Over the Counter Medications for Cold & Cough During Pregnancy Charts reprinted with permission from

U.S. Pharmacist

Pre-pregnancy, a cold or cough might not have stopped you in your tracks. You would stop by your local pharmacy and pick up an over-the-counter medication to help you get on with your day. But now that you're pregnant, even a sniffle can cause more discomfort than before, especially since you might not be sure what you can - or can't - take. Of course, you should always check with your health care provider, but we have reprinted the following chart from U.S. Pharmacist to give you an overview on the safety of OTC medications during pregnancy.

THERAPEUTIC CATEGORY

PREGNANCY CATEGORY

DOSAGE

POTENTIAL CONCERNS IN PREGNANCY (Evaluate for contraindications prior to use.)

Analgesics Acetaminophen (Tylenol) NSAIDs (multiple) B 325-1,000 mg (every 4-6 hrs max 4,000 mg/day) Ibuprofen 200-400 mg every 46 hours (max 1,200 mg/day); naproxen 200 mg every 8-12 hours (max 600 mg/day); ketoprofen 12.5 mg every 6-8 hours (max 75 mg/day) Preferred analgesic in pregnancy. Avoid in first trimester. Use smallest effective dose.

B (1st and 2nd triemsters) D (3rd trimester)

Salicylates Aspirin (Anacin, others) D N/A Not recommended unless under direct approval and supervision of physician.

Decongestants Pseudoephedrine (Sudafed) C 30-60 mg every 4-6 hours (max 240 mg/day) Oral decongestant of choice in pregnancybut avoid in first trimester. Possible link to

gastroschisis. Oxymetazoline nasal C 2-3 sprays per nostril every 1012 hours (max 2 doses/day) Nasal decongestant of choice in pregnancy. Avoid use for longer than 3 days.

Antitussive/Expectorant Guaifenesin (Robitussin) C 200-400 mg every 4 hours (max 2,400 mg/day) Avoid in first trimester. Possible link to inguinal hernia. Questionable efficacy. Unknown role ofN-methyl-oaspartate receptor antagonism on fetal brain growth. Questionable efficacy.

Dextromethorphan (Robitussin CoughGels)

10-20 mg every 4 hours (max 120 mg/day)

Antihistamines (Avoid in third trimester due to possible link to retrolental fibroplasias and convulsions) Brompheniramine (Dimetapp combination product) Chlorpheniramine (ChlorTrimeton) Clemastine (Tavist) C 4 mg every 4-6 hours (max 24 mg/day) 4 mg every 4-6 hours (max 24 mg/day) 1.34 mg every 12 hours (max 2.68 mg/day) 25-50 mg every 4-6 hours (max 300 mg/day) Possible link to malformations.

Antihistimine of choice in pregnancy. Possible link to limb reduction defects. Possible stimulation of uterine contractions at higher doses; possible like to polydactyly Possible malformations due to triprolidine or combination with pseudoephedrine.

Diphenhydramine (Benadryl)

Tripolidine (available in certain Actifed products)

2.5 mg every 4-6 hours (max 10 mg/day)

Miscellaneous Menthol/Camphor Unknown N/A Due to insufficient information, patient should contact physician prior to use.

Echinacea Zinc and Vitamin C

N/A

N/A

Avoid use in pregnancy. For cough/cold treatment, doses are higher than the recommended doses used for vitamin supplementation (e.g., prenatal vitamins) Use with caution, if at all.

Acceptable in N/A appropriate doses

What do those letters in 'Pregnancy Category' mean? FDA Pregnancy Categories PREGNANCY CATEGORY A CATEGORY DESCRIPTION

Human: Adequate, well-controlled studies in pregnant women have notshown an increased risk of fetal abnormalities in any trimester of pregnancy. Animal: N/A Human: No adequate, well-controlled studies in pregnant women AND Animal: No evidence of harm to the fetus OR Human: Adequate, well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester AND Animal: Studies have shown an adverse effect. Human: No adequate, well-controlled studies in pregnant women AND Animal: Studies have shown an adverse effect OR Human: No adequate, well-controlled studies in pregnant women AND Animal: No studies have been conducted. Human: Adequate, well-controlled or observational studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential rish. For example, the drug may be acceptable if needed in a life-threatening situation or serious disease for which safer drugs cannot be used or

are ineffective. X Adequate, well-controlled, or observational studies in animals pregnant women have demonstrated positive evidence of fetal abnormalities or risks. The use of the product is contraindicated in women who are or may become pregnant.

From Pregnancy and OTC Cough, Cold, and Analgesic Preparations, posted 3/15/06 in U.S. Pharmacist.