Thursday, April 27, 2023

Which Mucinex Products Are Safe During Pregnancy? Doctors Weigh In


The only thing worse than catching a bad cold and having one of those awful phlegmy coughs for weeks afterward, is doing it all while you’re pregnant. If you’ve taken some Tylenol for your body aches and now it’s time to address the cough, you’ll want to know exactly which cold medicines are considered safe to take during pregnancy. If you typically reach for the Mucinex right about now, there’s a lot you need to know before it goes down the hatch. That’s because, depending on which type of Mucinex you have, it could be totally safe to take during pregnancy, or totally not.

The following Mucinex products are safe to take during pregnancy, according to doctors:

  • Mucinex and generic of Mucinex
  • Mucinex DM (does not contain pseudoephedrine)

The following Mucinex products should not be taken during pregnancy.

  • Mucinex D (contains pseudoephedrine)
  • Mucinex Sinus Max (contains phenylephrine)

Taking Mucinex while pregnant

If your cough just won’t quit, OB-GYNs say you can get relief worry-free by taking Mucinex. “Mucinex and the generic of Mucinex are definitely safe in pregnancy,” says Dr. Clayton Alfonso, MD, board-certified OB-GYN at Duke Health.

“I think it’s one of the best things to take for anybody with cough or cold symptoms,” says Dr. Deepti Sharma, MD, board-certified OB-GYN at UAB Medicine. “It works really well, so I highly recommend this one. It’s usually my go-to.”

That said, it’s still best to check with your own OB-GYN before taking any medications during your pregnancy, just to be safe.

What Mucinex is used for

Mucinex is meant to help clear all that mucous and phlegm from your airways. If you need some help with that very thing, even while pregnant, that’s an appropriate time to take the medication.

“Mucinex would be used to treat more cough and congestion-based illnesses. We talk about Claritin more for allergy relief. Mucinex would be more for [when] you’ve got the common cold, you’ve got some sort of cough, and you need to suppress your cough. Mucinex would be a great consideration in pregnancy specifically for that,” Alfonso says.

Taking guaifenesin while pregnant

Guaifenesin is the generic name for Mucinex. If you’re Googling Mucinex’s safety during pregnancy, you’ll probably read some recommendations to avoid taking it in the first trimester. They cite the American Academy of Family Physicians (AAFP), which states there isn’t enough data about guaifenesin to deem it 100% safe in pregnancy.

“Few studies have addressed the safety of using cough medications during pregnancy,” says an AAFP resource for providers. “The expectorant guaifenesin has been weakly associated with neural tube defects and inguinal hernias. However, the evidence is not sufficient to determine its safety in pregnancy. It may be prudent to avoid this medication in the first trimester unless the potential benefits outweigh the risks.”

This assertion from the AAFP dates back to 2014. However, as of 2021, the National Library of Medicine states: “Every pregnancy starts out with a 3 to 5% chance of having a birth defect. This is called the background risk. Most studies suggest that guaifenesin is not associated with an increased risk of birth defects over background risk.”

For their part, both Sharma and Alfonso expressed no concerns over using Mucinex or its generic form guaifenesin during any trimester. “I’ve not seen any guaifenesin issues in the first trimester in the medical literature that I’m aware of. We typically use it throughout all of pregnancy,” Alfonso says.

How much Mucinex is safe to take while pregnant

Wondering if you can take the amount listed on the back of the bottle? Both OB-GYNs agree that, pregnant or not, you can follow the dosing guide on the product’s label.

“I’d recommend taking it as labeled. The typical dosing is going to be about 200 milligrams every four hours, and you’re not supposed to exceed a dose of 2,400 milligrams daily,” Sharma says. “We overall consider it to be safe in pregnancy at the normal dosing. Again, anything with alcohol we would recommend avoiding.”

“You would just follow the instructions that are on the over-the-counter package label,” Alfonso says.

As for any risks associated with taking Mucinex while pregnant, both Sharma and Alfonso said none have been documented. “In standard over-the-counter doses we don’t have an issue, and typically I think when you read the product label it even tells you only use it for a few days. So, you shouldn't be using it chronically. If you’re using it chronically, we need to figure out what’s going on,” says Alfonso.

Are other Mucinex products safe to take during pregnancy?

When it comes to medications that combine multiple active ingredients, most OB-GYNs will steer pregnant patients back to the original, simple form. That’s because sometimes those added ingredients aren’t safe in pregnancy.

“I usually just recommend plain Mucinex, or the generic, which is guaifenesin,” Sharma says.

“You have to look at what the label says is contained in that specific medication,” says Alfonso. “When you look at Mucinex, that is guaifenesin, and we know guaifenesin is safe.”

Here’s what Alfonso had to say about Mucinex’s other cough and cold products.

Taking Mucinex D while pregnant

“When you look at Mucinex D, that is a pseudoephedrine medicine that we don’t like. Mucinex D you would want to avoid in the first trimester and then use sparingly in the second and third trimester, but it’s only known to cause issues potentially and super rarely in the first trimester,” Alfonso says. “It’s important when patients are looking at the product labels of a lot of these sinus and cough and cold medicines to really look at what are the generic names of the products and trying to avoid ones with pseudoephedrine.”

Taking Mucinex DM while pregnant

Mucinex DM has a medicine called dextromethorphan; dextromethorphan is OK in pregnancy,” says Alfonso. “Mucinex DM is OK because it doesn’t have the pseudoephedrine, but I would avoid Mucinex D that does have the pseudoephedrine.”

Taking Mucinex Sinus Max while pregnant

“That would be one where, in the Mucinex Sinus Max, the acetaminophen is safe, the guaifenesin is safe, but the phenylephrine you probably would want to avoid.”

Alfonso recommends avoiding any medications that include phenylephrine, a common ingredient in nasal decongestants. “It’s been shown that it can sometimes increase patients’ blood pressure. Especially in patients with known high blood pressure in pregnancy, you definitely would want to avoid it, and I would probably recommend avoiding that medication in the first trimester as things are quickly developing.”

Cough and cold symptoms can take a few weeks to go away, but if you’re still feeling crummy after giving this bug some time to run its course, be sure to visit your doctor. They can help make sure your body is handling things as it should. In the meantime, drink some tea for your sore throat and cozy up with a good show while you rest.

Sources:

Dr. Clayton Alfonso, MD, board-certified OB-GYN at Duke Health

Dr. Deepti Sharma, MD, board-certified OB-GYN at UAB Medicine


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