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Safe cold medicines while pregnant: Safe OTC Cold and Flu Treatment to Use During Pregnancy

What cold medicine can you take while pregnant?

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Wondering whether it’s safe to take cold medicine during pregnancy? It depends. Some of the ingredients in cold medications have been studied and are generally considered safe for pregnant women. Others haven’t been researched well enough or have been linked to pregnancy complications and are best avoided.

Cold medications that are okay to take during pregnancy

The following drugs have been studied or used relatively often in pregnant women and are generally considered safe to use when you’re expecting:

  • Acetaminophin to relieve pain and reduce fevers. It’s best to take the minimum effective dose for only as long as you need it, and to never exceed the recommended maximum dosage per day.
  • Antihistamines to relieve nasal congestion. Antihistamines that are considered safe for pregnant women include:
    • Chlorpheniramine
    • Loratadine
    • Cetirizine
    • Dexchlorpheniramine
    • Doxylamine
    • Diphenhydramine (this common drug may cause uterine contractions, so in the third trimester it should be used only under the direction of your doctor)
  • The cough suppressant dextromethorphan is often found in over-the-counter cold medicines like Robitussin and is considered safe for pregnant women.
  • Cough drops with benzocaine or menthol are usually approved for use during pregnancy. Benzocaine doesn’t get into the bloodstream, so it’s very unlikely to pose a risk to a developing baby. Menthol is unlikely to cause problems during pregnancy, as long as it’s used as recommended.
  • Decongestant corticosteroid nasal sprays are usually considered safe for use over a short period of time. Nasal strips, saline nasal sprays, and Neti pots are the safest options to use during pregnancy, as they don’t contain any medications.
  • Decongestant chest rub with camphor oil (such as Vicks) is generally considered safe if used on the skin as directed, though it isn’t an effective decongestant. The ingredients in a chest rub might feel nice and make you feel like you’re breathing easier, though.

Cold medications to avoid or use with caution

Your doctor or midwife will likely suggest avoiding the following medications during pregnancy – or may recommend skipping them in certain trimesters – often because there’s a concern that they could contribute to possible birth defects or pregnancy complications:

  • The decongestants pseudoephedrine and phenylephrine are generally not recommended during the first 13 weeks of pregnancy. After the first trimester, occasional use of these medications (for example, once or twice daily for no more than a day or two) may be safe. More frequent use, however, could be problematic, because these drugs constrict blood vessels. This could decrease blood flow to the placenta and raise your blood pressure. So be sure to check with your healthcare provider first if you want to try either type of decongestant, especially if you’ve already been diagnosed with high blood pressure.
  • The expectorant guaifenesin (Mucinex) thins mucus secretions in the respiratory passages, making it easier to cough them up. While one study found an increased risk of inguinal hernias in babies exposed to this drug, most studies don’t suggest that guaifenesin increases the risk of birth defects. But since there hasn’t been a lot of research on the drug, your provider may recommend avoiding it in the first trimester.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, naproxen, and sodium salicylate, are usually not considered safe to use for pain relief during pregnancy, especially in the third trimester. The Food and Drug Administration (FDA) warns against using NSAIDs after week 20, as they can cause rare but serious kidney problems in unborn babies and lower a mother’s amniotic fluid levels.

Also keep in mind that herbal supplements (such as echinacea) haven’t been well-studied in pregnant women (and some are dangerous), so skip them unless you’ve cleared a specific supplement with your provider.

Be aware that some liquid cold medicines contain alcohol in concentrations as high as 4.75 percent. Look for products that are labeled “alcohol-free.”

Choosing the best cold medicine for pregnancy

Most cold medicines contain two or more drugs to treat several symptoms, making it more likely that they may contain a drug that isn’t safe during pregnancy. To be safe, read labels and choose an option with the least number of active ingredients. During pregnancy, it’s usually best to buy the specific medications you need individually rather than a multi-symptom medication.

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Always talk to your healthcare provider before taking any medication when you’re expecting. That way you can be sure you’re choosing the safest option at the recommended dosage, and that it doesn’t interfere with any other medications or supplements you’re taking.

Learn more about which medications are safe during pregnancy.

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Colleen de Bellefonds

Colleen de Bellefonds is a freelance health and lifestyle journalist. She’s raising her toddler daughter and newborn son with her French husband in Paris.

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Cold medications for pregnancy and breastfeeding

Selecting a cold medication while pregnant or breastfeeding (also called chestfeeding) that is going to be safe for both you and your baby can be stressful and overwhelming.

Here you’ll find answers to your questions and information about common ingredients found in cold medicines that are considered safe for you and your baby.

Can I take cold medicine while pregnant or breastfeeding?

There are certain cold medicines that are considered safe to take while you are pregnant or breastfeeding. The safety of using over-the-counter cold medication while pregnant or breastfeeding depends on the specific medicines within the products, how far along you are in your pregnancy, and any other medical conditions you may have. You should only use cold medicines for the shortest time possible to help with your symptoms. Always be sure to check with your healthcare provider or pharmacist before taking any over-the-counter cold medicines during pregnancy or while breastfeeding.

The American Pregnancy Association recommends limiting the amount of over-the-counter cold medicines you take and trying certain home remedies to alleviate symptoms. They promote washing your hands regularly, drinking plenty of fluids, getting ample amounts of rest, eating well and only using medications to treat the symptoms you are experiencing. As a home remedy for sinus congestion, they recommend using a humidifier, keeping your head elevated on a pillow while resting and/or using adhesive nasal strips. For a sore throat, they recommend sucking on ice chips, drinking warm herbal tea (non-caffeinated) or gargling warm salt water.

What cold medicine is safe for pregnancy and breastfeeding?

The common cold can cause a variety of symptoms, such as runny nose, fever, headache, body aches, cough, sore throat and congestion. Many over-the-counter cold medicines combine multiple medications that treat these symptoms into a single tablet or liquid. It’s important to review the active ingredients in these products when you’re pregnant or breastfeeding to ensure they are safe for both you and your child. In most cases, it’s best to avoid combination products and instead use single-ingredient products to help relieve the symptoms you are experiencing.

Pain relievers and fever reducers

Acetaminophen (Tylenol) is considered the preferred medication during all trimesters of pregnancy to treat fever, aches and pains and is safe to use while breastfeeding. NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), are less preferred in pregnancy but can still be used in the first and second trimesters. You should avoid all NSAIDs in the third trimester of pregnancy. According to the American College of Obstetricians and Gynecologists, ibuprofen is considered the preferred medication for pain while breastfeeding. Pregnant and breastfeeding women should avoid any products that contain aspirin.


Chlorpheniramine (Chlor-Trimeton) is recommended as the antihistamine of choice to treat runny nose and sneezing in all trimesters of pregnancy. Doxylamine (Unisom) and diphenhydramine (Benadryl) are also considered safe to use in all trimesters. These medications can cause drowsiness and shouldn’t be taken if you need to be awake and alert. Cetirizine (Zyrtec) and loratadine (Claritin) are both considered safe alternatives for pregnant women and cause less drowsiness. Loratadine is considered to be the preferred antihistamine to use while breastfeeding.

Cough suppressants

Dextromethorphan (Delsym) appears to be safe to use during all trimesters of pregnancy and while breastfeeding. You should limit the use of these products to the lowest strength and for the shortest time possible.

Nasal decongestants

Nasal decongestant sprays, such as oxymetazoline (Afrin) and phenylephrine (Neo-Synephrine), are the preferred decongestants for pregnant and breastfeeding women for temporary relief from sinus congestion. The use of these products should be limited to three days, as they can cause worsening of your original congestion if used longer. If you develop severe nasal congestion during your second or third trimester and aren’t able to use a nasal decongestant spray, you can use an oral decongestant such as pseudoephedrine (Sudafed). It’s recommended to only use oral decongestants on a limited basis. You should avoid using oral decongestants during your first trimester, while breastfeeding or if you have high blood pressure. Nasal saline sprays are considered a safe alternative for treating nasal congestion while pregnant or breastfeeding.


Guaifenesin (Mucinex) is used to thin out and loosen chest congestion and requires drinking plenty of fluids to be effective. It’s considered to be safe to use in the second and third trimester of pregnancy and likely to be safe while breastfeeding. You should avoid using products containing guaifenesin during your first trimester.

The American Pregnancy Association recommends that you contact your physician’s office if you have a fever that is 102°F or higher, are coughing up thick, yellow-green mucus, are experiencing a cough with chest pain and/or wheezing, or have symptoms that last more than a couple of days without improving. These are signs that you may have a more severe infection and need to be seen by your physician.

Clinically reviewed and updated December 2021.


  1. https://americanpregnancy.org/pregnancy-complications/cough-cold-during-pregnancy/
  2. https://www.aafp.org/pubs/afp/issues/2014/1015/p548.html
  3. https://pubmed.ncbi.nlm.nih.gov/31033501/
  4. https://pubmed.ncbi.nlm.nih.gov/20027042/
  5. Hernandez RK, Werler MM, Romitti P, Sun L, Anderka M. Nonsteroidal anti-inflammatory drug use among women and the risk of birth defects. Am J Obstet Gynecol. 2012;206(3):228.e1-8. doi: 10.1016/j.ajog.2011.11.019
  6. https://pubmed.ncbi.nlm.nih.gov/29781876/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474179/
  8. https://www.uptodate.com/contents/recognition-and-management-of-allergic-disease-during-pregnancy

Pregnancy and medicines / Obstetrics and gynecology, reproductive medicine / Articles about health / Articles and encyclopedia / madez.ru

We have been actively planning for a baby for a long time, but we never think about the dangers of drugs during pregnancy!

Gynecologist, gynecologist endocrinologist Popova Natalya Vladimirovna will tell you what medicines can be taken during pregnancy, and which ones are categorically not recommended.

One of the most important periods in a woman’s life is the period of bearing a child. And in these few months, the expectant mother must do everything in her power to give birth to a healthy baby. But pregnancy lasts nine calendar months – it is very difficult during this time to never feel any ailments or health problems.

If it is necessary to use any drug during pregnancy, the mother-to-be should remember:

  • Any drug during pregnancy (at any stage) can be used only in accordance with the indications and only as prescribed by the attending physician;
  • When choosing a medicinal product, preference should be given only to those medicinal products that have proven efficacy;
  • Prefer monotherapy, i.e. treatment with only one drug if possible; combined treatment during this period is undesirable;
  • Topical treatment is more desirable than systemic (oral, intravenous, intramuscular) administration of the drug.
  • A pregnant woman should remember that completely safe and absolutely harmless drugs do not exist.

The most dangerous period for the use of any drugs, both of chemical and natural origin, is considered the first trimester of pregnancy (the first 12 gestational weeks), when all organs and systems are laid in the fetus, which in the future will only develop and form the placenta. It is at this time that the fetus is considered the most vulnerable to any chemical and medicinal substances.

Pronounced mutagenic hazard:

1. in industry – asbestos, acetaldehyde, vinyl chloride, dimethyl sulfate; factors of metallurgical and rubber industries;

Metals: copper, nickel, lead, zinc, cadmium, mercury, chromium, arsenic, styrene, formaldehyde, chloroprene, epichlorohydrin, ethylene oxide.

2. agriculture – a mixture of defoliants, pesticides, insectiosides, repellents, fungicides, pesticides, methylpartion, phthalaphos, chlorophos, gardona, DDT, contan.

If you work in a hazardous industry and come into contact with these chemicals, from early pregnancy, switch to “light work”.

Global trends in early pregnancy from the point of view of evidence-based medicine are unambiguous: the need for rational diet therapy , intake of folic acid at least 400 mcg/day and potassium iodide 200 mg/day.

After 12-14 weeks of pregnancy, with an inadequate diet, the use of vitamin preparations during pregnancy and lactation is recommended as a way to improve the health of the mother and fetus . Vitamin complexes intended for other groups of the population (including children) are contraindicated for pregnant women!

Medicines during pregnancy

In existing classifications, it is customary to subdivide drugs during pregnancy into groups – safe, relatively safe, relatively unsafe and dangerous. Moreover, the list of drugs is periodically updated.

  1. Category A – safe drugs. Controlled trials have shown no risk to the fetus for the first 12 weeks of pregnancy. Regarding them, there is no evidence of a harmful effect on the fetus in late pregnancy. These are folic acid, levothyroxine sodium, paracetamol, magnesium sulfate.
  2. Category B – relatively safe drugs. Experimental studies have generally not shown their teratogenic effects in animals and children whose mothers took such drugs. These are amoxicillin, heparin, insulin, aspirin, metronidazole (except for the first trimester)
  3. Category C – relatively unsafe drugs. When testing these drugs on animals, their teratogenic or embryotoxic effects were revealed. Controlled trials have not been conducted or the effect of the drug has not been studied (isoniazid, fluoroquinolones, gentamicin, antidepressants, antiparkinsonian drugs). These drugs should only be used if the potential benefit outweighs the potential risk.
  4. Caregory D – dangerous drugs. The use of drugs in this group is associated with a certain risk to the fetus, but despite this, it is possible to use the drug for health reasons (anticonvulsants, doxycycline, kanamycin, diclofenac).
  5. Category X – dangerous drugs that are contraindicated for use.
    The teratogenic effect of drugs in this group has been proven, their use is contraindicated during pregnancy, as well as when planning a pregnancy.

Although almost 1000 chemicals are known to be teratogenic in animals, only a few chemicals have been proven to be permanently teratogenic in humans. These include a number of narcotic analgesics, chemotherapeutic drugs (antimetabolites, alkylating agents), anticonvulsants (trimethadione, valproic acid, fenithione, carbamazepine), androgens, warfarin, danazol, lithium, retinoids, thalidomide.

The safest drugs

(Larimore W.L., Petrie K.A., 2000)

Drug groups

The safest drugs


Paracetamol, narcotic analgesics (short courses), NSAIDs (except due date)


Aminopenicillins, macrolides (Vilprafen), azithromycin, cephalosporins, clindamycin, erythromycin, metronidazole (except 1st trimester), penicillins, trimethoprim (except 1st trimester)


Venlafaxine, fluoxetine, trazodone




Andacids, doxylamine, prochlorperazine, promethazine, vitamin B


B-blockers, hydralazine, methyldopa, prazosin



Antituberculous drugs

Ethambutol, isoniazid


Amantadine, acyclovir


Cetirizine, loratadine



Epinephrine, inhaled bronchodilators, theophylline

Cardiovascular medicines

B-blockers, calcium channel blockers, digoxin, nitroglycerin

Constipation products

Bisacodyl, methylcellulose



Gastrointestinal drugs

Sucralfate, metoclopramide

Thyroid hormones

Levothyroxine, liothyronine


It is very important that every pregnant woman remember that any drug during pregnancy can bring not only benefits, but also considerable harm, therefore, any self-administration during this period is not permissible, since their consequences are unpredictable and in many cases can cause irreparable harm to the developing fetus.


Cold during pregnancy. What to do?

When you’re expecting, your immune system works at a slower pace than usual, which is actually a good thing because it protects your growing baby and keeps your body from thinking the fetus is a foreign creature. However, the downside of this immune suppression is that your body does not defend itself against many of the viruses that cause colds, which can make you more vulnerable to symptoms such as nasal congestion, cough, and sore throat.

The good news about even the worst cold symptoms is that your child doesn’t experience any of them. In fact, the environment of the womb keeps the baby completely protected from these hardships.

As far as you are concerned, a cold is basically an uncomfortable irritation that is best relieved by rest, drinking plenty of water, patience, and consultation with your doctor. The doctor must be aware of all your symptoms and ailments, including any cold. If necessary, he can also prescribe you the necessary medicines that are considered safe during pregnancy.

Although many cold medicines are usually prohibited during pregnancy, you do not need to suffer from a runny nose and a violent cough when you are pregnant. Some of the most effective cold remedies are not available over the counter.

Here are some of them:

  1. Lying in bed doesn’t necessarily shorten the duration of a cold, but if your body is asking for some rest, be sure to listen.
  2. If you do not have a fever or cough, do some light to moderate exercise that is safe for pregnant women. It can really help you feel better faster.
  3. Keep eating. Sure, you probably don’t have much of an appetite, but eating as healthy a meal as possible can help you manage some of your cold symptoms.
  4. Vitamin C foods can help boost your immune system naturally. Try all kinds of citrus fruits (oranges, tangerines, grapefruits), strawberries, melon, kiwi, mangoes, tomatoes, bell peppers, papaya, broccoli, sauerkraut and spinach.
  5. Zinc may also help strengthen the immune system. Pregnant women should aim to get 11-15 milligrams each day from all sources, including vitamins.
  6. Fever, sneezing and a runny nose help you lose fluids that you and your baby need. Warm drinks are soothing, so keep a thermos of hot beverages like ginger tea, hot soup, or chicken broth close at hand. Try to drink enough to stay “well hydrated” – your urine should be the color of pale straw. Water and juices also work great, but they don’t have to be very cold.
  7. If you have a runny nose, elevate your head with a pair of pillows to help you breathe easier. Cold patches can also help. They gently open the nasal passages, making it easier to breathe, moreover, they are sold without a prescription and are completely safe.
  8. If the air in the house is dry, you can use a special humidifier. Well, or according to my grandmother’s recipe – put wet towels on the battery (during the heating season).
  9. Use saline nasal drops, sprays or rinses.