Pseudoephedrine (Sudafed) In Pregnancy: Is It Safe?

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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 thefirst trimestermay be associated with gastroschisis, a condition where elevated blood pressure causesvasoconstrictionⁱXNarrowing of blood vessels impacting the blood circulation.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 intestinalatresiaⁱXA condition causing the partial or complete blockage of intestinal passages., andhemifacial microsomiaⁱXA congenital condition where a part on one side of the face is underdeveloped..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 other safer prescription drug choices such as chlorpheniramine and tripelennamine(3). So, always consult your doctor before taking pseudoephedrine during pregnancy.

Gynecologist and laparoscopic surgeonDr. Swati Chitnissays,“Levocetirizine and fexofenadine are alternatives to pseudoephedrine for pregnant women since they are not associated with increased risk of congenital abnormalities.”

What Are The Possible Risks Of Taking Pseudoephedrine During Pregnancy?

In addition to the probable risk of gastroschisis (when used during thefirst trimester), the use of pseudoephedrine is associated with other perinatal health risks such as a raise in blood pressure due to its vasoconstricting property. Hence women with high blood pressure should take the medication only when prescribed by a doctor and not opt for self-medication(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?

的recommended doses of 30-60 mg of pseudoephedrine every 4-6 hours in the second andthird trimesterscould be used for pregnant women who do not have hypertension(7).However,your dosage might be different from the recommended dosage.的refore, you should follow the dosage and the medication safety 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

• Headaches
• Dry mouth
• Restlessness

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