During the first trimester of pregnancy, the safest cold medicine options are limited to those with the least risk to the developing baby. Here are the recommended medicines and considerations:
Safe Cold Medicines in the First Trimester
- Acetaminophen (Tylenol®) : Considered safe throughout pregnancy for pain and fever relief when taken as needed and in recommended doses. Avoid if allergic or if you have liver problems
- Certain Antihistamines :
- Diphenhydramine (Benadryl®) and chlorpheniramine (Chlor-Trimeton®) are generally safe for use during pregnancy, including the first trimester, though chlorpheniramine is not recommended while breastfeeding
* Loratadine (Claritin®) is also considered safe but is more commonly recommended in later trimesters
- Cough Suppressants : Dextromethorphan (DM), commonly found in OTC cough medicines like Robitussin, has not been linked to increased risk of birth defects and is considered safe for short-term use
- Saline Nasal Sprays or Drops and Nasal Strips : These are medication-free options safe to relieve nasal congestion
Medicines to Avoid or Use with Caution in the First Trimester
- Pseudoephedrine (Sudafed®) : Not recommended in the first trimester due to a small risk of abdominal wall birth defects; safe only in the second and third trimesters if no contraindications like hypertension or heart disease
- Guaifenesin (Mucinex®) : Usually avoided in the first trimester; considered safe in the second and third trimesters
- NSAIDs (Ibuprofen, Naproxen) and Aspirin : Generally avoided, especially in the third trimester; ibuprofen may be used cautiously in the first and second trimesters but is less preferred
- Combination Multi-symptom Cold Medicines : Often contain multiple ingredients, some of which may not be safe during pregnancy. It is better to avoid these and use single-ingredient products targeted to your symptoms
General Advice
- Always consult your healthcare provider before taking any medication during pregnancy, especially in the first trimester when fetal development is most sensitive
- Use medications only as needed and for the shortest duration possible.
- Non-medication remedies such as rest, hydration, warm saltwater gargles, and honey (for cough) can help alleviate symptoms safely
In summary, acetaminophen is the preferred pain and fever reducer, diphenhydramine or chlorpheniramine can be used for allergy symptoms, and dextromethorphan is a safe cough suppressant in the first trimester. Avoid decongestants like pseudoephedrine early in pregnancy and always check with your doctor before starting any medication
