Experiencing a cough while pregnant can cause physical discomfort and generate concern. When simple measures, like sucking on cough drops or sipping hot tea, fail to suppress a cough, some mothers-to-be seek relief with over-the-counter or prescription cough medicine. The safety of different types of cough medicine for pregnant women varies, depending primarily on the specific drug or drugs in the medication and how far along the pregnancy is. Pregnant women with a cough should consult their healthcare provider about the potential risks and benefits before taking cough medicine and to determine whether they need to be seen for further evaluation of their cough.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Guaifenesin is an expectorant, meaning it helps loosen airway phlegm so it can be coughed up more easily. It is an ingredient in many over-the-counter cough medicines (Mucinex, Robitussin) and some prescription medications 1. Guaifenesin is a pregnancy category C drug, meaning animal studies suggest it might be harmful to the developing baby, but the risk hasn't been adequately studied in people. An August 2007 article published in "The Journal of Family Practice" reports that one study showed a weak association between guaifenesin use in pregnancy and nervous system abnormalities and hernias in babies 6. However, it's unclear whether these abnormalities are caused by taking guaifenesin. To be safe, many doctors recommend that pregnant women avoid taking guaifenesin for the first 12 weeks of pregnancy 6.**
Expectorants While Pregnant
Dextromethorphan is a cough suppressant 7. A study published in February 2001 in "Chest" reported that among 184 women who took dextromethorphan during their pregnancy, there was no increased risk of birth defects among their babies 7. Dextromethorphan is a common ingredient in over-the-counter cough medicines (Robitussin DM, DayQuil Cough, Delsym) as well as prescription medications 1.** It is a pregnancy category C medication. Although no human studies suggest fetal risk, the drug caused abnormalities in a study conducted with chick embryos. Because no human studies suggest risk, many doctors are comfortable recommending dextromethorphan for cough at any time during pregnancy.
- Dextromethorphan is a cough suppressant 7.
- Because no human studies suggest risk, many doctors are comfortable recommending dextromethorphan for cough at any time during pregnancy.
Well known as a pain reliever, codeine is also a prescription cough suppressant. A study published in December 2011 in the "European Journal of Clinical Pharmacology" found neither birth defects nor infant survival rate were adversely affected among 2,666 mothers who took codeine while pregnant, compared to women who did not take the medicine 5. Codeine is deemed a pregnancy category C drug for short-term use during most of pregnancy, but it also carries the risks of any narcotic medication. The authors of the "European Journal of Clinical Pharmacology" study urge caution during the latter stages of pregnancy because they found a slightly increased risk of unplanned delivery via cesarean section and heavy bleeding after delivery 56.**
Warnings and Precautions
Cough Syrup While Breastfeeding
Even with the relative safety of cough remedies established, it is always advisable for a pregnant woman to consult her doctor before taking any medication, supplement or herb -- new or previously used. This is especially important for women less than 12 weeks or more than 38 weeks pregnant.
It's also important to recognize that something as seemingly harmless as a cough sometimes signals a more serious problem. Contact your doctor if you experience: -- Fever or extreme fatigue. -- Difficulty breathing or shortness of breath. -- Green, yellow or thick phlegm. -- Chest pain 7.** -- Severe sore throat. -- Body aches or headache.
- Even with the relative safety of cough remedies established, it is always advisable for a pregnant woman to consult her doctor before taking any medication, supplement or herb -- new or previously used.
- This is especially important for women less than 12 weeks or more than 38 weeks pregnant.
Expectorants While Pregnant
Cough Syrup While Breastfeeding
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How Does Mucinex Work?
List of Cough Medicines
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Side Effects of Methadone on Babies
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Is N-Acetyl Cysteine Good for Colds?
Safe Anxiety Medications for Pregnant Women
- American Family Physician: Over-the-Counter Medications in Pregnancy
- Merck Manual Professional Version: Drugs In Pregnancy
- U.S. Department of Health & Human Services: FDA Pregnancy Categories
- Saunders Nursing Drug Handbook 2014; Barbara B. Hodgson, RN, OCN, and Robert J. Kizior, BS, RPh
- European Journal of Clinical Pharmacology: Effects of Codeine on Pregnancy Outcome: Results From a Large Population-Based Cohort Study
- The Journal of Family Practice: Is Guaifenesin Safe During Pregnancy?
- Chest: The Safety of Dextromethorphan in Pregnancy: Results of a Controlled Study
- National Center for Biotechnology Information. Dextromethorphan.
- Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev. 2014;(11):CD001831. doi:10.1002/14651858.CD001831.pub5
- Spangler DC, Loyd CM, Skor EE. Dextromethorphan: A case study on addressing abuse of a safe and effective drug. Subst Abuse Treat Prev Policy. 2016;11(1):22. doi:0.1186/s13011-016-0067-0
- U.S. Food and Drug Administration. When to give kids medicine for coughs and colds. Updated November 27, 2018.
- MedlinePlus. Dextromethorphan. Updated February 15, 2018.
- Dicpinigaitis PV, Dhar S, Johnson A, Gayle Y, Brew J, Caparros-Wanderley W. Inhibition of cough reflex sensitivity by diphenhydramine during acute viral respiratory tract infection. Int J Clin Pharm. 2015;37(3):471–474. doi:10.1007/s11096-015-0081-8
- National Center for Biotechnology Information. Diphenhydramine.
- MedlinePlus. Diphenhydramine. Updated August 15, 2018.
- U.S. Food and Drug Administration. FDA drug safety communication: FDA requires labeling changes for prescription opioid cough and cold medicines to limit their use to adults 18 years and older. Updated January 22, 2018.
- U.S. Food and Drug Administration. Hycodan (hydrocodone bitartarate and homotropine methylbromide). Updated January 2017.
- U.S. Food and Drug Administration. FDA Issues Alert on Tussionex, a Long-Acting Prescription Cough Medicine Containing Hydrocodone. FDA News Press Release 11 Mar 08.
- U.S. Food and Drug Administration. Questions and Answers About FDA’s Enforcement Action Regarding Unapproved Hydrocodone Drug Products.
A registered nurse, former educator and endurance athlete, Stephanie Lewis earned her Bachelor of Science in nursing degree graduating magna cum laude from Nevada State College. Her first work published in 2005, Lewis is a contributor for LIVESTRONG.COM.