Cold Medicines During Pregnancy

By Jeffrey Ecker, M.D.
Content provided by the Faculty of the Harvard Medical School

Question:

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Jeffrey Ecker, M.D. is an Associate Professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics and Gynecology at Massachusetts General Hospital, where he practices maternal-fetal medicine.

Which cold mediations do you recommend during pregnancy?

Answer:

In general, acetaminophen (Tylenol and generic versions) may be safely used during pregnancy. This drug is effective in treating the fever, aches and pains that can accompany colds. You should limit the amount of acetaminophen in a 24-hour period to no more than 3,000 milligrams per day. Women with liver problems should not use acetaminophen until they have checked with their doctors.

Ibuprofen (Motrin, Advil and generic versions) and other non-steroidal anti-inflammatory drugs are generally avoided in pregnancy. They may have an effect on the fetal heart and kidneys. These effects are most concerning late in pregnancy. Brief use of ibuprofen early in pregnancy probably has very low risk.

Diphenhydramine (Benadryl and generic versions) can be useful in treating some of the congestion that comes along with a cold. It is safe to take during pregnancy.

Pseudoephedrine (Sudafed and generic versions) is a common decongestant but recent information shows it should be avoided, especially in the first trimester. It may effect maternal and fetal blood vessels. Perhaps because of this, it has been associated with an increased risk of certain birth defects.

Later in pregnancy — after organs are more fully formed — there is probably much lower risk from pseudoephedrine as along as a mother's blood pressure is normal (pseudoephedrine can cause a rise in blood pressure). The absolute risk of problems from medications, even those not recommended, is low, however. If you have taken things without knowing of risks or before recognizing you were pregnant, you should not panic. Probably all is well.

And of course the remedies your mother would recommend — chicken soup and rest — are fine as well in pregnancy.

Copyright: Copyright Harvard Health Publications

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