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Can you take Sudafed while pregnant?

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Here’s everything you need to know about Sudafed while pregnant, plus other health and pregnancy tips for the first time mom!

Pregnancy is a tough time for the first time mom, and if you add sickness on top of it, it can become overwhelming. Your immune system takes a hit during pregnancy so it’s especially important to know what medications are safe to take.

Every food, beverage, and medication you put into your body can each have an effect on your unborn child. You should only consume items that are proven safe and are well-tested.

So, what do you do when those seasonal allergies kick in or cold and flu season hits?

Don’t panic. There are lots of approved medications for pregnant women that can bring you much-needed relief. Depending on your symptoms, you’ll want to research the best options that maximize results for you and minimize harm to your growing child.

If you’re suffering from a runny nose, sinus pressure, or upper respiratory allergies, you may think to reach for Sudafed. But is it safe?

Note: If you are in your first trimester, Sudafed is not considered safe. This is explained in detail below.

Sick pregnant woman cradles belly and holds tissue under nose with pained expression.

What is Sudafed?

Sudafed is the brand name for pseudoephedrine which is a nasal decongestant used to help relieve sinus pressure and increase airflow while a person is sick. It works by constricting blood vessels in a stuffy nose. As a result, the surrounding tissues shrink to allow normal mucus and airflow.

Sudafed is typically sold as a combination product with other active ingredients like:

  • Acetaminophen – Helps to relieve pain and headaches, and reduces fever
  • Dextromethorphan – Relieves cough caused by minor throat and bronchial irritation
  • Guaifenesin – Loosens mucus and thins bronchial secretions for more productive coughs
  • Naproxen sodium – Helps to relieve pain and headaches, and reduces fever

If you can, find formulas made for your specific symptoms. Avoid multi-symptom and combination products where possible, especially those that include acetaminophen. It’s very easy to exceed the daily recommended dose of acetaminophen if you’re not careful.

If you do purchase a combination drug, make sure all the ingredients are considered safe for pregnancy. And check that you don’t have any history of adverse side effects or allergies.

NOTE: Pseudoephedrine is often used to manufacture methamphetamine (meth), so it’s likely not offered over the counter at your pharmacy. You may need to provide identification to purchase it, and stores may track how often you buy it. The highest dose of a typical decongestant is 240 mg in 24 hours.

Is Sudafed safe for pregnant women?

Pregnant woman holds several opened medication blister sheets while sitting cross-legged with a box of tissues.

Generally, yes!

Pseudoephedrine and phenylephrine (the generic names for Sudafed) are safe for most pregnant women. But, you should avoid use during the first trimester of pregnancy and later when breastfeeding. Taking decongestants in early pregnancy can lead to a higher risk of birth defects.

For example, an unborn child is 8 times more likely to develop a heart defect, called endocardial cushion defect, when the mother uses phenylephrine in the first trimester.

The FDA lists Sudafed as a category C drug. This means it falls in the middle of recommended safety. This is based on the fact that there hasn’t been extensive research conducted on humans and/or animals. However, the benefits outweigh the risks when taken properly.

In the second and third trimesters, pregnant women can take Sudafed in the proper recommended dose with very little risk. The correct dosage is 30 to 60 mg every 4-6 hours as needed. And you should only take the immediate release form to minimize exposure to the developing fetus.

You should NOT take Sudafed PE (Phenylephidrine, not to be confused with Phenylephrine) as there is uncertainty regarding its effectiveness and safety during pregnancy.

If you have high blood pressure, you must consult with your health care provider before taking Sudafed while pregnant. It can cause certain adverse effects like the jitters and racing heartbeats.

It can also constrict blood vessels and blood flow which can be dangerous for someone with this condition. (And, it’s always a good idea to clear any new medication with your doctor beforehand just to be safe).

What other medications besides Sudafed are safe while pregnant?

Woman holds several packages of medication in front of her pregnant belly.

Below are several medications to take as an alternative to Sudafed and to treat other illnesses and maladies while pregnant. These products are considered safe, but you should always check with your doctor before use.

Try natural remedies first like honey and salt water. If those don’t bring relief, move on to the next least invasive medication.

Sudafed Alternatives While Pregnant

If your doctor recommends against Sudafed while pregnant, here are several other cold medications and oral decongestants to try. These can help with nasal congestion, sinus congestion, sore throat, and other cold symptoms. Get those nasal passages open and start feeling better with other options like:

  • Honey
  • Robitussin and Robitussin DM
  • Salt water (for gargling)
  • Nasal decongestant spray or drops
  • Tylenol
  • Vick’s VapoRub
  • Chloraseptic spray
  • Benzocaine lozenges or cough drops
  • Plain cough syrup

You can also use Tylenol to help with pregnancy symptoms like pregnancy headaches, morning sickness or nausea, and pregnancy cramps.

Safe Allergy Medications

Pregnancy allergies are no joke. Here are some safe medicines and nasal sprays, according to Advanced Women’s Healthcare. However, please note that antihistamines should be avoided during the third trimester. These can cause uterine contractions and preterm labor.

Safe allergy medications:

  • Zyrtec
  • Chlor-Trimeton
  • Benadryl
  • Allegra
  • Claritin
  • Nasalcrom
  • Rhinocort

Pay attention to your allergy medication label. Medications like Benadryl can cause drowsiness, so it’s best to take those medications right before bed.

If you started allergy shots before pregnancy you may be able to continue treatments. Your doctor will make the proper recommendation. But you should not start shots during pregnancy.

Safe Heartburn, Gas and Stomach Remedies

Woman sitting on couch holds her pregnant belly while wincing from stomach pain.

Heartburn and gas frequently occur during pregnancy, and you may experience painful constipation or uncomfortable diarrhea. Here are some safe options to get relief.

You should also avoid any foods or drinks you think may be contributing to excess gas and increased heartburn episodes. And be sure to learn the important known foods to avoid during pregnancy, too!

Safe heartburn and gas medications:

  • Gas-X
  • Famotidine (Pepcid)
  • Ranitidine (Zantac)
  • Sucralfate (Carafate)
  • Maalox Anti-Gas
  • Mylanta Gas
  • Mylicon
  • Simethicone
  • Maalox
  • Mylanta
  • Rolaids
  • Tums
  • Gaviscon 

Safe Medications for Constipation:

  • Psyllium
  • Metamucil, Citracel, Fibercon, Benefiber 
  • Pericolace (Docusate + Sennosides), 1 tablet 1-3 times a day
  • Colace
  • Milk of Magnesia, Correctal, Fleets enema and Miralax

For diarrhea:

  • Imodium liquid or capsules

When should I be concerned while taking Sudafed?

Pregnant woman with blanket over back blows her nose and checks temperature.

If you experience adverse reactions to Sudafed while pregnant or any other medication, reach out to your doctor right away. They’ll confirm any dangerous underlying issues or new health risks to manage.

Pay attention to symptoms like a rapid heartbeat that won’t subside, feeling faint, blurry vision, lightheadedness, or high fever. Seek medical care as soon as possible if these occur.

If you can’t make it into your doctor’s office, you can also reach out to a nurse’s hotline or schedule an online doctor’s visit. These can be incredibly handy for immediate needs and are typically offered and/or covered through your health insurance.

Below are frequently asked questions to address additional concerns.

FAQs

What kind of Sudafed can I take while pregnant?

Sudafed (Pseudoephedrine and Phenylephrine) are safe in the proper and recommended dose during the second and third trimesters.

Sudafed PE (Phenylephidrine, not to be confused with Phenylephrine) should be avoided. There isn’t enough information on taking this form of Sudafed while pregnant so it cannot be cleared as safe or effective.

What if I took Sudafed PE while pregnant?

If you took Sudafed PE while pregnant, stop use right away and call your doctor. Your doctor may want to perform extra checks and screenings to monitor your baby’s development and rule out any adverse effects.

While these drugs can increase the risk of birth defects, it’s not a guarantee that your child will be negatively affected. Try to keep calm and seek further advice and guidance from your healthcare provider.

Does taking Sudafed increase the risk of miscarriage?


Unfortunately, there is a risk of miscarriage in any pregnancy. Currently, there are no studies looking at whether pseudoephedrine increases the risk of miscarriage in pregnancy.

Does taking Sudafed in the second and third trimesters cause any other pregnancy complications?


Pseudoephedrine can constrict blood vessels which may cause high blood pressure in some pregnant patients. If you’re at risk for pre-eclampsia or gestational hypertension, you will want to discuss this with your health care provider.

Can I take Sudafed while breastfeeding?


While Sudafed does pass into the breast milk, the American Academy of Pediatrics has said it’s likely safe to take Sudafed while breastfeeding.

But a small study found that babies can be more irritable after nursing from a mother who’s taken Sudafed. The medication can also lower your milk supply. Either way, you’ll want to carefully monitor how your baby and milk production responds to you taking pseudoephedrine and speak with a health care provider if you have any concerns.

The Bottom Line

Sick pregnant woman rests hand on belly and blows her nose while sitting on couch.

If you’re sick and pregnant, there are lots of options out there that can bring you relief. You can add Sudafed to your list. Just keep your doctor in the loop and get the okay before starting something new. This is especially true if you’re using a combination of products. Mixing medications can be risky, so keep a keen eye on that.

Just like most adverse pregnancy symptoms, your pregnancy sickness won’t last forever. Take safe medications, get plenty of fluids and lots of rest and it will be over before you know it.

Here’s the bottom line:

  • Sudafed is generally safe during the second trimester and third trimester.
  • Avoid Sudafed or speak to your healthcare provider if you have high blood pressure.
  • Take only the recommended dose.
  • Seek medical care if you experience any adverse effects.

Want More?

There’s a lot to take in as a new mother! Here are some other helpful resources to add to your arsenal. Along with advice from your doctor or midwife, try these helpful pregnancy tips for:

Your Turn

Did you learn anything new about taking Sudafed while pregnant? Anything you think I should add? Let me know in the comments!

Pinterest graphic with text and sick women in need of Sudafed while pregnant.