Pseudoephedrine (Sudafed) In Pregnancy: Is It Safe?

Pseudoephedrine is an over-the-counter (OTC) medication used for symptomatic relief from sinus congestion and pressure and nasal congestion arising from upper airway allergies, hay fever, or the common cold sinus congestion. You should consult a doctor before taking pseudoephedrine in pregnancy. It is sold under the brand name Sudafed and is available in pharmacies without a prescription, and may also be included as one of the ingredients of OTC nasal decongestants. Read on as we tell you whether or not pseudoephedrine is safe during pregnancy, its possible risks, and side effects (1) (2).

Is It Safe To Take Pseudoephedrine During Pregnancy?

Pseudoephedrine is classified as a pregnancy category B drug by the US Food and Drug Administration (USFDA). It means animal studies showed no risk to the fetus but there are no well-controlled studies on pregnant women.

• A cover article titled “Over-the-Counter Medications in Pregnancy,” says that the use of pseudoephedrine during the first trimester may be associated with gastroschisis, a condition where elevated blood pressure causes vasoconstriction in the uterine arteries and affects the blood flow to the fetus. This theory is debatable as some evidence suggests that the effect is negligible at typical doses (3).

• Studies using pharmaceutical data stated that the use of decongestant in the first trimester is associated with a small increase in the risk of defects such as gastroschisis, small intestinal atresia, and hemifacial microsomia. However, these findings are inconsistent in magnitude, and the results could be influenced by the exposure to vasoconstrictive agents such as cigarette smoking (4).

Your doctor might prefer to prescribe other safer choices such as chlorpheniramine and tripelennamine (3). So, always consult your doctor before taking pseudoephedrine during pregnancy.

What Are The Possible Risks Of Taking Pseudoephedrine During Pregnancy?

Image: Shutterstock

In addition to the probable risk of gastroschisis (when used during the first trimester), the use of pseudoephedrine is associated with other risks such as a raise in blood pressure due to its vasoconstricting property. Hence women with high blood pressure should not take this medication unless the doctor prescribes it (5).

Do not take pseudoephedrine within two weeks of taking monoamine oxidase inhibitor (MAO Inhibitor) antidepressants such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, etc., to avoid a possible drug interactions (6).

What Is The Recommended Dosage Of Pseudoephedrine During Pregnancy?

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The recommended doses of 30-60 mg of pseudoephedrine every 4-6 hours in the second and third trimesters could be used for pregnant women who do not have hypertension (7). However, your dosage might be different from the recommended dosage. Therefore, you should follow the dosage prescribed by your doctor.

What Are The Side Effects Of Pseudoephedrine During Pregnancy?

Decongestants might have the following side effects (8):

• Drowsiness or sleepiness
• Irritation in the lining of the nose

Image: Shutterstock

• Headaches
• Dry mouth
• Restlessness

Infographic: Side Effects Of Pseudoephedrine During Pregnancy

While pseudoephedrine is an effective OTC decongestant, you must take caution when taking this medication during pregnancy. Although the potential side effects of pseudoephedrine may not harm the baby, it can cause discomfort and put the pregnant woman at risk of injury. See the infographic below to learn more about the potential side effects of this drug.

References:

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Dr. Anita Gondy

(MD, FACOG)

Dr. Anita Gondy is an Ob/Gyn at The Ob-Gyn Center in Las Vegas. In practice since 1998, Dr. Gondy began her medical training at Rangaraya Medical College in Kakinada, India and completed studies at the University of Nevada School of Medicine, where she also did an obstetrics and gynecology residency. She is also a Fellow member of The American College...
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shreeja pillai

(MSc)

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer of more than two years experience, she aims...
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