What cold and sinus medications are safe during pregnancy

During pregnancy, your immune system is usually suppressed — and not all medications are safe to use. Here’s how to treat colds while you're pregnant.

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In This Article

• Symptoms of a cold during pregnancy
• What causes colds during pregnancy?
• How long does a cold during pregnancy last?
• Is it a cold — or the flu?
• How to feel better if you get a cold during pregnancy
• What can pregnant women take for a cold?
• Medications to avoid during pregnancy
• How to prevent a cold during pregnancy
• When to see a doctor

When you’re expecting, your immune system runs at a lower speed than usual — which is actually a good thing, since it keeps your growing baby protected and stops your body from thinking that the fetus is a foreign entity. The downside of this immune suppression, though, is that your body doesn't ward off many of the viruses that cause the common cold, which can make you more vulnerable to symptoms including a stuffy nose, cough and sore throat.

The upside to even the nastiest cold symptoms is knowing your baby isn’t experiencing any of them. In fact, the womb’s environment keeps baby completely sheltered from cold bugs.

As for you, colds are mostly an uncomfortable annoyance best managed with rest, fluids, patience and a quick call to your practitioner to make sure he or she is aware of all your symptoms, including any fever. If necessary, your doctor can also steer you towards cold medications that are considered safe during pregnancy. Here’s what you need to know to feel better.

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
• Sneezing
• Mild fatigue
• A dry cough, particularly near the cold’s end, which may continue for a week or more after other symptoms have subsided
• Low-grade fever (usually under 100 degrees Fahrenheit)

What causes colds during pregnancy?

Colds are most commonly caused by a type of virus known as a rhinovirus, which is easily passed from person to person. There are 200 or more cold viruses, which is why may get them frequently.

How long does a cold during pregnancy last?

Cold symptoms generally last 10 to 14 days. And yes, sorry to say, you can get a brand new cold just as the last one is ending, so if it feels like you always have the sniffles, you may be right.

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However, if your symptoms persist past 10 to 14 days, or seem to be getting progressively worse, let your practitioner know. He or she will want to make sure your never-ending cold isn’t evolving into something more serious, like COVID-19 or the flu.

Is it a cold — or the flu?

You can usually tell the difference between a cold and the flu by taking stock of the symptoms:

• A cold, even a bad one, is milder than the flu. Its symptoms come on gradually, and there’s usually little to no fever. The sore throat that usually starts off the cold goes away after a day or two, leaving the runny nose and cough as the main symptoms.
• Influenza, aka the flu, is more severe and comes on more suddenly than a cold. Symptoms of the flu include a high fever (usually 101 degrees F to 104 degrees F or higher), headache, chills, a sore throat that generally worsens by the second or third day (unlike with a cold), often intense muscle soreness, and general weakness and fatigue, which can last a couple of weeks or longer. You may also experience occasional sneezing and a cough that can become severe.

COVID-19 symptoms — including fever, cough, chills and fatigue — can mimic those of the cold and flu. If you’re sick with COVID-19 or think you may have COVID-19, stay home and call your doctor for next steps.

What can you do to feel better if you get a cold during pregnancy?

Although many of the medications that relieve cold symptoms are typically off-limits during pregnancy, you don’t have to suffer with a runny nose and hacking cough when you’re pregnant. Some of the most effective cold remedies don’t come from the pharmacy shelf. Here's how to feel better faster:

• Rest. Taking a cold to bed doesn’t necessarily shorten its duration, but if your body is begging for some rest, be sure to listen.
• Stay active. If you’re not running a fever or coughing and you feel up to it, do some light to moderate, pregnancy-safe exercise, which may actually help you feel better faster.
• Keep eating. Sure, you probably don’t have much of an appetite, but eating as healthy a diet as possible when you do feel up to it can help with some of your cold symptoms.
• Focus on foods with vitamin C. They can help boost your immune system naturally. Try all types of citrus fruits (oranges, tangerines, grapefruit), strawberries, melon, kiwi, mango, tomatoes, bell peppers, papaya, broccoli, red cabbage and spinach.
• Chow down on more zinc. It may also help boost the immune system; pregnant women should aim to get 11-15 milligrams each day from all sources, including your prenatal vitamin. Fill up on turkey, beef, pork, cooked oysters, eggs, yogurt, wheat germ and oatmeal.
• Drink up. Fever, sneezes and a runny nose will cause your body to lose fluids that you and your baby need. Warm beverages will be particularly soothing, so keep a thermos of a hot drink like ginger tea or a hot soup like chicken broth next to your bed. Try to drink enough to stay well hydrated too — your urine should be the color of pale straw. Water and cold juices also work fine, if that’s what you’re thirsting for.
• Supplement safely. Taking your prenatal vitamin, which contains vitamin C and zinc, is smart even when you’re fighting a cold. Just don’t take any other supplements beyond your prenatal without your doctor’s approval.
• Sleep easy. Breathe easier when you’re lying down or sleeping by elevating your head with a couple of pillows. Nasal strips, which gently pull your nasal passages open, making breathing easier, may also help. They’re sold over the counter and are completely drug-free.
• Moisturize your air. If dry conditions in your home aggravate your sensitive nasal passages and throat, misting the room with a cold or warm air humidifier at night can help. Adults can use either kind, but for safety’s sake, don’t ever use a warm-air version in a baby’s or toddler's room.
• Use saline nose drops, sprays or rinses. These help moisten your nasal passages; since they’re un-medicated, they’re completely safe to use as often as you need. Just avoid neti pots, since they’re more apt to spread germs.
• Gargle with saltwater. Gargling with warm salt water (1/4 teaspoon of salt to 8 ounces of warm water) can ease a scratchy or sore throat, wash away post nasal drip and help control a cough.
• Eat honey. A couple of teaspoons straight — or mixed in hot water with lemon — has been shown to help suppress the kind of dry cough that often comes with and after a cold at least as effectively as an OTC cough syrup.

What can pregnant women take for a cold? Safe medications for colds during pregnancy

Before you reach for anything in your medicine cabinet when you’re in bed with a cold, reach for the phone to call your practitioner so you can ask which remedies are considered safe in pregnancy, as well as which will work best in your case.

Be sure to double-check any prescription or OTC medication or supplement recommended by a different health care provider, such as a therapist, nutritionist or pharmacist, with your practitioner to make sure it’s safe. And watch out for multi-tasking meds, like general pain relievers, which could contain ingredients that aren’t cleared for pregnant women. Some remedies you’re used to taking may not be safe during pregnancy.

So what cold medications are generally considered safe during pregnancy? Here's a list:

• Acetaminophen: If you're running a fever or suffering from nasty body aches or headaches, it's generally considered safe to take products containing acetaminophen (like Tylenol) over the short-term.
• Cough medications: Expectorants (like Mucinex), cough suppressants (such as Robitussin or Vicks Formula 44), vapor rubs (like Vicks Vapo Rub) as well as most cough drops are considered safe during pregnancy, but ask your practitioner about dosing.
• Some nasal sprays: Most steroid-containing nasal sprays are fine to use during pregnancy, but check with your doctor about brands and dosing. Plain saline drops and sprays are always safe to take when you're expecting and can help clear and moisturize a stuffy nose.
• Some antihistamines: Benadryl and Claritin often get the green light during pregnancy, but be sure to check with your practitioner before taking them. Some doctors will advise staying away from those medications in the first trimester.

Always check with your practitioner before you take any medication — prescription, over the counter or homeopathic. And don’t put off calling the doctor or refuse to take a medication he or she prescribes because you think all drugs are harmful in pregnancy. Many are not. But do be sure the prescribing doctor knows you’re expecting.

COVID-19 symptoms — including fever, cough, chills and fatigue — can mimic those of the cold and flu. If you’re sick with COVID-19 or think you may have COVID-19, stay home and call your doctor for next steps.

Medications to avoid during pregnancy

Some of the medications that could help with cold symptoms are off-limits to moms-to-be because they may complicate pregnancy and cause harm to their unborn baby, although further research needs to be done. Don’t panic if you happened to inadvertently take one of these medications. It’s probably fine, but just let your doctor know. Off-limit meds include:

• Some pain relievers and fever reducers. Studies suggest an association between analgesics such as aspirin, ibuprofen (Motrin or Advil) and naproxen (Aleve), especially during the third trimester, and pregnancy complications, including low birth weight and preterm delivery.
• Most decongestants. Most practitioners say to stay clear of decongestants such as Claritin-D, Sudafed or DayQuil. Even those experts who say it’s okay to take some decongestants will probably caution that they're only safe to use after the first trimester, and only in a limited amount (for example, once or twice daily for no more than a day or two).
• Some nasal sprays. Steer clear of non-steroidal nasal decongestant sprays containing oxymetazoline (like Afrin) unless given the green light by your practitioner. Many will tell you to avoid these sprays completely while you're expecting, while others will advise only limited use (one or two days at a time) after the first trimester.
• Alternative or homeopathic remedies. Don’t take echinacea, supplemental vitamins like zinc supplements or other over-the-counter herbal remedies without medical approval.

How to prevent a cold during pregnancy

Besides avoiding anyone who is visibly sick, wash your hands with soap and water a little more often — and scrupulously — than you did before. Don’t just wash and shake; use a towel to make sure your hands are completely dry when you’re done. In a pinch, carry an alcohol gel with 60 percent alcohol on the label for quick sanitizing on the go.

But don’t blame yourself if you still come down with a cold — or several — during your pregnancy, despite your best efforts. Viruses are almost impossible to avoid, especially in the winter. There are many joys of being pregnant, but alas, being even more vulnerable to nasty cold bugs isn’t one of them. And just remember: This, too, shall pass.

When to see a doctor

Call your doctor if:

• You have a fever over 101 degrees F
• Your cold is severe enough to interfere with eating or sleeping
• You’re coughing up greenish or yellowish mucus
• You have a cough with chest pain or wheezing
• Your sinuses are throbbing
• If symptoms last more than 10 to 14 days; it’s possible that your cold has progressed to a secondary infection, and a prescription medication may be needed for your safety and your baby’s

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

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