From the Guidelines
Dextromethorphan is considered safe for cough suppression during pregnancy, and it's recommended to use the lowest effective dose for the shortest time needed, with typical adult dosing being 10-30 mg every 4-8 hours as needed, not exceeding 120 mg in 24 hours 1. When considering cough suppressants during pregnancy, it's essential to prioritize the safety of both the mother and the fetus.
- Dextromethorphan, found in over-the-counter cough medicines like Robitussin DM and Delsym, is generally considered safe for cough suppression during pregnancy, as stated in the study published in Thorax 1.
- Guaifenesin (Mucinex) is also considered relatively safe as an expectorant to thin mucus.
- However, it's crucial to avoid cough medicines containing alcohol, codeine, or pseudoephedrine, especially in the first trimester, due to potential risks to the fetus.
- Non-medication approaches should be tried first, including staying hydrated, using a humidifier, gargling with salt water, and consuming honey (except for women with gestational diabetes).
- The American College of Chest Physicians (ACCP) provides evidence-based clinical practice guidelines for cough suppressant and pharmacologic protussive therapy, which can be useful in guiding treatment decisions 1.
- Always consult your healthcare provider before taking any medication during pregnancy, as individual circumstances may affect recommendations.
- Many coughs during pregnancy are self-limiting and resolve without medication, so using non-drug approaches when possible is preferable.
From the FDA Drug Label
If pregnant or breast-feeding, ask a health professional before use. The FDA drug label does not answer the question.
From the Research
Cough Suppressants Safe During Pregnancy
- Dextromethorphan is considered safe during pregnancy, as a study found no increased risk of major malformations above the expected baseline rate of 1% to 3% 2.
- Codeine is also considered compatible with breastfeeding by the AAP and may be an acceptable choice for short-term use as a cough suppressant 3.
- When taking medications during pregnancy, it is essential to read labels carefully and consult with pharmacists to ensure that only necessary medications are taken 4.
General Guidelines for Medication Use During Pregnancy
- Pregnant women should only take medications that are necessary and avoid combination products 3.
- The evidence-based information for most over-the-counter cold medications suggests no increased risk with short-term use 4.
- It is crucial to individualize treatment options to each patient's disease activity, response to medication, and adverse effects 5.