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Taking cold medications during pregnancy

Some of the ingredients in cold medications are considered safe for pregnant women, but others should be avoided.

Most cold medicines are multisymptom remedies that contain two or more drugs, although you can also buy these drugs individually. The drugs include antihistamines for alleviating allergy symptoms and helping you sleep, antitussives for suppressing coughs, expectorants for loosening up mucus, decongestants for relieving stuffiness, and analgesics for easing aches and pains.

Remember that no drug is 100 percent safe for all women, so it's a good idea to check with your doctor or midwife before taking any kind of medicine during pregnancy. Don't take more than the recommended dose and, if possible, avoid taking anything during your first trimester, when your developing baby is most vulnerable.

Here are a few drugs that are okay to take during pregnancy:

The antihistamines chlorpheniramine, loratadine, doxylamine, brompheniramine, phenindamine, pheniramine, triprolidine, and diphenhydramine are considered low risk during pregnancy, but they can make you sleepy, especially doxylamine and diphenhydramine.

The expectorant guaifenesin thins mucous secretions in the respiratory passages, making it easier to cough them up. While some studies have found an increased risk of inquinal hernias in babies exposed to this drug, others have not.

The cough suppressant dextromethorphan got some bad press after one study found that it caused birth defects in chick embryos, but this study had many flaws and is generally not given much credibility. What's more, some good studies of women who took the drug during pregnancy have found that it doesn't raise the risk of birth defects in humans.

The local anesthetic benzocaine is combined with dextromethorphan in one product to treat sore throats. Benzocaine doesn't get into the bloodstream, so it doesn't pose a risk to a developing baby.

The pain reliever and fever reducer acetaminophen has been well studied. It's considered safe to take during pregnancy as long as you take no more than the dose recommended on the label.

Here are some drugs to avoid:

It's best to avoid the decongestants pseudoephedrine and phenylephrine, especially in the first 13 weeks of pregnancy, since there have been some reports of birth defects. Although the risk appears to be low, it could be higher if you're a smoker. After 13 weeks, occasional use of these medications — for example, once or twice daily for no more than a day or two — is probably safe. More frequent use, however, can reduce blood flow to the placenta.

You'll also need to avoid the pain relievers aspirin, ibuprofen, naproxen, sodium salicylate, and other nonsteroidal anti-inflammatory drugs (NSAIDs). When taken in the first month of pregnancy, NSAIDs have been shown to cause some women to miscarry. New information also suggests that use of NSAIDs in the second and third months of pregnancy might increase the risk of birth defects, particularly those involving the heart.

When used in the last trimester of pregnancy, NSAIDs can cause major toxicity in the unborn child. Finally, when aspirin is taken within a week of delivery, it can increase the amount of bleeding when you give birth.

One final caution: Some liquid cold medicines contain alcohol in concentrations as high as 4.75 percent. Look for products that are labeled "alcohol free."

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