Can I Take Cold Medicine During Pregnancy?

Pregnant woman resting
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While there is never really a good time to have a cold or the flu, having one during pregnancy comes with additional difficulties. Unfortunately, getting sick during pregnancy isn’t uncommon—the immune system goes through a series of changes during those nine months.

When faced with a seasonal cold or flu while pregnant, you must consider not only your own health but that of your baby's. While there are certain drugs to avoid, suffering through your symptoms isn't necessary. Read on for a few tips to consider.

Treating a Cold or Flu in Early Pregnancy

While it is usually recommended that women avoid medications during the first 12 weeks of pregnancy, there are exceptions. Tylenol to prevent fever is recommended, as fever can be detrimental to a developing embryo.

This is not to suggest that all drugs have a potential for harm. In many cases, they don't. But, in others, we simply don't know. For this reason alone, you should adhere to your doctor's advice to avoid all medications for at least the first 12 weeks.

Instead, make every effort to help your body recover by slowing down, resting, and avoiding stresses that can affect your immune system. You can do this by:

  • Staying in bed, napping, and getting as much rest as possible
  • Drinking plenty of water, soup broth, or juice
  • Gargling with salt water to treat a sore throat or cough
  • Sucking on ice chips to alleviate a sore throat and to help with hydration
  • Using a humidifier to help relieve congestion
  • Eating small, healthy meals regularly
  • Taking your prenatal vitamins

Flu Prevention

You can also take steps to avoid contracting the flu while you are pregnant. The Centers for Disease Control and Prevention suggests that changes to the heart, lungs, and immune system during pregnancy make women more prone to experiencing severe effects of the flu. For this reason, the CDC recommends that pregnant women should get a flu shot. Research suggests that getting a flu vaccination reduces the risk that a woman will be hospitalized for flu-related complications by approximately 40%.

Other preventative steps you can take include washing your hands frequently, stay away from people who are sick, avoid touching your mouth and nose, and avoiding crowds.

Types of Cold Medications to Consider

Even after your first trimester, it is best to speak with your doctor about the types and brands of cold medications that are safe to take. Typically speaking, you should avoid any multi-symptom product, which could include ingredients that range from painkillers and decongestants to expectorants and cough suppressants.

Instead, get the drug to treat the symptom you're experiencing. There are a number of over-the-counter (OTC) drugs considered to be safe in pregnancy, such as:

  • Anesthetic cough drops such as Chloraseptic or Cepacol lozenges
  • Expectorants containing guaifenesin to help clear mucus
  • Alcohol-free cough syrups containing dextromethorphan, such as Tussin DM
  • Combination guaifenesin/dextromethorphan drugs
  • Tylenol (acetaminophen) to treat fever and minor aches and pains
  • Menthol rubs such as Vicks or Mentholatum ointment

When buying any over-the-counter cold or flu remedy, always read the label closely. In some cases, there may be ingredients you should avoid. In others, there may be ingredients you don't need.

Common Medications to Avoid

Knowing what not to take is almost more important than knowing which medications are safe to take during pregnancy. There are a number of medications to avoid while pregnant unless recommended by your doctor. These include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin and Advil (ibuprofen), Bayer (aspirin), and Aleve and Naprosyn (naproxen), higher doses of which can cause premature blood vessel closure in the baby. However, low-dose aspirin is now routinely recommended for other indications.
  • Any cold remedy containing alcohol, including Benadryl and NyQuil
  • Codeine, a narcotic drug which may cause fetal respiratory depression
  • Bactrim (sulfamethoxazole/trimethoprim), an antibiotic that can interfere with folic acid metabolism while stimulating the production of bilirubin (a pigment found in the liver and excreted in bile), both of which are not good for the baby. The concern for folic acid metabolism is only in the first trimester, and the concern for jaundice is only after 32 weeks gestation. The medication can otherwise be used without concern, especially when treatment is necessary.
  • Pseudoephedrine- and phenylephrine-based decongestants, both of which may cause the constriction of blood vessels, potentially increasing the risk of a specific birth defect in the first trimester (particularly if you are a smoker) and risk of elevated blood pressures if used later in pregnancy.

If your cold or flu is severe and you are experiencing chest pains, are coughing up discolored mucus, or have a fever over 102o F, call your doctor immediately.

Cold vs. Flu

The cold and flu are caused by different viruses, but they often share common symptoms, which can make it difficult for people to tell the difference between the two. In most cases, the symptoms of the flu are more serious than those of a cold. 

According to the CDC, colds usually have a generally onset and are commonly marked by sneezing, stuffy nose, sore throat, and mild to moderate chest discomfort. The flu, on the other hand, has an abrupt onset marked by fever, aches, fatigue, headache, and chest pain. The flu is also more likely to result in serious associated complications, such as pneumonia, that may require hospitalization.

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Article Sources

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  1. Sass L, Urhoj SK, Kjærgaard J, Dreier JW, Strandberg-Larsen K, Nybo Andersen AM. Fever in pregnancy and the risk of congenital malformations: a cohort studyBMC Pregnancy Childbirth. 2017;17(1):413. doi:10.1186/s12884-017-1585-0

  2. Thompson MG, Kwong JC, Regan AK, et al. Influenza vaccine effectiveness in preventing influenza-associated hospitalizations during pregnancy: a multi-country retrospective test negative design study, 2010-2016. Clin Infect Dis. 2018;68(9):1444-1453. doi:10.1093/cid/ciy737

Additional Reading

  • Aghaeepour N, Ganio EA, Mcilwain D, et al. An immune clock of human pregnancy. Sci Immunol. 2017;2(15):eaan2946. doi:10.1126/sciimmunol.aan2946

  • Briggs, G. and Freeman. R. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk (10th Edition). Philadelphia, PA: Lippincott Williams & Wilkins;2014.

  • Honein, M.; Gilboa, S; and Broussard, C. The need for safer medication use in pregnancy. Expert Rev Clin Pharmacol. 2013;6(5):453-55. doi:10.1586/17512433.2013.827401