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What cold medications are safe during pregnancy?

Colds are obviously extremely common, and I always warn patients that they can take a little longer to get over when you're pregnant because your immune system isn't as sturdy. As far as medications are concerned, there are many over-the-counter medications that are out there. I usually recommend plain Sudafed, plain Actifed, Tylenol, Robitussin DM if you have a cough. You can also use Vicks VapoRub; that can be quite helpful because you get more congested at night, and you're already more congested in pregnancy anyway. A humidifier can also be very helpful. I just try to avoid any real strong decongestants because that sometimes can affect the flow to the placenta, and obviously we want to avoid that.
Anthony L. Komaroff, MD
Internal Medicine
In general, acetaminophen (Tylenol and generic versions) may be safely used during pregnancy. This drug is effective in treating the fever, aches and pains that can accompany colds. You should limit the amount of acetaminophen in a 24-hour period to no more than 3,000 milligrams per day. Women with liver problems should not use acetaminophen until they have checked with their doctors.

Ibuprofen (Motrin, Advil and generic versions) and other non-steroidal anti-inflammatory drugs are generally avoided in pregnancy. They may have an effect on the fetal heart and kidneys. These effects are most concerning late in pregnancy. Brief use of ibuprofen early in pregnancy probably has very low risk.

Diphenhydramine (Benadryl and generic versions) can be useful in treating some of the congestion that comes along with a cold. It is safe to take during pregnancy.

Pseudoephedrine (Sudafed and generic versions) is a common decongestant but recent information shows it should be avoided, especially in the first trimester. It may effect maternal and fetal blood vessels. Perhaps because of this, it has been associated with an increased risk of certain birth defects.

Later in pregnancy — after organs are more fully formed — there is probably much lower risk from pseudoephedrine as along as a mother's blood pressure is normal (pseudoephedrine can cause a rise in blood pressure). The absolute risk of problems from medications, even those not recommended, is low, however. If you have taken things without knowing of risks or before recognizing you were pregnant, you should not panic. Probably all is well.

And of course the remedies your mother would recommend — chicken soup and rest — are fine as well in pregnancy.
Dr. Pina LoGiudice, LAc, ND
Naturopathic Medicine

 

For my pregnant moms, the first step to treating a cold is rest and plenty of sleep. Then, avoid all cow's milk and dairy products to help lower inflammation and mucus, along with avoidance of sugary foods which can suppress the immune system. Adequate water intake is very important during this time as well.

My favorite go-to cold remedies include steam pots, nasal rinses, Echinacea and low dose vitamin C. Echinacea and vitamin C have been studied during pregnancy, and in proper dose are safe and helpful. A year 2000 study in the Archives of Internal Medicine showed that Echinacea was safe to use in pregnant women. While vitamin C has also been shown as safe, megadosing vitamin C can induce excess colon movement which can spur miscarriage, so it is important to not over do the vitamin C.

Whenever possible, I prefer the above natural remedies over over-the-counter cold remedies, for these tend to have artificial colors, flavors, and chemicals that are not natural to a woman's body.

Picture of embryo at 37th week

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.