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  • Cough

    Dr. Hale,
    I am 16.5 weeks pregnant and I have a horrible cold. I am coughing constantly especially when laying down to sleep. I have tried the OTC cough medicine, dextromethorphan, but it hasnt proven to be effective for this cough. Is there anything that I can take for the cough that is both effective and safe? I looked back at past posts in the forum and it looks like you recommended codeine as both safe and effective. Is this still the case? Thank you so much for your help.
    Last edited by Walla158; 01-24-2019, 06:42 AM.

  • #2

    Codeine is probably ok for short term use, especially in the 2nd trimester. It is rated a P3-Unknown-risk to fetus cannot be ruled out. "Codeine is an opioid analgesic used for mild to moderate pain relief and as an antitussive agent.[1] There does not appear to be an increase in the risk of congenital malformations but when given near term can cause neonatal withdrawal and CNS depression in the neonate.[2-5] There have been some reports in human studies regarding the use of codeine during pregnancy and the development of cleft palate, hydrocephaly, cardiac defects, pyloric stenosis, umbilical hernia, and respiratory tract problems. So far, none of these proposed effects of codeine in pregnancy have been confirmed.[6,7,8,9] It is unlikely that the fetus will be affected if codeine is given soon before delivery or after time has been allowed to pass since the administration.[10]" (Medications and Mothers' Milk database, Dr Thomas Hale PhD).

    1.##Kastrup E. Drug Facts and Comparisons 2010: Wolters Kluwer Health; 2010.
    2.##Briggs G, Freeman, R., and Yaffe, S. Drugs in Pregancy and Lactation. Vol Seventh Ed. Philadelphia PA: Lippincott, Williams, and Wilkins; 2005.
    3.##Khan K, Chang J. Neonatal abstinence syndrome due to codeine. Arch Dis Child Fetal Neonatal Ed. Jan 1997;76(1):F59-60.
    4.##Koren G. Medication Safety in Pregnancy and Breastfeeding. McGraw-Hill. Accessed June, 23, 2010, 2007.
    5.##Shaw GM, Todoroff K, Velie EM, Lammer EJ. Maternal illness, including fever and medication use as risk factors for neural tube defects. Teratology. Jan 1998;57(1):1-7.
    6.##Bracken MB & Holford TR: Exposure to prescribed drugs in pregnancy and association with congenital malformations. Obstet Gynecol 1981; 58:336-344.
    7.##Rothman KJ, Fyler DC, Goldblatt A, et al: Exogenous hormones and other drug exposures of children with congenital heart disease. Am J Epidemiol 1979; 109:433-439.
    8.##Saxen I: Associations between oral clefts and drugs taken during pregnancy. Int J Epidemiol 1975; 4:37-44.
    9.##Heinonen OP, Slone D, & Shapiro SHeinonen OP, Slone D, & Shapiro S: Birth Defects and Drugs in Pregnancy, Publishing Sciences Group, Inc, Littleton, MA, 1977.
    10.##Herschel M, Khoshnood B, & Lass NA: Role of naloxone in newborn resuscitation. Pediatrics 2000; 106:831-835.

    Sandra Lovato R.N.
    InfantRisk Center