Version May 2024
| Agent | Effect in randomly controlled trial (not pregnant) | Pregnancy data |
| Rhinorrhea, sneezing, throat pain | ||
| Ipratropium bromide 0.06% nasal spray | Mild improvement in rhinorrhea and sneezing | It is presumed that the agent can be used nasally in pregnancy because of the small systemic absorption and reassuring animal data. |
| Cromolyn sodium* aqueous nasal spray (5.2 mg per spray) or Cromolyn sodium* as dry powder (20 mg per inhalation in spincaps). Note: Not available in the United States. Other cromolyn inhalation preparations*: solution for nebulization 20 mg/2 mL (available in United States) and metered dose inhaler (MDI) 5 mg/puff (not available in United States) | Mildly shortens the duration and severity of cold symptoms including sneezing and sore throat | Less than 10% of an inhaled dose of cromolyn is believed to be absorbed systemically. Animal data are reassuring. The published data with respect to the use of this agent to treat asthma in pregnancy are very reassuring. |
| Saline nasal irrigation or spray | Buffered normal and hypertonic saline irrigation or spray modestly improve symptoms of rhinitis and chronic rhinosinusitis Benefit in acute URI not established | Systemic absorption is expected to be low with proper use. The published data with respect to the use of this agent to treat chronic rhinosinusitis and pregnancy rhinitis is very reassuring. |
| Anesthetic lozenges or sprays | Small studies of benzocaine or lidocaine lozenges and sprays demonstrate benefit in relief of sore throat pain Data are lacking for most other over-the-counter preparations such as dyclonine and phenol lozenges and sprays | Systemic absorption of lidocaine and benzocaine occurs via mucous membranes of oral cavity. Over-the-counter anesthetic lozenges and sprays (dyclonine, phenol): Fetal harm appears to be unlikely when used appropriately. Limited data from a study in rats and two epidemiologic studies in humans did not show an increased risk of teratogenesis from use of throat lozenges made from cetylpyridinium chloride (eg, Cepacol). Since human and animal data are lacking for most agents, we prefer acetaminophen based upon availability of pregnancy safety data. |
| Antipyretics and simple analgesics | ||
| Acetaminophen | Antipyretic and symptomatic relief of associated myalgias, headaches and sore throat | Extensive animal data and population-based studies are very reassuring regarding the safety of this agent in pregnancy. It is the antipyretic of choice during pregnancy¶. |
| Nonsteroidal anti-inflammatory drugs (NSAIDs) | Reductions in headache, malaise, myalgia with a 29% reduction in the total (5-day) symptom score. Has no effect on nasal symptoms. | NSAID exposure during the first trimester is not strongly associated with congenital malformations; however, cardiovascular anomalies, cleft palate, and gastroschisis have been observed following NSAID exposure in some studies. The absolute risk appears to be low. The use of an NSAID close to conception may be associated with an increased risk of miscarriage. When used in the third trimester, NSAIDs have been associated with oligohydramnios, pulmonary hypertension, intracranial hemorrhage, and necrotizing enterocolitis in infants. We recommend restricting NSAID use to specific indications in which the internist/subspecialist and obstetrician agree that maternal benefit outweighs fetal risk. NSAID use in pregnancy is not appropriate for the treatment of common cold symptoms. Acetaminophen will offer similar relief in this setting without placing the fetus at increased risk. |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
