From the Guidelines
For pregnant women with a cough, non-medication approaches should be tried first, including staying hydrated, using a humidifier, drinking warm liquids with honey (except for women with gestational diabetes), and elevating the head while sleeping. If medications are needed, acetaminophen (Tylenol) is generally considered safe for pain or fever at regular doses (650mg every 6 hours, not exceeding 3000mg daily) 1. For cough specifically, dextromethorphan (such as Robitussin DM) is typically considered acceptable after the first trimester at recommended doses on the package 1. Guaifenesin (Mucinex) may be used as an expectorant. Pregnant women should avoid aspirin, NSAIDs like ibuprofen in the third trimester, and combination cold medicines. It's essential to consult with a healthcare provider before taking any medication during pregnancy, as recommendations may vary based on individual health factors, pregnancy stage, and the underlying cause of the cough 1. Some key considerations for managing cough in pregnant women include:
- Staying hydrated to thin out mucus
- Using a humidifier to relieve congestion
- Avoiding irritants like smoke and pollution
- Getting plenty of rest to help the body fight off infection Persistent cough, especially with fever, chest pain, or difficulty breathing, requires prompt medical attention as it could indicate a more serious condition requiring specific treatment 1. In terms of specific medications, the most recent and highest quality study 1 suggests that nasal corticosteroids like budesonide, fluticasone, and mometasone are safe to use for CRS maintenance during pregnancy at recommended doses. However, oral corticosteroids should be used with caution and only after consulting with the patient's obstetrician, as they may be associated with slightly increased risk of cleft lip with or without cleft palate, increased incidence of preeclampsia, and the delivery of both preterm and low birth weight infants. Overall, the management of cough in pregnant women requires a careful and individualized approach, taking into account the underlying cause of the cough, the stage of pregnancy, and the potential risks and benefits of different treatments.
From the FDA Drug Label
If pregnant or breast-feeding, ask a health professional before use. If pregnant or breast-feeding, ask a health professional before use.
The recommended treatment for a cough in pregnant women is to consult a health professional before use of any medication, such as guaifenesin (PO) 2 or dextromethorphan (PO) 3.
- Key considerations:
- Pregnancy: Ask a health professional before use.
- Breast-feeding: Ask a health professional before use.
From the Research
Treatment Options for Cough in Pregnant Women
- The treatment of cough in pregnant women depends on the underlying cause of the cough 4.
- For acute and self-limiting cough, usually secondary to a viral upper respiratory tract infection, symptomatic treatment may be considered 4.
- Pregnant women with cough should read labels carefully and consult with pharmacists to ensure they are not taking unnecessary medicine 5.
- Dextromethorphan, an active ingredient in many cough and cold remedies, has been studied for its safety in pregnancy, and one controlled study found no increased risk of major malformations with its use 6.
Safety of Medications During Pregnancy
- Over-the-counter cold medications, including those containing dextromethorphan, are generally considered safe for short-term use in pregnancy, but pregnant women should exercise caution and consult with their healthcare provider 5, 6.
- Inhaled and intranasal corticosteroids, such as budesonide, are considered safe for use in pregnancy and may be preferred for treating asthma and allergic rhinitis 7.
Importance of Proper Diagnosis and Treatment
- Definitive treatment of cough depends on determining its precise cause and then initiating specific therapy for the underlying disorder 4.
- Combination cough preparations should not be prescribed, and symptomatic treatment should only be considered when the cause of cough remains unknown or when cough performs no useful function and its complications represent a potential hazard to the patient 4.