Cough medicines that are safe for pregnant people, home remedies and tips for preventing cough

 Key takeaways

• Cough medications, like dextromethorphan, guaifenesin, and vitamin C, are generally safe to use during pregnancy to alleviate cough and its symptoms. However, some other medications, like Pseudoephedrine, also used to treat cough, may not be safe for pregnant people. 
• Home remedies and preventive measures, such as drinking warm water and using a humidifier, can also help manage coughs during pregnancy.
• Always consult with your healthcare provider before taking any medication during pregnancy, including cough medicines, and be sure to follow recommended doses and guidelines provided by health professionals.

A cough functions as a reflexive response aimed at clearing the air passages from mucus and irritants like dust or smoke, often indicating a minor concern. Typically, such coughs resolve themselves within three weeks without necessitating any treatment. 

But cough can be irritating and something you would want to get rid of as quickly as possible, especially if pregnant. There are a lot of safe cough medications you can take during pregnancy. Still, some cough medicines should be used with caution or avoided entirely. 

 Cough medications that are safe to use during pregnancy

Some medications that can be used to treat cough during pregnancy include dextromethorphan, guaifenesin, acetaminophen, saline nasal spray, vitamin C, and first-generation antihistamines such as chlorpheniramine.

 1. Dextromethorphan

Dextromethorphan is one of the cough medications that is safe to use during pregnancy. It works by reducing activity in the brain region, which is responsible for triggering cough. Dextromethorphan temporarily alleviates cough triggered by the common cold, flu, or similar ailments.

The recommended dose of dextromethorphan is 0.5mg/kg, with a maximum of 30mg given three or four times daily. It usually takes about 30 minutes to start working.

Some side effects that are mostly common when taking dextromethorphan for cough include: 

• Nausea and vomiting 
• A sense of intoxication or euphoria
• Nystagmus (an involuntary eye movement that may be rapid or slow and can occur horizontally, vertically, or in a rotary pattern). 

It is worth noting that alcohol-containing dextromethorphan products should be avoided during pregnancy to reduce the risk of adverse effects.

 2. Guaifenesin

Guaifenesin is an expectorant that is safe to use in pregnancy. It works by thinning mucus (phlegm) in the airways, making it easier for excess mucus to be coughed up, thereby effectively clearing the airways. This mechanism aids in reducing congestion and promoting easier breathing.

Guaifenesin is usually dosed 200-400 mg every 4 hours, with a maximum of 2400 mg /day, for immediate-release (fast-acting) formulations. For extended-release (long-acting) formulations, Guaifenesin is dosed 600-1200 mg 12 hourly, a maximum of 2400 mg/day. Guaifenesin acts within 30 minutes after being administered orally.

Common side effects of Guaifenesin include nausea, vomiting, dizziness, and headache. It is important to increase your fluid intake while using Guaifenesin to aid in loosening congestion and keeping the throat lubricated.

 3. Saline nasal spray

Like Guaifenesin, saline nasal sprays are safe to use during pregnancy and also work by thinning the mucus, hence relieving congestion. They are used to relieve dry nasal passages caused by cough, cold, nasal surgery, and dry air.

Saline nasal sprays are usually administered one or two sprays into each nostril as required. They provide immediate relief as soon as administered.

Side effects of these sprays are minimal and may include mild irritation or discomfort.

 4. Acetaminophen (paracetamol)

Paracetamol is an analgesic that works by relieving the associated symptoms of cough and cold, such as headache, joint pain, and earache. It does not necessarily alleviate cough or nasal congestion.

Acetaminophen usually comes in 500mg tablets and is dosed one or two tablets 4-hourly, up to 4 times a day with a maximum of 8 tablets daily. It provides relief within 30 minutes of administration.

Side effects usually associated with paracetamol include: 

• Rashes
• Itching
• Nausea
• Dizziness, and 
• Stomach pain.

 5. Vitamin C

Vitamin C is safe for pregnant people and helps in the relief of cough by acting as an antihistamine and reducing 5-hydroxytryptamine levels or synthesizing prostaglandins. It also boosts immune functions, aids in fighting viruses by neutralizing free radicals, and provides energy for the cells.

The recommended dose of vitamin C during pregnancy is less than 2g/day for pregnant women over 19 years old. Pregnant women between 14 and 18 should take less than 1800 mg/day. Vitamin C is a supplementary therapy, so it may take some time to build up in the body in order to achieve the needed relief.

Side effects of vitamin C supplements include gastrointestinal discomfort or diarrhoea, especially when high doses are consumed. 

Consider taking foods rich in vitamin C as part of a balanced diet to support overall health during pregnancy.

 6. First-generation antihistamines (chlorpheniramine)

Older-generation antihistamines like chlorpheniramine might indirectly suppress cough by affecting central pathways that change mucus production. This indirect effect could be related to central histamine or non-histamine receptors. 

Additionally, the sedating properties of certain older antihistamines may also play a role in cough suppression. Antihistamines also help to reduce the symptoms like runny nose and itchy associated with cough.

The usual dose of chlorpheniramine for adults and pregnant women is 1 tablet every 4 to 6 hours. Be sure not to take more than 6 tablets in 24 hours. Each tablet contains 4mg of chlorpheniramine. After taking chlorpheniramine, you should start to feel better within 30 minutes to an hour. 

Common side effects of chlorpheniramine include: 

• Nausea
• Dizziness or difficulty concentrating
• Dry mouth
• Headaches and 
• Blurred vision.

 Cough medications to avoid or use with caution when pregnant

Here are some medications to avoid when treating cough during pregnancy:

 Pseudoephedrine

It is not advisable to use pseudoephedrine in pregnancy, especially in the first trimester, because of the potential increased risk of gastroschisis (an abdominal wall defect). This medication may also constrict blood vessels, potentially affecting blood flow to the fetus and inducing maternal hypertension.

 NSAIDs (ibuprofen, indomethacin)

Non-steroidal anti-inflammatory drugs like ibuprofen and indomethacin are used to relieve pain and inflammation. 

As much as NSAIDs can also help relieve pain associated with cough, they are not recommended for use in pregnancy. This is because of the associated side effects like labor inhibition, premature closure of the ductus arteriosus (the blood vessel in fetuses that connects the aorta to the pulmonary artery), and low amniotic fluid levels.

Newborns may also experience lung problems, kidney damage, and brain bleeding due to maternal use of these medications. Use very low doses if you must take NSAIDs when pregnant or seek a doctor’s opinion.

 Codeine

Codeine, a cough suppressant containing opioids, can pass through the placenta and potentially lead to respiratory problems or other negative effects in newborns. It is usually not advised during pregnancy unless a healthcare provider prescribes it.

 Salicylates (Aspirin)

Salicylates like aspirin are sometimes used for treating cold and flu-like symptoms. However, it is best for pregnant people to avoid them as they have been linked to higher mortality rates, bleeding in newborns, reduced birth weight, and longer pregnancy duration and labor.

 Home remedies for cough during pregnancy

Home remedies that may be effective for cough treating cough during pregnancy include:

• Drinking warm water with lemon and honey to soothe the throat
• Getting plenty of rest to support the immune system
• Using a humidifier to add moisture to the air and ease congestion
• Gargling with salt water to reduce throat inflammation and irritation

 Tips for preventing cough during pregnancy

These tips can help prevent or reduce the chances of having a cough when pregnant:

• Wash hands frequently to prevent the spread of germs.
• Avoid close contact with individuals who are sick.
• Stay hydrated by drinking plenty of fluids.
• Eat a balanced diet rich in fruits, vegetables, and whole grains to support immune health.