Is it Safe To Take Sudafed During Pregnancy?

What is Sudafed (Pseudoephedrine)?

Pseudoephedrine, or Sudafed as it is popularly known, is a type of drug that specializes in treating colds, cough, flu symptoms, nasal congestion, sinusitis, and other similar medical conditions. One reason it is so popular is that it is known to be a medication that is safe enough to be used by pregnant women.

Sudafed, although considered safe during pregnancy, must be avoided in the first trimester, as this is the time that basic physical development takes place. It is a lot safer to take during the second and most especially on the third trimester when the baby is a lot more developed.

Although it’s safe to take Sudafed while pregnant but the dosage have to be controlled. If needed during the second or third trimesters, Sudafed can be taken in 30-60mg dosages every 4-6 hours for women without hypertension or high blood pressure.

Related: Is it safe to take Mucinex during pregnancy?

FDA Pregnancy Category for Sudafed

Although taking Sudafed during pregnancy is deem safe by many doctors, but the Food and Drug Authority (FDA), has labeled Sudafed to be a Category C drug. This means that it can be harmful to a growing fetus because it can easily pass through the placenta. However, there is no proven study or research to support this effect, especially in human beings.

The FDA has labeled Sudafed to be a Category C drug. #KnowYourPregnancyDrugs

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For more information about FDA category, watch this short video…

Recommended Dosage of Sudafed During Pregnancy


The appropriate dosage for pregnant women when they find the need to take Sudafed is usually 30 to 60 mg. But just like most medicines and supplements for pregnant women, it is highly recommended to seek the advice of a doctor to make sure that the mom and the fetus are kept safe from adverse effects.

Risks of Taking Sudafed While Pregnant

Use in the first trimester

There are risks in taking Sudafed when you are pregnant. In the first trimester, the drug can possibly constrict blood vessels and cause the uterine blood flow to slow down. Several health maintenance organizations have conducted research on this and only 9 babies out of 902 have acquired any physical malfunction.

Decongestants and risks to the fetus

The use of any type of decongestant, like what Sudafed is, is dangerous to the first stages of pregnancy. However, certain studies have been done on several pregnant women who have taken Sudafed, either in the first or last trimester, and there were was no increase on the rate of babies born with defects.

Risk of Gastroschisis


Source: Cardinal Glennon

There is also a risk that babies may be born with a condition called Gastroschisis wherein their abdominal wall fail to develop, thus, the intestines are left hanging outside of the body.

Gastroschisis have been associated with other problems such as pre-term birth, cardiac problems and intrauterine growth restriction. In gastroschisis, the bowel floats freely with the amniotic fluid instead of being contained, and as such, the bowel may become seriously damaged.

Gastroschisis is a serious congenital abnormality requiring surgery. The risk of gastroschisis is higher when pregnant women take Sudafed in the early or first trimester of their pregnancy.

Taking Sudafed vs Sudafed PE During Pregnancy


Both drugs, Sudafed and Sudafed PE are used for treating symptoms of cold, flu, congestion and blocked nose. Although bearing similar trade names, their generic names are different as Sudafed is pseudoephedrine, while the active ingredient in Sudafed PE is phenylephrine.

Sudafed PE is categorized under the Pregnancy Category C status (i.e Risk cannot be ruled out) by the FDA due to lack of research based evidence regarding its potential ill effects.

Sudafed While Breastfeeding


As the results vary in pregnant women, it also does in breastfeeding mothers. The drug can be passed through the milk; however, the American Academy of Pediatrics (AAP) says it is safe and harmless.

Studies, however, show that milk volume may be lessened and babies may become irritable. Hence, for breastfeeding mothers, it is best to avoid Sudafed whenever possible.

A research done on 8 mothers whom took pseudoephedrine and the effect on breast milk production and found out that there are indeed decrease in milk production after taking 60mg of pseudoephedrine. However the study did not provide enough statistical evident that pseudoephedrine is the one to be blame.

Before Taking This Medicine


When a woman gets pregnant, everything that enters her system must now be taken with caution. All types of drugs, no matter how safe they say it is for an unborn child needs to be checked out first.

It is always advisable for pregnant women to consult their doctor immediately to ask if they should continue any vitamins or prescription drugs now that there is a little baby inside them. This way, doctors can consider if they should indeed stop or if the dosage needs to be reduced to make it a lot safer but still effective.

Pseudoephedrine or other decongestants are also contained in many combination medicines. Hence, taking certain medications together might result in you having too much of it in your system. It is always best to ask your doctor before using any cold or cough medicine. Pseudoephedrine is only recommended for use during pregnancy when benefit outweighs risk.

How Should I Take Pseudoephedrine?

Sudafed, if given the go signal by doctors, can be taken in a variety of ways during pregnancy. More often than not, the traditional way to take this drug is through oral syrups or tablets.

Oral syrups and tablets can be a lot more dangerous and higher risk so it is highly recommended to take it through nasal sprays especially when treating congestion. This way, only a small amount of the drug actually enters the system but it is still effective enough to ease the pregnant woman of any discomfort.

However, if prescribed Sudafed in tablet form by the doctor, swallow the tablet with a glass of water, WITHOUT chewing or crushing the tablet as that may cause too much of the drug to be released all at one go.

If given the oral syrup, shake it well and ensure you take the right dosage by measuring the liquid with a proper measuring spoon or cup, not our regular tablespoon.

Alternatively, women can opt for other type of safe drug that contains a hint of Sudafed to reduce the risk a lot more. In any case, DO NOT take pseudoephedrine for more than 7 days in a row and always store it away from heat and moisture.

What Other Drugs Will Affect Pseudoephedrine?

Sudafed may become a lot more dangerous when taken along with other drugs or substances. It should not be taken along with other drugs like diet pills, or those that contain caffeine, and other stimulant drugs because the risk of blood vessel constriction increases, although not an alarming level. Taking the drug and smoking are harmful together or separately.

However, Sudafed is a lot safer in appropriate portions as prescribed by a doctor. It is still best to seek the advice of the doctor to know exactly what it can be taken with and how it should be taken especially with pregnant women.

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Other Safe Medications to Take During Pregnancy

While it’s safe to take Sudafed while pregnant, the table below also contained other drugs that are deem to be safe for pregnancy. However, each pregnancy is different and sometime these drugs can have adverse effect to your pregnancy if taken without first consult with a doctor.


Safe Medications to Take During Pregnancy*


Antihistamines including:

​Chlorpheniramine (Chlor-Trimeton, Efidac, Teldrin)

​Diphenhydramine (Benadryl)

​Loratadine (Alavert, Claritin, Loradamed, Tavist ND Allergy)

Cold and Flu

Halls*, Robitussin, Romilar, Trind-DM, Vicks Cough Syrup

Saline nasal drops or spray

​Actifed, Dristan, Neosynephrine*, Sudafed

​Tylenol (acetaminophen) or Tylenol Cold

​Warm salt/water gargle

*Do not take "SA" (sustained action) forms or "Multi-Symptom" forms of these drugs.






​Milk of Magnesia



For 24 hours, only after 12 weeks of pregnancy:




First Aid Ointment


J & J



Tylenol (acetaminophen)










​Preparation H


​Witch hazel

Nausea and Vomiting


​Emetrol (if not diabetic)

​Sea bands

​Vitamin B6 (100 mg tablet)


Benadryl cream

​Caladryl lotion or cream

​Hydrocortisone cream or ointment

​Oatmeal bath (Aveeno)

Yeast Infection

Monistat or Terazol

Do not insert applicator too far

*Please Note: While all pregnancy is different, hence, no drug can be considered 100% safe to use during pregnancy. Best to always consult your doctor before taking any over-the-counter medicines. Source: WebMD.com

Here is a helpful video on which over-the-counter medications are safe to be taken during pregnancy…

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