Cold and Flu Medicine During Pregnancy: What Is Safe?

Catching a cold while pregnant is miserable, partly because your usual medicine cabinet is suddenly off limits or uncertain. The good news is that you can treat most symptoms safely if you target them one at a time rather than reaching for an all-in-one combo. Here is how to feel better while keeping things simple and safe.

Treat one symptom at a time

In plain English: the safest approach is to pick a single-ingredient product for the symptom that is actually bothering you, rather than a combination cold and flu medicine that throws several drugs at you whether you need them or not. Here is the symptom-by-symptom guide.

• Fever and body aches: acetaminophen (Tylenol) is the preferred option. Avoid ibuprofen and other NSAIDs in pregnancy unless specifically directed.
• Stuffy or runny nose: saline nasal sprays or rinses are safe and effective. Many providers also consider steroid nasal sprays acceptable. Certain antihistamines can help a runny nose too.
• Congestion and oral decongestants: pseudoephedrine and phenylephrine come with cautions in pregnancy, particularly the first trimester, so most providers steer you toward saline, a humidifier, and rest instead. Ask before using an oral decongestant.
• Cough: plain dextromethorphan is generally considered low risk, and guaifenesin is usually considered acceptable later in pregnancy. Warm fluids and a spoon of honey genuinely help.
• Sore throat: warm salt water gargles, honey and lemon, and throat lozenges (check the label) are gentle first steps.

The non-medicine basics that work

Rest as much as you can, drink plenty of fluids, use a humidifier or steamy shower for congestion, and prop yourself up to sleep. Most colds run their course in about a week, and supporting your body is half the battle.

Colds versus the flu

The flu tends to come on fast with a high fever, body aches, and exhaustion, and it can be more serious during pregnancy. The flu shot is recommended in pregnancy and is a good way to lower your risk. If you think you have the flu, do not wait it out: call your provider quickly, because antiviral medicine such as oseltamivir works best when started early and is commonly recommended for pregnant people.

When to call your provider

Reach out if you have a fever (especially over 38C or 100.4F) that is not coming down, trouble breathing, chest pain, symptoms that last more than about ten days or suddenly get worse, or if you simply are not sure what is safe to take. Your pharmacist is also a quick, knowledgeable resource for choosing a product.

Medical Disclaimer: This article is for general educational purposes only and is not medical advice, and it does not replace guidance from your doctor, midwife, or pharmacist. Recommendations depend on your individual history and stage of pregnancy, so always confirm what is safe for you with a qualified professional. If you think you may be experiencing a medical emergency, contact your local emergency services right away.

Sources

• American College of Obstetricians and Gynecologists (ACOG). Guidance on cold, flu, and medication use in pregnancy, and influenza vaccination.
• Centers for Disease Control and Prevention (CDC). “Flu and Pregnancy” and antiviral treatment guidance.
• MotherToBaby (OTIS). Fact sheets on dextromethorphan, guaifenesin, and decongestants in pregnancy.