Is Delsym (dextromethorphan) safe to use during pregnancy?

Safety of Delsym (Dextromethorphan) During Pregnancy

Delsym (dextromethorphan) can be used during pregnancy when needed for cough suppression, as research shows no increased risk of birth defects compared to the baseline population rate. 1

Evidence on Dextromethorphan Safety in Pregnancy

The FDA drug label for dextromethorphan recommends consulting a healthcare professional before use during pregnancy or breastfeeding, but does not contraindicate its use 2. This cautious approach is standard for many medications during pregnancy.

Research specifically examining dextromethorphan use during pregnancy found:

• A controlled study of 184 women who used dextromethorphan during pregnancy showed no increased risk of major malformations (2.3% in the dextromethorphan group vs. 2.8% in the control group) 1
• The study demonstrated that dextromethorphan use did not increase malformation rates above the expected baseline rate of 1-3% 1
• No significant differences were observed in:
  • Birth weight
  • Spontaneous abortion rates
  • Minor malformations

Considerations When Using Delsym During Pregnancy

When considering dextromethorphan use during pregnancy:

• Use the lowest effective dose for the shortest duration needed
• Avoid combination products that may contain other active ingredients with less established safety profiles
• Be aware of potential drug interactions, particularly:
  • Do not use with MAO inhibitors (certain drugs for depression, psychiatric conditions, or Parkinson's disease) 2
  • Use caution if you have a sulfite allergy (contains sodium metabisulfite) 2

General Medication Principles During Pregnancy

When evaluating any medication during pregnancy:

• The benefits of treating maternal symptoms should be weighed against potential risks to the fetus
• Untreated severe symptoms (like respiratory distress) may pose greater risks to both mother and fetus than medication use 3
• For cough specifically, non-pharmacological approaches (hydration, humidification, honey for non-diabetic patients) can be tried first

Conclusion

Based on available evidence, dextromethorphan (Delsym) appears to have a reassuring safety profile during pregnancy with no demonstrated increase in adverse fetal outcomes. While all medication use during pregnancy should be discussed with a healthcare provider, the controlled study data suggests dextromethorphan can be used when clinically indicated for cough suppression during pregnancy.