What relief medications are recommended for a pregnant woman at 31 weeks and 4 days gestation with a sore throat, negative for streptococcal (strep) pharyngitis?

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From the Guidelines

For a sore throat during pregnancy at 31 weeks 4 days with a negative strep test, I recommend acetaminophen (Tylenol) as the first-line medication, taking 650 mg every 6 hours as needed, not exceeding 3,000 mg per day. This recommendation is based on the guideline for the management of acute sore throat, which suggests the use of acetaminophen or paracetamol for relief 1.

Some key points to consider for relieving a sore throat during pregnancy include:

  • Staying hydrated with cool liquids
  • Using throat lozenges containing benzocaine (like Cepacol)
  • Consuming cold foods like popsicles or ice cream to help soothe discomfort
  • Trying honey mixed in warm tea or water as a natural remedy
  • Avoiding NSAIDs like ibuprofen during the third trimester, as they can cause complications

It's essential to monitor symptoms and contact a healthcare provider if they worsen, including a fever above 100.4°F, difficulty swallowing, or persistence beyond 5-7 days. Acetaminophen is considered safe throughout pregnancy and works by reducing pain signals and lowering fever without affecting the developing baby when used as directed.

From the FDA Drug Label

ACTIVE INGREDIENT (IN EACH CAPLET) Acetaminophen USP, 650 mg The FDA drug label does not answer the question.

From the Research

Sore Throat in Pregnancy

  • A sore throat in pregnancy can be caused by bacterial or viral infections, with group A beta-hemolytic streptococcal pharyngitis being a common bacterial cause 2, 3.
  • The diagnosis of streptococcal pharyngitis is typically made using clinical decision rules, such as the modified Centor score, followed by rapid antigen testing if the diagnosis is unclear 2, 3.
  • In this case, the patient has tested negative for strep, suggesting a viral etiology 2, 4.

Relief Medications

  • For symptomatic relief, medications such as non-steroidal anti-inflammatory drugs and paracetamol may be used 4.
  • Steroids are not recommended for symptomatic treatment of sore throat 2.
  • It is essential to follow the recommended treatment guidelines and consult a healthcare provider for proper evaluation and management 2, 4, 3.

Considerations in Pregnancy

  • The management of sore throat in pregnancy should take into account the potential risks and benefits of different treatments, including the use of antibiotics and other medications 2, 4, 3.
  • It is crucial to consult a healthcare provider for personalized advice and treatment, especially during pregnancy 2, 4, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Streptococcal Pharyngitis: Rapid Evidence Review.

American family physician, 2024

Research

Diagnosis and treatment of streptococcal pharyngitis.

American family physician, 2009

Research

Sore throat.

BMJ clinical evidence, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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