Pregnancy-Safe Cold Medicine Brands

Is cold medicine safe during pregnancy? What are the safest cold medicine brands for expectant mothers?

As to going-to-be mother, you are obviously concerned about everything you are using, more so what food items and medicines you are ingesting or eating. You want to be sure that nothing that you have is in any way harmful for your growing precious one.

Drugs or pharmaceuticals are especially significant in this category. Not every pill that you popped before pregnancy is right for your child. As a rule, always and I mean always, consult your physician or gynecologist before taking any drug. Be sure that you are using the safe option for your condition and not one that is going to harm your child. 

Medications circulate in the blood and reach different organs. Similarly, they also reach the growing baby. They do so along with the blood that flows through the placenta and into the baby’s circulation. Levels of drugs in your circulation are high, for example, in adult doses and the same reaches the child. You know how doses for kids are different and how you ask your pediatrician about it. So, even if a drug is safe for the use of a child, it does not mean that it is also safe for the baby growing inside you. This is a common misconception among women, who are misinformed or misunderstand instructions.

In addition, the entire nine months of life that the growing baby spends inside you is an eventful time. The baby forms its different organs and tissues during the initial months. From a single cell, it keeps dividing at a rapid speed. While dividing, the cells also differentiate or grow into different types of cells. Thus, from a single cell, bone cells, liver cells, skin cells, and so on are formed. You can see how crucial a time it is. You may feel that you have taken only one pill or maybe pills for only one day, but the baby is growing and developing so rapidly that even small exposures of potentially harmful drugs can affect a crucial phase of its life. 

The second phase is the fetal phase where the organs and tissues are formed and they now keep growing in size so that at the end of nine months, your child is well-grown to be born and to live in the outside world. Any medication overdose in this phase, as you can understand, affects the growing phase resulting in stunting of organs and parts of the body. 

It cannot be emphasized enough that you need to be extremely careful about what medications and pills you pop from the day you learned about your pregnancy and ideally from the time you are trying to conceive, since usually a few weeks of your pregnancy have passed by the time you learn that you are impregnated. 

Now, no need to feel anxious. Luckily, there are pregnancy-safe options available for common conditions and diseases that you can avail in consultation with your doctor. These medications, for most part, will not cross the placenta and enter your precious one’s body. So, they are pretty much safe for you and your little one.

What is Common Cold or Cold?

You must have heard these terms being thrown around loosely. “I just have a cold”, you could have heard a friend say this. At times, people describe their allergies as cold,”I have a cold whenever I work in the garden.” 

Some people describe their flu as cold. “It’s the flu season and I am down with a cold.” So, what exactly is cold? 

Cold and flu are both infections caused by viruses affecting the upper respiratory tract including the nose, throat, and sinuses. Both present with nasal stuffiness, headache, and sneezing. Though cold and flu are caused by viruses, the type of virus is different in both cases. Flu or influenza is caused by influenza virus, while colds are caused by a variety of viruses. There are over 200 viruses that cause colds, rhinovirus is the most common and is highly contagious. 

Influenza or flu is seasonal while colds can occur at any time of the year. Cold is caused by different types of viruses. The influenza virus, though only of three types, changes forms regularly. Every new strain of influenza causes a fresh wave of influenza every year. There are no vaccines for colds due to the wide range of viruses and the changes in them. However, there does exist a vaccine for influenza which is updated every year to include new strains.

Thus, you can see that common cold and seasonal flu are caused by viruses and cause similar symptoms. But flu is seasonal due to the variations in the strain of the influenza viruses, while common cold can affect you anytime of the year. Also, flu tends to have more severe symptoms as compared to the common cold.

What are the Symptoms of Common Cold?

You must have suffered from a common cold at some point in your life. So, you know how that feels. 

Most people experience nasal stuffiness or a blocked nose. This is due to the inflamed mucosa or lining of your nose and excess secretions of mucus, the sticky substance. Both occur under the influence of the offending virus. 

• Often, you may also experience a runny nose, like thin and watery secretions will flow from your nose. This is another form of mucus in reaction to the viral infection. Every viral infection elicits some sort of an allergic reaction, and the runny nose is one symptom of this. You are contagious during the runny nose initial stage of the illness and can spread the virus quickly.

• You also tend to have reduced or no appetite to eat. This is related to the lack of taste and smell senses. Inflamed mucosa of the mouth and nose restrict the flavor of food that we need to feel hungry and enjoy or savor our food. You may just force yourself to sip some warm soup to soothe your throat.

Symptoms in flu may be more severe and additionally, you may have fever which may be high grade with or without chills. The body ache may be more severe and debilitating. At times, you may have diarrhea or vomiting too.Symptoms may last for a few days up to two weeks. The initial days have more symptoms and you tend to improve over the next few days.

Now you may wonder why these symptoms are dealt with in such detail, it is probably something you all know and have experience. The reason is that there is no cure or treatment directed at the virus for common cold. Treatment consists of just managing the symptoms, making you as comfortable as possible. It aims at resting your body to give it time for your immune system to work against the virus naturally. In the absence of specific cure or treatment, you mostly rely on medications to control or relieve your symptoms.

How Do You Prevent Common Cold?

Prevention is the best cure, and you can take several measures to avoid catching a virus. It will definitely reduce your chances of getting a common cold though not completely eliminate it. 

Viruses enter your body while breathing. Someone who has the virus spreads it while talking, sneezing, and coughing. The droplets with virus particles remain suspended in the air and when you take in the air, viruses enter your body. Additionally, virus droplets settled on surfaces and objects can spread to you if you touch these objects or surfaces and then touch your mouth, nose, or eyes. 

Symptoms begin within the next few days and you can spread the virus easily in the initial 3-4 of the illness.

The way to avoid getting the virus is to stay clear of someone who has symptoms like runny nose, fever, cough of sudden onset suggesting a viral infection.

• Wear a mask around such a person and avoid using the same objects used by this person.
• Maintain hygiene, sanitize, and clean surfaces to remove the viral droplets. Objects like doorknobs are common spreaders of the virus. 
• If you cannot keep cleaning surfaces like if you are at work, then you can keep sanitizing your hands and avoid touching your nose, mouth, or eyes. 
• Wash your hands repeatedly with soap and water or use a sanitizer that has alcohol.
• If you catch the virus, stay home, avoid crowded and public spaces, and keep your objects like towels, toothbrush, etc. separate. 
• Stay away from children as they can catch infections quite easily and can spread it to other children or caretakers. 
• Cover your nose and mouth with a handkerchief while sneezing and coughing, clean your hands after the same. 
• Following a healthy lifestyle by eating healthy and exercising helps protect you from contracting the virus and having a severe form of the illness. 
• Eat fruits and vegetables, include whole grains and lean meat and fish in your diet. 
• Moderate exercise 5 to 7 times a week, adequate sleep and rest go a long way in helping you combat colds and flu.

For influenza, the best way to avoid getting the virus is to take the flu vaccine every year just before the flu season. Flu vaccines can be taken by anyone above the age of 6 months and is recommended in the elderly and those with respiratory illnesses. These vaccines are safe during pregnancy and you must speak with your gynecologist regarding this¹. Flu vaccines are known to reduce chances of hospitalization and are the first in the  line of management². Antivirals are secondary³.

Thus, you understand that maintaining good hygiene and keeping good health are imperative to protect yourself from the cold and flu viruses.

Which Drugs for Common Cold Are Safe During Pregnancy?

In this article, we will touch upon those medications that are safe when you are suffering from a common cold⁴. For flu or severe symptoms, you must consult your doctor prior to self-diagnosis and self-medications.

Firstly, do not freak out if you fall ill during pregnancy and need to take medications. According to the Centers for Disease Control and Prevention (CDC), nine out of ten pregnant women take medications at some point during their pregnancy. So, you are not alone at all! Also, the advantages of taking medications outweigh any possible disadvantages. There are several pregnancy-safe options and you should make an informed decision by consulting your doctor.

You should be aware regarding OTC or over-the-counter and prescription medications. These types of medications can be purchased from a store while the latter require a prescription that authorizes the pharmacy to dispense the medications.

Do Drugs Carry Different Levels of Risk for Your Fetus?

The Food and Drug Administration (FDA) of the USA has divided drugs into categories based on the risk that they pose to your pregnancy and these are based on the composition of drugs. There are five categories i.e., A, B, C, D, and X in the order of increasing risk to the pregnancy. Category X includes medications that have proven adverse effects in population or human or animal studies. These medications are not used in women who are or may be pregnant.

The next category, category D includes drugs that have shown to increase the risk to the fetus in human or animal studies. These medications are also not used in pregnant women except when in emergency conditions, like one which threatens the life of the mother. In situations where the benefits of using the category D drug outweighs the risk to the fetus justify their use. 

Category C medications have limited data in pregnant women. They have shown adverse effects in animal models but haven’t been studied in human models. They are prescribed with caution in pregnant women. Category B drugs have either not shown adverse effects in animal models or have shown adverse effects in animal studies which are not supported by studies on pregnant women in their first trimester. 

Lastly, Category A medications have not shown any adverse effects in controlled studies in pregnant women during the first trimester and later. These are the safest category of drugs for you⁵. By knowing which FDA category the drug belongs to you can know the risk that you are being exposed to. 

Which Analgesics are Safe in Pregnancy?

Analgesics or pain-killers are drugs you use to relieve pain, in this case headache and bodyache. Acetaminophen, ibuprofen, and acetylsalicylic acid (ASA) are the common pain medications that are available over-the-counter. 

Among these OTC medications, the safety of acetaminophen is well documented in pregnancy. Belonging to FDA pregnancy risk classification category B/B/B (for first/second/third trimester), it is the analgesic of choice during pregnancy. There are multiple large studies to support acetaminophen that show that there is no increase in the risk of major malformations in the fetus that are caused by or are associated with the use of this drug^{6 7} . Acetaminophen is commonly known as Tylenol.

NSAIDs or nonsteroidal anti-inflammatory drugs are other medications that are used as painkillers and these should be avoided. These drugs are not found to increase the risk of congenital birth defects, preterm delivery, or intrauterine growth retardation which could result in your baby being born small or underweight. However, they may be associated with spontaneous abortion according to one study conducted in 2001⁸. Use of NSAIDs in the third trimester also causes problems with the blood circulation in unborn babies. It may result in early closure of an important blood vessel called ductus arteriosus and hence, it should be avoided⁹. NSAIDs include ibuprofen (Known as Advil, Motrin – FDA pregnancy risk classification category B/B/D), naproxen (Known as Aleve – FDA pregnancy risk classification category B/B/D), Ketoprofen (Known as Orudis – FDA pregnancy risk classification category B/B/D) and other similar drugs. 

Aspirin is also to be avoided in pregnancy, it belongs to the FDA pregnancy risk classification category D/D/D. It is associated with delivery complications and adverse effects in newborns¹⁰. Therefore, use in analgesic doses is not recommended in late pregnancy. However, low doses of the drug are found to be safe¹¹.

What Cough Medications are Safe for Use During Pregnancy?

The only available options belong to FDA pregnancy risk classification category C and so, many doctors and pregnant women prefer these medications after twelve weeks of gestation. Also, you need to take these only in consultation with your doctor.

Dextromethorphan (DM) is a cough suppressant or antitussive commonly found in OTC cold medications. There are a number of human studies on the use of DM during pregnancy that did not find an association between this drug and an increased risk of birth defects¹². It is non-narcotic and is available as Benylin DM or Robitussin. It belongs to FDA pregnancy risk classification category C and is consumed at night. 

For expectorants that are used to treat a productive cough that requires you to cough up the sputum, Guaifenesin is an option. However, its safety in the first trimester is not established and it may increase the risk of neural tube defects. So, it is avoided in the first trimester. Belonging to the FDA pregnancy risk classification category C, it should be consumed only with the prescription of your doctor. Unlike cough suppressants, it should be consumed during the day.

Which Decongestants are Safe During Pregnancy?

There are several studies that failed to show any increased risk of malformations when oral decongestants were used during pregnancy¹³. Decongestants reduce the inflammation and secretions, thereby reducing the stuffiness of the nose and throat. The drugs in this category include the antihistamines or the antiallergic agents that control the allergic component of the viral infection.

Chlorpheniramine is the antihistamine of choice.Commonly known as Chlor-Trimeton, it belongs to FDA pregnancy risk classification category B. Additionally, Pseudoephedrine is a common oral decongestant in OTC cold medications. Commonly called Novafed, it too belongs to the FDA pregnancy risk classification category B. It is also a decongestant used that can be given in pregnancy¹⁴.

In some studies, decongestant use in the first trimester has been associated with a small increase of defects such as gastroschisis (birth defect in the wall of the stomach or abdomen), small intestinal atresia (nondevelopment of part of bowel or intestine), and hemifacial microsomia (poorly developed half side of the face).

Diphenhydramine, commonly present in Benadryl, is an antihistamine classified as FDA pregnancy risk classification category B. Though it may be safe in lower doses, at higher levels it can have a possible oxytocin-like effect that can induce labor. 

Xylometazoline and oxymetazoline are inhaled decongestants, which are also available OTC. Xylometazoline is absorbed in your circulation, but whether it enters the placenta and into your baby, is something that is unknown. Occasional studies on pregnant women did not reveal any increased incidence of abnormalities in the fetus. Though considered relatively safe for use during pregnancy, you should know regarding rebound effects from overuse of these products¹⁵.

How Do You Naturally Treat a Common Cold During Pregnancy?

You must have heard the saying, ‘Feed a virus to kill a virus’. What this means is that you need to eat healthily and take enough rest to allow your body to fight against the virus and develop immunity.

• Also, stay hydrated as fevers tend to soak up the body water. This is thought to be the best strategy to tackle the cold and flu viruses. The rationale behind chicken soup in treating colds lies in the fact that both fluid and protein-rich meals are combined in one go. Similarly, a cup of warm green tea packed with antioxidants can help you feel better and recover faster.
• In case you also have some nausea or diarrhea, it is better to stick to starchy bland foods like potatoes and rice. Fluids and salts are to be replenished adequately to avoid complications related to loss in diarrhea or vomiting.
• Keep your throat clean by gargling regularly with warm salt water. Saline nasal drops are an easy way to clear the nose and nasopharynx without having any rebound congestion as seen with nasal decongestants. 
• Another effective way to relieve decongestion is by steam inhalation.Use a steamer or a utensil with boiling water. You can use a towel over your head and the steamer if you wish. Be careful with the steam and do not get burned! 
• Additionally, add a leaf of cabbage to your steaming water. It is effective in not only removing congestion and making your sinuses lighter, it somehow relieves your aches and pains and helps you recover faster. This is a personal tip that works for me. Likewise, adding a piece of solid turmeric or adding some turmeric powder to boiling water has medicinal properties that get vaporized and help you recover quickly.
• You could also use a humidifier in your room to help you recover better. This is a good remedy especially if you have some bronchoconstrictor or asthmatic tendencies that get aggravated by a virus.
• Applying a menthol rub to your chest, back, and forehead is another way of getting relief from decongestion. You can also apply warm compresses to your chest, forehead, and other places that are congested or where there are muscle aches. 
• Suckle on herbal or menthol lozenges for throat relief. It goes without saying that all these measures also need to be done in moderation. 
• Nasal strips are another safe option.

FAQs Related to Common Cold in Pregnancy

Does Common Cold Cause Harm to Your Baby?

Common cold is caused by a virus and this usually does not cause harm to your baby. It just makes you feel uncomfortable and under the weather for a few days. Common cold usually causes a mild illness that you will overcome when you develop immunity in a few days. 

Experiencing more severe symptoms like running high fever can affect the growing baby and you must seek professional help.

Is It True that Pregnant Women are More Susceptible to Get Common Cold?

Usually people suffer from about 2 or 3 episodes of common cold in a year. Pregnancy is a time when your immune system is under the influence of high levels of several steroid pregnancy hormones. These reduce the power of your immune system and may increase your chances of catching a virus that you may get exposed to.

Also, pregnancy is the time that many of your illnesses can get exacerbated like underlying or controlled respiratory problems. These also increase your risk of catching a virus and suffering from common cold easily. More importantly, you could catch a flu virus and hence, it is necessary to be careful and take the preventive measures mentioned in the previous paragraphs.

When Should I See a Doctor For Common Cold?

Common cold during pregnancy affects you much the same way as it does otherwise. It usually resolves in a week or two when you develop adequate immunity. However, there are some symptoms that you should watch out for as they could indicate higher severity or development of another illness like flu.

Please consult your doctor in case of the following:

• High fever 
• Difficulty breathing
• Cough with dark yellow or green sputum
• Wheezing 
• Bluish discoloration of nails
• Feeling faint or fainting
• Excessive vomiting or diarrhea
• Symptoms that do not improve or worsening symptoms
• Persistence of symptoms more than 7 to 10 days
• Flu symptoms
• Excessive coughing

Catching a cold is quite common during pregnancy and there is hardly anything to worry about. The illness is mild and self-limiting for the majority of the cases. By self-limiting, we mean that the illness will resolve on its own whether or not you treat it. Yet, there are several steps that you can take to make yourself comfortable and relieve yourself from symptoms that are distressing.

• Use natural remedies as far as possible. They are safe and carry absolutely no harm. They are also better at handling viruses. 
• Avoid taking medications that are hidden under the garb of a ‘natural or herbal’ label where you are not certain of the ingredients or their efficacy. There are many options available in various cultures, but they are largely unstudied. 
• Use only those natural remedies that you are aware of and comfortable taking. Speak with your doctor before trying something novel or new suggested by a well-meaning friend or colleague.
• Continue taking your prescribed medications for pregnancy even during the cold. If you are taking folate supplements, please continue doing so. 
• Also, try and prevent catching a cold as much as possible. There are many points outlined in the previous paragraphs that can help you safeguard yourself from catching a cold and similarly catching the flu virus.
• But, even if you end up catching the common cold and need to take medications, relax, there are many safe options available. You must always consult with your doctor before taking something you are not sure about.

For most cases, the above-mentioned OTC medications are safe for short-term use or consumption during the immediate period of the illness in the prescribed dose. Just because they are categorized as safe for use in this fashion does not justify their indiscriminate use for longer periods of time. Do not abuse them just because they are available OTC. Some of these components can be addictive if used over longer periods of time and can accumulate in the body and have adverse effects. 

Remember, when we say safe, we mean safe if consumed in the prescribed form for the appropriate time in proper dosages. Also,only medications appropriate to the symptoms must be ingested.

References

¹https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/flu-vaccine-pregnancy.html

²https://www.cdc.gov/flu/highrisk/pregnant.htm

³https://www.cdc.gov/flu/professionals/antivirals/avrec_ob.htm

⁴https://www.aafp.org/afp/2003/0615/p2517.html

⁵https://www.cdc.gov/pregnancy/meds/treatingfortwo/index.html

⁶Aselton P, Jick H, Milunsky A, Hunter JR, Stergachis A. First-trimester drug use and congenital disorders. Obstet Gynecol. 1985;65(4):451–5.

⁷Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 7. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. p. 800

⁸Nielsen GL, Sorensen HT, Larsen H, Pedersen L. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ. 2001;322(7281):266–70.

⁹Koren G, Florescu A, Costei AM, Boskovic R, Moretti ME. Nonsteroidal anti-inflammatory drugs during the third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006;40(5):824–9

¹⁰Corby DG. Aspirin in pregnancy: maternal and fetal effects. Pediatrics. 1978;62(5 Pt 2 Suppl):930–7.

¹¹Trudinger BJ, Cook CM, Thompson RS, Giles WB, Connelly A. Low-dose aspirin therapy improves fetal weight in umbilical placental insufficiency. Am J Obstet Gynecol. 1988;159(3):681–5.

¹²Einarson A, Lyszkiewicz D, Koren G. The safety of dextromethorphan in pregnancy: results of a controlled study. Chest. 2001;119(2):466–9

¹³Källén BA, Olausson OP. Use of oral decongestants during pregnancy and delivery outcome. Am J Obstet Gynecol. 2006;194(2):480–5.

¹⁴The use of newer asthma and allergy medications during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) and the American College of Allergy, Asthma, and Immunology (ACAAI). Ann Allergy Asthma Immunol. 2000;84:475–80

¹⁵Källén BA, Olausson OP. Use of oral decongestants during pregnancy and delivery outcome. Am J Obstet Gynecol. 2006;194(2):480–5.

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