What Cold and Flu Medicine Can You Take While Pregnant?

The good news is that you don’t have to suffer through your cold or flu symptoms unmedicated. There are safe and effective ways to manage them during pregnancy.

However, you should always get the green light from your doctor first before taking any new medications when you’re carrying a child. Here’s a rundown of what is and isn’t safe, and some non-drug alternatives you can try,

There are safe medications you can take while you’re pregnant, but also plenty you should stay away from.

In general, it’s best to stick to single-ingredient medications that specifically target your symptoms. Combination medications that treat multiple symptoms at once often contain ingredients that are unnecessary and may be potentially harmful during pregnancy (some even contain alcohol). 1

Pay close attention to the active ingredients, dosages, and warnings on medication labels. Again, always check with your pharmacist, doctor, or midwife before starting any new medication when you’re pregnant, including over-the-counter drugs and “natural” herbal remedies.

Here’s a breakdown of common cold symptoms and the medications that can help:

Fever and pain

Acetaminophen (i.e., Tylenol or paracetamol) is the safest option for treating pain, infection, and fever during pregnancy. Note that despite what you may have read or heard, research hasn’t confirmed the belief that it causes autism. 2 3

With all that said, while you can take Tylenol while you’re pregnant, it’s best to take the lowest effective dose for the shortest amount of time you need to relieve your symptoms. 2 Never exceed the recommended maximum dosage per day.

Nasal congestion

Antihistamines are many people’s go-to option. Up to 15% of pregnant women use them to treat allergic rhinitis or “hay fever” (sneezing, congestion, itchy nose, and watery eyes), as well as morning sickness. 4 5

First-generation antihistamines like Benadryl are generally considered safe during pregnancy, but they can make you drowsy, which can be inconvenient. 4 Some newer options are still pregnancy-safe while being nondrowsy: 6

• Loratadine (Claritin, Alavert) 7
• Fexofenadine (Allegra)
• Cetirizine (Zyrtec, Aller-Tec, Wal-Zyr) 8 9
• Levocetirizine (Xyzal)
• Desloratadine (Clarinex)

Watch out for medications that combine these drugs with decongestants, such as Allegra-D, which are unsafe during your first trimester.

You can also try certain nasal sprays. These corticosteroid options are safe and especially effective for hay fever symptoms: 10 11

• Mometasone (Nasonex)
• Budesonide (Rhinocort)
• Beclomethasone (Beconase AQ, Qnasl) 12
• Fluticasone (Flonase)

Cough and sore throat

If you’re dealing with a sore throat and persistent cough, try these syrups and medications:

• Dextromethorphan (Robitussin, Delsym): This cough suppressant is often found in over-the-counter cold medicines and is generally considered safe. 1 13 Be careful to choose a formulation without alcohol.
• Guaifenesin (Mucinex): This expectorant helps thin mucus. It’s generally safe, but there have been a few studies tentatively linking it to certain birth defects, so some doctors recommend avoiding it in the first trimester, the most critical stage of your baby’s development. 14 15
• Cough drops: It’s generally okay to use cough drops while you’re pregnant. Those containing benzocaine (such as Chloraseptic, Cepacol, or Halls) or menthol are usually safe. 16 17 However, many of them have corn syrup or other sweeteners, so stick to the recommended dosage and choose sugar-free versions (with no herbs or aspartame) if you have type 1, type 2, or gestational diabetes. 18 17
• Mentholated chest rubs (Vicks Vapor Rub): These are considered safe for topical use. 17

Not all products from these brands are safe to take. For instance, you should avoid Mucinex D and Robitussin DM. 19 They contain combination medications that aren’t safe during pregnancy. Verify which versions of their medications are safe to take with your doctor.

Don’t take any nonsteroidal anti-inflammatory drugs (NSAIDs). These include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac (Voltaren, Cambia), and celecoxib (Celebrex). 20 21 22 23

The US Food and Drug Administration (FDA) warns that taking NSAIDs can cause your baby to develop kidney problems and other complications. 24

You should also use caution with:

• Oral decongestants: Steer clear of pseudoephedrine (Sudafed) during your first trimester, as there’s a small risk of it causing birth defects. 25 Another type, phenylephrine, also reduces the flow of blood and oxygen to your baby, which can result in birth defects. 26
• Decongestant nasal sprays: You shouldn’t use sprays with oxymetazoline (e.g., Afrin and Sinex) for more than a few days, or you’ll end up with rebound congestion, meaning you’ll become even more congested and will need to depend on the spray to keep your nasal passages clear. 27
• Diphenhydramine (Benadryl): As mentioned, Benadryl is generally considered a safe allergy medication to take during pregnancy. However, some reports link birth defects with its use in the first trimester. Using higher-than-recommended doses in the third trimester may also trigger contractions. 28 You don’t necessarily need to avoid Benadryl entirely, but be cautious with it, and talk to your doctor about it.
• Combination medications (NyQuil, DayQuil, Tylenol Cold): Although some forms of NyQuil are safe to take when you’re pregnant, many of these combination medications contain ingredients that may not be safe during pregnancy. Many also contain alcohol, which you should avoid entirely during pregnancy. 19 1 29
• Herbal supplements: Most herbal supplements haven’t been well-studied in pregnant women, and some can be dangerous. 30 Always check with your doctor before using any herbal remedies.

Note that this list isn’t exhaustive, and as we keep noting, your doctor is the best source of information on which medications to take and avoid.

Before reaching for medication, consider trying the usual home remedies, such as staying hydrated and getting more rest (make sure you keep your head elevated when sleeping to help relieve congestion). 31

You can also use a neti pot to rinse your sinuses with a saline solution. Alternatively, you can use sterile, distilled, or boiled and cooled water to clear your passages. 32 Saline nasal sprays (e.g., Sterima and Neilmed Nasamist) are also safe and effective for relieving congestion by rinsing and moisturizing your nasal passages. 10

If you have a sore throat, try gargling with warm water and salt, and consider eating a spoonful of honey (which you can also add to your water or tea). If you have gestational diabetes, check with your doctor first before doing that.

Lastly, take a steamy shower or use a humidifier to moisten the air and help relieve your congestion. 33 Make sure you clean or sterilize your humidifier after each use, per the manufacturer’s instructions. Ask your doctor if it’s safe to add a few drops of peppermint or eucalyptus oil to the shower for added relief.

While a mild cold is generally harmless during your pregnancy, getting sick with a fever can cause your baby to develop birth defects. 34 35 Contact your doctor if you suspect you have the flu (e.g., you have a fever, chills, and worsening symptoms).

You should see your doctor immediately for treatment if you experience any of the following at any time: 34 13

• Difficulty breathing
• Chest or abdominal pain
• Severe muscle pain
• Persistent or recurring cough
• Lack of urination for a long time
• Concerns about your baby’s movements

Your doctor can get you the right treatment to minimize the impact on your baby.

Getting sick when you’re pregnant can feel like the worst thing ever, but there’s hope for relief. Discuss your medications with your doctor to protect the health of both you and your baby. Prioritize safe and effective remedies, and you’ll breeze through cold and flu season with no problem.