From the Guidelines
Cough medications safe during pregnancy include short-acting bronchodilators like Salbutamol (Albuterol) and Terbutaline.
Safe Options
- Salbutamol (Albuterol) is the preferred short-acting inhaled beta 2-agonist due to its excellent safety profile and extensive data related to safety during pregnancy 1.
- Terbutaline is also considered safe, although it may cause maternal and fetal tachycardia, maternal hyperglycaemia, and neonatal hypoglycaemia 1.
Long-acting Options
- Formoterol and Salmeterol are long-acting beta 2-agonists that are probably safe during pregnancy, with Salmeterol being preferred due to greater experience during pregnancy 1.
Other Considerations
- Theophylline is considered compatible with pregnancy, but blood levels should be monitored, and neonates exposed during pregnancy should be observed for evidence of toxicity or withdrawal 1.
- Inhaled corticosteroids, such as Budesonide, are the preferred long-term control medication for asthma during pregnancy, with no data indicating that other ICS preparations are unsafe 1. It is essential to weigh the benefits and risks of each medication and consult with a healthcare provider to determine the best course of treatment for cough during pregnancy.
From the Research
Cough Medications Safe During Pregnancy
- Dextromethorphan is considered safe to use during pregnancy, as a study found no increased risk of major malformations above the expected baseline rate of 1% to 3% 2
- Nasal decongestants can be used with caution and up to 7 days, and intranasal corticosteroids, such as budesonide, are considered relatively safe 3
- Second-generation antihistamines, such as cetirizine and loratadine, are considered safe to use during pregnancy 3, 4
- Inhaled asthma medications, such as inhaled beta agonists and inhaled corticosteroids, are considered safe to use during pregnancy, as they do not increase the risk of preeclampsia, total congenital malformations, preterm birth, or low birth weight infants 5
Precautions and Considerations
- Pregnant women should read labels carefully and consult with pharmacists to ensure they are not taking unnecessary medicine 6
- Medications should be evaluated individually, and the safety of the materno-foetal unit should be considered paramount 3
- Some medications, such as selective COX-2 inhibitors and BCG vaccination, are contraindicated in pregnancy 3
- Oral corticosteroids have been associated with reduced birth weight, an increased risk of preeclampsia, and an increased risk of oral clefts, but may still be necessary for severe uncontrolled asthma 5