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.
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. 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. 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.
Dextromethorphan is a cough suppressant. 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. Dextromethorphan is a common ingredient in over-the-counter cough medicines (Robitussin DM, DayQuil Cough, Delsym) as well as prescription medications. 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.
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. 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.
Warnings and Precautions
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.
-- Severe sore throat.
-- Body aches or headache.
- 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
- University of Michigan Health Center: Colds and Flu During Pregnancy
- 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