Acetaminophen / Dextromethorphan / Guaifenesin / Phenylephrine Pregnancy And Breastfeeding Warnings
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Medically reviewed by Drugs.com. Last updated on Nov 29, 2021.
Cold Medicine And Pregnancy
Coming down with the common cold is always unpleasant, let alone if youâre pregnant. While many medications are off-limits during pregnancy, there are some remedies to relieve your symptoms.
Common Cold Medicine and Pregnancy: Go Natural
Before you consider taking drugstore medicines for the common cold, you might want to consider some good old-fashioned home remedies, says Elisa Ross, MD, an obstetrician and gynecologist on staff with the Cleveland Clinic in Ohio.
The reason: No over-the-counter medicines are really treating the cold or helping you get better, they just control symptoms.
Dr. Ross suggests:
- Chicken soup
Common Cold Medicine and Pregnancy: Whats Safe?
If you canât get enough relief from those home remedies, its possible to use common cold medicines with a few precautions. First, guidelines say its best to avoid all medication during the first trimester.
âIn the first 12 weeks the baby is making its organs, and so in general, if people donât need to take something during that time it would be great if they didnt,â says Dr. Ross. more serious consequences at the beginning of the pregnancy.â
Next, Ross says the safest bet is to look for medications with the fewest ingredients possible.
There are also specific medicines to avoid during pregnancy:
Can I Take Cold And Flu Meds While Pregnant
Pregnant women need to be very careful with cold and flu medications because many contain pseudoephedrine: It can affect maternal blood flow, which can have an adverse effect on the baby, says MacQuarrie. Koren recommends treating symptoms topically with medicated nose drops. These have much lower concentrations of the chemicals that constrict the blood vessels in the nose, and thats much safer, he says. Very little of the medication is getting into your system, or the babys. Read the box or ask a pharmacist if youre not sure if a product contains pseudoephedrine.
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Before Taking This Medicine
Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.
You should not use this medication if you are allergic to acetaminophen, dextromethorphan, guaifenesin, or phenylephrine.
Ask a doctor or pharmacist if it is safe for you to take this medicine if you have other medical conditions, especially:
enlarged prostate or urination problems
cough with mucus, or cough caused by emphysema or chronic bronchitis
It is not known whether Tylenol Cold & Flu Severe will harm an unborn baby. Do not use this medicine without a doctor’s advice if you are pregnant.
Acetaminophen, dextromethorphan, guaifenesin, and phenylephrine may pass into breast milk and may harm a nursing baby. may also slow breast milk production. Do not use this medicine without a doctor’s advice if you are breast-feeding a baby.
Artificially sweetened liquid medicine may contain phenylalanine. Check the medication label if you have phenylketonuria .
Medical Alternatives To Medicine
Choose alternatives to help with cold symptoms during pregnancy that are Category B rather than using Tylenol Cold.
Tylenol itself is safe to take for fever. For a cough, take Robitussin .
Pseudoephedrine, sold by the brand name Sudafed, is safe after the first trimester for stuffiness and congestion. Take single-ingredient medications to treat only the most severe symptoms of your cold during pregnancy, and always check with your doctor prior to taking any medication.
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How Do I Know If I Have A Cold During Pregnancy
Symptoms of a cold during pregnancy are no different than the usual cold symptoms. These include:
Having a fever in early pregnancy has been linked to birth defects. If you notice a fever at any time during your pregnancy, talk to your healthcare provider to see if treatment is needed.
Common Medications To Avoid
Knowing what not to take is almost more important than knowing which medications are safe to take during pregnancy. There are a number of medications to avoid while pregnant unless recommended by your doctor. These include:
- Nonsteroidal anti-inflammatory drugs such as Motrin and Advil , Bayer , and Aleve and Naprosyn , higher doses of which can cause premature blood vessel closure in the baby. However, low-dose aspirin is now routinely recommended for other indications.
- Any cold remedy containing alcohol, including Benadryl and NyQuil
- Codeine, a narcotic drug which may cause fetal respiratory depression
- Bactrim , an antibiotic that can interfere with folic acid metabolism while stimulating the production of bilirubin , both of which are not good for the baby. The concern for folic acid metabolism is only in the first trimester, and the concern for jaundice is only after 32 weeks gestation. The medication can otherwise be used without concern, especially when treatment is necessary.
- Pseudoephedrine- and phenylephrine-based decongestants, both of which may cause the constriction of blood vessels, potentially increasing the risk of a specific birth defect in the first trimester and risk of elevated blood pressures if used later in pregnancy.
If your cold or flu is severe and you are experiencing chest pains, are coughing up discolored mucus, or have a fever over 102o F, call your doctor immediately.
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Tylenol Cold & Flu Severe Side Effects
Get emergency medical help if you have signs of an allergic reaction:hives difficult breathing swelling of your face, lips, tongue, or throat.
In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.
Stop using this medicine and call your doctor at once if you have:
chest pain, fast, slow, or uneven heart rate
severe dizziness, feeling like you might pass out
mood changes, confusion, hallucinations
urinating less than usual or not at all
nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, jaundice or
dangerously high blood pressure .
There is a fair amount of overlap between early pregnancy symptoms and flu symptoms.
Pregnancy is a time of altered immune status, so being pregnant may increase your risk of acquiring infectious diseases such as the flu.
Why do pregnant women experience so many flu-like symptoms? Its because the body is stressed.
What Cold Medicines Are Not Safe During Pregnancy
There are a few medications that are generally not safe to take if you’re pregnant. Before starting any new medications, always check with your healthcare provider first.
Some studies show a higher risk of birth defects with oral pseudoephedrine and phenylephrine during pregnancy. But a study of over 4,000 pregnant women taking oral decongestants, found no greater risk. Overall, the safety of phenylephrine during pregnancy is not certain. And ACOG recommends avoiding pseudoephedrine in the first trimester. Talk to your healthcare provider if you need a decongestant at any time during pregnancy.
Intranasal decongestants deliver medication only where its needed: the nose. There isnt much research on this nasal spray in pregnancy. One study showed that there might be a link between Afrin and birth defects. Always check with your healthcare provider before using Afrin or any decongestant. Afrin shouldn’t be used for more than three consecutive days. Using the spray longer can cause a stuffy nose to get worse .
Nonsteroidal anti-inflammatory drugs
Syrups containing ethanol
Syrups containing natural sugars
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How Can I Prevent The Flu During Pregnancy
There are many steps that can be taken as precautionary measures to prevent the flu. A few of these simple steps include regularly washing your hands, healthy eating habits, getting plenty of sleep, and staying away from those who have the flu. The CDC recommends getting your flu vaccination as the most effective way to prevent getting the flu while pregnant.
How To Take Tylenol
Take your acetaminophen product as directed on the label. Do not take more than recommended.
If you are giving acetaminophen to a child, be sure to use the correct product for the child’s age and weight. Consult with your child’s healthcare provider if you have questions about appropriate use and/or dosage. Adults can usually take Tylenol four to six times throughout the day. However, it is important to not take more than directed on the package label due to the potential risk of liver damage.
The following are tips for using various acetaminophen formulations:
- Tylenol suspension: Shake well before using. Measure the medication with a medication measuring oral syringe or dosing cup, not a kitchen measuring device. If the product comes with a measuring device, use the measuring device that comes with the product.
- Tylenol dissolving tablets: Chew the tablet or let it dissolve on the tongue.
- Tylenol chewable tablets: Chew the tablet thoroughly before you swallow.
- Tylenol extended-release tablet: Swallow the tablet whole. Do not chew, crush, or split the tablet.
- FeverAll rectal suppository: Follow the directions on the product packaging. Ask your healthcare provider for dosing for a child if unsure. Unwrap the suppository before inserting it rectally . The suppository is for rectal use only and should not be taken by mouth or swallowed.
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How Much Tylenol Is Safe During Pregnancy
If you are taking Tylenol Extra Strength, your recommended dose will be 2 caplets every 6 hours while the symptom lasts. Pregnant women can take a maximum of 3,000 mg of acetaminophen in 24 hours, which is the same as any non-pregnant adult.
Historically, the daily maximum dose of acetaminophen was 4000 mg in 24 hours for adults. In 2012, FDA suggested a daily dose of 3,000 mg but did not mandate it. If you think, you might need more than the recommended dose of Tylenol during pregnancy, consult your OB-GYN first.
If you are taking Tylenol PM, which contains diphenhydramine along with acetaminophen, the suggested dosage is 2 caplets at bedtime with not more than 2 caplets in 24 hours.
It is crucial to keep in mind that acetaminophen is also present in other over-the-counter drugs like the medications for cough, cold, and flu. So, if you are taking multiple medicines, you must consider the total dose of acetaminophen per day and not only how much Tylenol you are taking.
About 65% of women have used acetaminophen at some point during their pregnancy and it is generally considered safe in proper dosage compared to other pain-relieving drugs like Aspirin and Ibuprofen, which have been linked to birth defects.
Pregnant People Can Take Regular Tylenol Doses
Laursen says that the dose of Tylenol for pregnant women is the same as for adults who are not pregnant. Take no more than 3,000 milligrams of acetaminophen every 24 hours.
For regular strength Tylenol, that’s the equivalent of 2 tablets at 325 milligrams per tablet every 4 to 6 hours. And always review proper dosing guidelines on the medicine container.
Also, be aware that acetaminophen is often found in other medications, such as over-the-counter cold, cough, and flu medications. So if you’re taking multiple medications, whether prescribed or over-the-counter, look for acetaminophen listed as an ingredient to make sure you don’t take too much in one day.
For more information about what you can or cannot take, see our article on how to treat a cold when you’re pregnant. For allergies, you can take Benadryl. If you’re not sure if you have allergies, the cold, or the flu, learn how to tell the difference.
Too much acetaminophen can cause severe liver damage, whether you’re pregnant or not. That’s because your liver processes the drug into a form your body can use. Too much can overstress it and cause acute liver failure. In fact, acetaminophen overdoses account for an estimated 50% of overdose-related cases of acute liver failure in the US.
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What Can I Take For A Cold While Breastfeeding
Colds and influenza are both viral illnesses, so these medicines provide only symptom relief. They are not cures. If you have severe symptoms, you should see your doctor. They may want to test you for influenza and perhaps prescribe curative antiviral treatment. You can take some medicines at home for usual symptoms, with some precautions.
Avoid combined products like Tylenol Cold and Flu. There are four active medicines in the tablets, and the syrup of the same name contains even more. Taking each medicine you need separately will be safer for your baby. This way, you can take the ones considered safe and avoid the others.
Colds and the flu often cause high fever, body ache, or headaches. Acetaminophen is considered safe to use while nursing. Instead of taking it on a fixed schedule, take a tablet only when you have a high fever. This will probably cut down your medicine intake.
Ibuprofen is another safe drug for pain and fever. Very little of it reaches breast milk. It is safe for babies. Ibuprofen and acetaminophen also relieve the pain of a sore throat. But you can take a lozenge or throat spray instead.
For a stuffy nose, try oxymetazoline nose drops or sprays. They have minute doses of the drug, and even these may not reach your blood and breast milk. If you do need an oral decongestant, pseudoephedrine is safe. It is present in breast milk in only small amounts. Decongestant drugs can sometimes decrease your breast milk supply.
What Are The Symptoms Of A Cold During Pregnancy
A cold usually begins with a sore or scratchy throat that lasts for a day or two, followed by the gradual appearance of other symptoms, including:
- A runny, then later stuffy, nose
- Mild fatigue
- A dry cough, particularly near the colds end, which may continue for a week or more after other symptoms have subsided
- Low-grade fever
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How Can I Stay Healthy While Taking Tylenol
Talk to your healthcare provider about other non-pharmaceutical measures you can try with Tylenol to relieve your symptoms. For example, if you are taking Tylenol for arthritis pain, you may also want to try physical therapy.
If you drink alcohol, ask your healthcare provider about alcohol intake while taking Tylenol. Tylenol can harm the liver, and alcohol can increase the risk of liver damage.
When taking Tylenol, follow the directions on the label carefully. If you have certain medical conditions, you may need a lower dose. Ask your healthcare provider if you are unsure.
Children are dosed according to age and weight. To give the correct dosage, this medication should be measured with a medicine measuring device. Check with your child’s healthcare provider or pharmacist before using Tylenol if you are unsure of the dose or the appropriate product.
While unlikely, severe skin reactions are possible. Watch out for any skin changes, such as rash, redness, or blistering, and notify your healthcare provider right away if changes occur.
How To Treat Your Cold And Flu While Pregnant
Having the cold and flu while pregnant is the worst. What medications can you safely take?
You know that unpasteurized brie is a no-go during pregnancy, and those double martinis and oysters on the half shell are strictly verboten. But what about cold and flu medications? When you inevitably come down with a hacking cough, myriad aches and pains, and a serious case of the sniffles, what can you take? Here, our guide to navigating cold and flu season with a baby on board.
Get the vaccine
YOURE PREGNANT!Sign up to get weekly email updates on your baby Â»Influenzaa severe respiratory illness that causes fever, cough and congestionis not something to be trifled with. As Laura Magee, an obstetrician and clinical associate professor at the University of British Columbia, says, women who are pregnant and have the flu are at an increased risk of serious complications. And that list of potential repercussions includes pneumonia, kidney failure, swelling of the brain, premature labour and even death. An estimated 10 to 20 percent of Canadians becomes infected with influenza each year, causing upwards of 12,000 hospitalizations and 3,500 deaths.
The good news is the vaccine is safe throughout pregnancy. Be sure, however, to request the injection, which is made from an inactivated virus, and not the nasal-spray vaccine, as thats made from a live virus and not recommended for use by pregnant women.
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