From the Guidelines
Pregnant women can safely use FDA-evaluated cough medications such as salbutamol, terbutaline, and theophylline, which are classified as category A or B.
FDA- Evaluated Cough Medications
- Salbutamol is a short-acting β2-agonist (SABA) that is considered compatible during pregnancy, with no evidence of teratogenic effects 1.
- Terbutaline is also a SABA that is considered probably safe during pregnancy, although it may cause maternal and fetal tachycardia, maternal hyperglycemia, and neonatal hypoglycemia 1.
- Theophylline is a methylxanthine that is considered compatible during pregnancy, with no evidence of teratogenic effects, but blood levels should be monitored 1.
Considerations for Use
When using these medications during pregnancy, it is essential to weigh the benefits and risks, considering the potential for maternal and fetal adverse effects.
- Intranasal corticosteroids, such as budesonide, may also be used during pregnancy due to their safety and efficacy profile, although most are given an FDA Pregnancy Category C rating 1.
- Montelukast is a Pregnancy Category B drug that may be considered if there has been a favorable pre-pregnancy response, although animal reproductive studies and unpublished human safety data are reassuring 1. It is crucial to use these medications at the lowest effective dose and to monitor for potential adverse effects. Additionally, breastfeeding women should be cautious when using these medications, as some may pass into breast milk.
From the Research
FDA-Evaluated Cough Medications for Pregnant Women
There are several FDA-evaluated cough medications that are considered safe for pregnant women, including:
- Acetaminophen, which has a good safety record 2
- Chlorpheniramine, an antihistamine that is commonly used to relieve cough and cold symptoms 2
- Dextromethorphan, a cough suppressant that is often used in combination with other medications 3
- Guaifenesin, an expectorant that helps to thin and loosen mucus, making it easier to cough up 3
Safety Categories for Medications
The FDA has assigned a risk category to each medication, including:
- Category A: Controlled studies show no risk or controlled studies suggest no increased risk of congenital anomalies or other adverse pregnancy outcomes
- Category B: The use of the drug in pregnant women is not suspected to cause significant harm, but there are no controlled data in human pregnancy 4
- Category C: Risk cannot be ruled out, but there are no controlled data in human pregnancy 4
Precautions and Considerations
Pregnant women should always consult with their healthcare provider before taking any medication, including over-the-counter cough medications, to discuss the potential risks and benefits 5, 3, 2, 4. Additionally, women should be aware of the potential risks associated with certain medications, such as birth defects or other adverse pregnancy outcomes 3, 2.