What can you take for nasal congestion while pregnant

Key takeaways:

• Some cold medications are safe to take during pregnancy. Others might be harmful to you or your baby.

• Ask your healthcare provider or pharmacist before taking any medications during pregnancy.

• If you need medication during pregnancy, take the lowest amount for the shortest period of time possible.

The average adult gets two to three colds per year, and pregnant people are no exception. In fact, it’s common for pregnant women to get sick more easily. And expectant mothers have something unique to consider: are cold medications safe for my unborn baby?

The best way to avoid getting sick while you’re pregnant is to stay healthy. Eat well, wash your hands to avoid germs, and get plenty of rest. But you may do these things and still get a cold. While medications can’t make your cold go away, they can help treat your symptoms. 

Below, we’ll talk about how to tell if you have a cold, which cold medications are safe to take while pregnant, and which to avoid to prevent harm to your baby.

How do I know if I have a cold during pregnancy?

Symptoms of a cold during pregnancy are no different than the usual cold symptoms. These include:

• Cough

• Runny nose

• Stuffy nose (nasal congestion)

• Eyes watering more than usual

• Sore throat

• Post-nasal drip

A cold can be easily confused with the flu because the two infections share many of the same symptoms. But unlike a cold, the flu can also cause more serious symptoms. These include:

• Fever

• Body aches

• Chills

• Headaches 

Having a fever in early pregnancy has been linked to birth defects. If you notice a fever at any time during your pregnancy, talk to your healthcare provider to see if treatment is needed. 

Which cold medicines are safe during pregnancy?

A variety of cough and cold medications are available at your local pharmacy. But it can be overwhelming to figure out which ones are safe to take while pregnant. Different medications target different cold symptoms. Pinpointing your specific symptoms can help you decide which medications to take.

Research on cough and cold medications during pregnancy is limited. Some research suggests that certain medications should be avoided during the first trimester. This is because the first trimester is an important time of development for your baby. And you don’t want anything to interfere with that process.

Below, we’ll cover different medications that can be used for various cold symptoms. Always ask your healthcare provider or pharmacist before taking any medications while pregnant. If you need medications, take the lowest amount needed to relieve your symptoms. And only take them for the shortest period of time possible.

Cough

Dextromethorphan(Delsym, Robitussin)

Dextromethorphan (DM) works to lessen how much you cough by lowering activity in the part of the brain that causes coughing. Studies of pregnant women taking DM did not find a link between DM use and birth defects. DM is generally safe to take during pregnancy.

Guaifenesin (Mucinex)

Guaifenesin is an expectorant. It thins the mucus in your lungs so it’s easier to cough up. It can help relieve “wet” or productive coughs. Research on guaifenesin use during pregnancy is limited. To be safe, avoid taking guaifenesin during your first trimester. In your second and third trimesters, guaifenesin may be an option. As always, ask your provider before starting any medication.

Runny nose

Older (1st generation) antihistamines 

Most antihistamines are considered safe in pregnancy. Specifically, chlorpheniramine is a first-choice option to relieve a runny nose while pregnant. Side effects of older antihistamines include sleepiness, tiredness, and dry mouth.

Newer (2nd generation) antihistamines

For 2nd generation antihistamines, the American College of Obstetricians and Gynecologists (ACOG) –– the leading professional organization for obstetrician/gynecologists (OB/GYNs) –– recommends cetirizine (Zyrtec) and loratadine (Claritin) as alternatives after the first trimester. These newer antihistamines are less likely to cause bothersome side effects.

Intranasal corticosteroids

A study looked at 2,500 women who used steroid nasal sprays while pregnant. Researchers found that budesonide (Rhinocort Allergy) and fluticasone (Flonase, Flonase Sensimist) over-the-counter (OTC) nasal sprays are not linked to birth defects. Nasal sprays can cause nose-related side effects, like nosebleeds, nasal dryness, and stinging.  

Congestion

Decongestants

It’s not certain whether medications that treat congestion are safe during pregnancy (more on that below). Trying home remedies is a good place to start if you have congestion. Drink plenty of fluids (e.g., water, soup) throughout the day to stay hydrated. Using saline nose drops and a humidifier at night can help as well.

Pain due to headaches or sore throat

Acetaminophen (Tylenol)

Acetaminophen is a first-choice medication for pain relief in pregnant people. Some researchers suggest that taking acetaminophen during pregnancy might not be as safe as previously thought. But ACOG still recommends it as one of the only safe pain relievers expectant mothers can take. 

What cold medicines are not safe during pregnancy?

There are a few medications that are generally not safe to take if you're pregnant. Before starting any new medications, always check with your healthcare provider first.

Intranasal corticosteroids

Avoid triamcinolone (Nasacort). Studies suggest that this nasal spray is linked to birth defects. These defects were specifically in the nasal passages.

Oral decongestants

Some studies show a higher risk of birth defects with oral pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) during pregnancy. But a study of over 4,000 pregnant women taking oral decongestants, found no greater risk. Overall, the safety of phenylephrine during pregnancy is not certain. And ACOG recommends avoiding pseudoephedrine in the first trimester. Talk to your healthcare provider if you need a decongestant at any time during pregnancy. 

Oxymetazoline (Afrin)

Intranasal decongestants deliver medication only where it’s needed: the nose. There isn’t much research on this nasal spray in pregnancy. One study showed that there might be a link between Afrin and birth defects. Always check with your healthcare provider before using Afrin or any decongestant. Afrin shouldn't be used for more than three consecutive days. Using the spray longer can cause a stuffy nose to get worse (rebound congestion).

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are pain relievers. This group of medications includes ibuprofen (Advil, Motrin) and naproxen (Aleve). The FDA recommends avoiding NSAIDs if you’ve been pregnant for 20 weeks or longer. After 20 weeks, NSAIDs can lower the level of fluid in your belly that protects your baby (amniotic fluid). This can impact the development of your baby’s kidneys, lungs, and other organs. At 30 weeks of pregnancy or later, NSAIDs can cause problems with your baby’s heart development. Because of these risks, acetaminophen may be a better option for pain relief. If you need pain relief at any time during your pregnancy, talk to your healthcare provider.

Syrups containing ethanol

Some medications come as a syrup that contains ethanol. Ethanol is a form of alcohol. Ingesting alcohol while pregnant can lead to negative outcomes. These include pregnancy loss and fetal alcohol spectrum disorders in your baby. If you’re looking for a liquid cough or cold medication, read the label to make sure the product is alcohol-free. If you’re not sure, ask your provider or pharmacist before purchasing.

Syrups containing natural sugars

Syrups can contain sweeteners for flavoring. These sweeteners can affect your blood sugar levels. It’s best to use “sugar-free” syrups if needed. These typically contain sugar alcohols, like sorbitol, or artificial sweeteners, like sucralose. Most sugar alcohols and artificial sweeteners are safe during pregnancy. They don't affect your blood sugar levels as much as natural sugars. This is especially important if you have gestational diabetes. Still, consume the smallest amount of these sugar-free syrups as possible. Consuming a large amount of artificial sweeteners during pregnancy can lead to problems. These include preterm birth and childhood obesity. 

Combination products

Many OTC cough and cold products contain more than one medication. Some of these combination products contain medications that are not safe during pregnancy. For example, Claritin-D contains loratadine and pseudoephedrine. As discussed, pseudoephedrine is not typically recommended in pregnancy. Always ask your healthcare provider and pharmacist before starting any combination products. 

The bottom line

Certain medications to treat a cold can be safe during pregnancy. Others might cause harm to you or your baby. If you are pregnant, ask your healthcare provider or pharmacist which medications are safe to take. If you do need medication, it's best to take the lowest dose for the shortest time possible.

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