting research on how safe it is. Still, ACOG recommends it as one of the only safe pain relievers you can take while pregnant.
If you have a headache or sore throat from a cold, it’s best to try nonmedicated treatment options first (more on this later). Take acetaminophen while pregnant only if you truly need it. And make sure it’s OK with your prenatal team first.
Which cold medicines aren’t safe during pregnancy?
A few cold medications are best to avoid during pregnancy unless your healthcare team tells you otherwise. We’ll cover some of these below. But you should always check with your prenatal team before taking any medication during pregnancy, even if it isn’t listed below.
1. Triamcinolone nasal spray (Nasacort)
Avoid triamcinolone nasal spray (Nasacort) during pregnancy. Studies suggest that it may lead to birth defects in the respiratory tract (including the throat and windpipe) of the fetus. As discussed above, other nasal steroid sprays are safer options during pregnancy.
2. 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.
ACOG recommends avoiding pseudoephedrine in the first trimester of pregnancy. If you need a decongestant later in your pregnancy, talk to your prenatal team. They may suggest trying a nonmedication treatment option first.
Good to know: Products that contain pseudoephedrine are kept behind the pharmacy counter. Most OTC decongestants on the shelf contain phenylephrine. But the FDA recently proposed removing oral phenylephrine from the market because it isn’t an effective congestion treatment. It has also been linked to birth defects. So it’s also best to avoid oral phenylephrine.
3. Nasal decongestant sprays, such as oxymetazoline (Afrin)
Nasal decongestant sprays, such as oxymetazoline (Afrin), deliver medication directly to the nose. They’re typically considered safer than oral decongestants, since they don’t reach the bloodstream in large amounts. But there isn’t much research on these nasal sprays in pregnancy. And the studies we do have show conflicting results when it comes to their risks during pregnancy.
Since the risk of nasal decongestant sprays is unclear, they’re typically recommended only for severe congestion that isn’t relieved by nonmedication options. If your prenatal team OKs a decongestant nasal spray, be sure to use it for only 3 days or less. Using the spray longer than that can cause rebound congestion that’s much harder to treat.
4. NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are common OTC pain relievers. But it’s best to avoid NSAIDs during pregnancy unless your prenatal team recommends them. This group of medications includes ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn).
In the first half of pregnancy (before Week 20), NSAIDs may raise the risk of miscarriage and birth defects. The FDA recommends avoiding NSAIDs even after the 20-week mark in pregnancy. At 20 weeks or later, NSAIDs can cause kidney issues in the fetus and decrease the amount of fluid in your belly that protects your baby (amniotic fluid). And at 30 weeks of pregnancy or later, NSAIDs can cause problems with your baby’s heart.
Acetaminophen is usually preferred for pain relief during pregnancy. Your healthcare team can provide a treatment recommendation that’s specific to your needs.
5. Liquid medications containing alcohol or sugar
Some liquid cough and cold medications contain alcohol — in some cases at a higher percentage than beer or wine. Ingesting alcohol while pregnant can lead to pregnancy loss, birth defects, and developmental problems in your baby. If you’re looking for a liquid medication, read the label to make sure the product is alcohol-free. If you’re not sure, ask your pharmacist.
Liquid medications may also contain sweeteners for flavoring. These sweeteners can increase your blood sugar (glucose) levels. And this may be a problem if you have gestational diabetes.
In this case, it’s best to choose sugar-free liquid medications during pregnancy. These typically contain sugar alcohols or artificial sweeteners, such as sorbitol or sucralose. They may be safer during pregnancy since they 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, such as preterm birth and childhood obesity.
6. Combination medications
It’s best to avoid combination cold products during pregnancy. Common examples include DayQuil (acetaminophen / dextromethorphan / phenylephrine) and Advil Cold and Sinus (ibuprofen / pseudoephedrine). These products contain multiple medications, and some may not be safe during pregnancy. Combination products also make it more likely that you’ll take medication for symptoms you don’t even have.
It’s best to buy single-ingredient medications for your specific symptoms. This helps minimize risk to you and your fetus.
Natural remedies for a cold that are pregnancy-safe
If you are 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 one of the best things you can do. And nonmedication options are often safer than medications for you and your fetus.
Here are some other tips you can try at home to relieve your cold symptoms:
Use a humidifier in your room to open your nasal passages.
Try a nasal saline rinse to help relieve congestion.
Elevate your upper body on a pillow while resting. This should help with congestion and reduce coughing.
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
If you have a cold while you’re pregnant, it’s best to try nonmedication options first. If needed, certain cold medications are considered safe for most people during pregnancy. These include dextromethorphan (Delsym) for cough, chlorpheniramine for a runny nose, and acetaminophen (Tylenol) for a headache or a sore throat. Most steroid nasal sprays, such as budesonide (Rhinocort Allergy), are also considered safe during pregnancy. But always check in with your prenatal team or pharmacist before taking any medication.
Other medications may cause fetal harm if you take them while pregnant. These include pseudoephedrine (Sudafed), triamcinolone (Nasocort), and nonsteroidal anti-inflammatory drugs (NSAIDs). So it’s best to avoid them unless recommended by your prenatal team. While you’re pregnant it’s a good idea to avoid liquid cough and cold medications that contain alcohol or sugar. Combination cough and cold products are also best avoided.
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References
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