What cough medications are safe during pregnancy?

From the Guidelines

During pregnancy, it's best to avoid most cough medications, especially in the first trimester, and instead try non-medication approaches first, such as drinking plenty of fluids, using a humidifier, trying honey (1-2 teaspoons) for cough, and rest, as recommended by recent guidelines 1. When considering medication, acetaminophen (Tylenol) is generally considered safe for fever and pain at regular doses (650mg every 6 hours, not exceeding 3000mg daily), according to various studies 1. For severe cough, your doctor might approve limited use of dextromethorphan (like Robitussin DM) or guaifenesin after the first trimester, as suggested by recent guidelines 1. It's essential to avoid medications containing alcohol, iodine, pseudoephedrine, phenylephrine, and NSAIDs like ibuprofen, as they may pose risks to fetal development 1. Always consult your healthcare provider before taking any medication during pregnancy, as your specific situation may require different recommendations, and prioritizing your baby's development is crucial, as many cough ingredients haven't been well-studied in pregnancy and some may affect fetal development 1.

Some key points to consider:

• Maintaining asthma control during pregnancy is important for the health and well-being of both the mother and her baby, as emphasized by the guidelines 1.
• Inhaled corticosteroids, such as budesonide, are preferred for long-term control of asthma during pregnancy, as they have a more established safety profile 1.
• The treatment goal for pregnant women with asthma is to provide optimal therapy to maintain control of asthma, ensuring minimal symptoms, exacerbations, and limitations on activities, while minimizing adverse effects from medications 1.

By prioritizing non-medication approaches and consulting with a healthcare provider, pregnant women can effectively manage their cough while minimizing potential risks to their baby's development.

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 Medications and Pregnancy

• The safety of cough medications during pregnancy is a concern for many expectant mothers, with studies suggesting that short-term use of over-the-counter cold remedies poses no increased risk 2.
• However, it is essential for pregnant women to read labels carefully and consult with pharmacists to ensure they are not taking unnecessary medication 2.
• Approximately 90% of pregnant women use medications, including over-the-counter and prescription medications, with 10% of birth defects directly linked to medications taken during pregnancy 3.
• Common over-the-counter medications, including antipyretics, analgesics, and expectorants, may be considered safe for use during pregnancy, but research is limited due to ethical concerns 3.

Specific Cough Medications

• A clinical trial examining the effectiveness of three cough syrups found that codeine, dextromethorphan, and guaifenesin are equally effective in relieving cough symptoms 4.
• Dextromethorphan is a safe and effective antitussive agent present in several over-the-counter cough and cold medications, but it can cause psychoactive effects at higher doses 5.
• The pharmacokinetics and pharmacodynamics of dextromethorphan have been extensively reviewed, highlighting the importance of understanding its metabolism to avoid adverse effects 5.

Regulatory Approval and Safety

• The US Food and Drug Administration plays a crucial role in approving drugs for marketing, including those for use during pregnancy 6.
• The agency is committed to protecting and advancing the public health of pregnant women by guiding the development and ensuring the availability of effective and safe therapeutics for obstetrical indications and medical conditions during pregnancy 6.