Guaifenesin Pregnancy Third Trimester

Is guaifenesin safe to take for a long time?

Guaifenesin is safe to take for a long time. It has been used in pregnant women for decades. The maximum daily dose of guaifenesin during pregnancy is 1200 mg, and most people can take that amount without any side effects.

Guaifenesin works by thinning the mucus produced by your lungs and airways so it’s easier to breathe when you’re sick. It’s especially helpful if you have congestion from allergies or colds, which are common during pregnancy. The main side effect of taking guaifenesin is a dry mouth—but this can be easily managed by drinking plenty of fluids like water or juice with meals!

When taking guaifenesin, it’s important not to take more than 1200 mg per day—this amount has been proven safe for pregnant women according to studies by the National Institutes of Health (NIH). Taking any more than this could cause serious harm because too much medication can affect levels of another drug needed by your baby inside the womb

what is the drug guaifenesin used for?

Guaifenesin is a cough suppressant. It’s used to treat coughs and colds by thinning the mucus in the lungs. It’s also used to treat chest congestion by thinning the mucus in the lungs.

Guaifenesin may also be used for purposes not listed in this medication guide.

Is it safe to take guaifenesin during the first trimester of pregnancy?

Guaifenesin is a safe medication that can be used during the first trimester of pregnancy. However, if you are allergic to guaifenesin or have asthma or COPD, it’s best to avoid using this medication during pregnancy.

guaifenesin pregnancy third trimester

guaifenesin pregnancy third trimester

In a persuasive tone:

You should know that guaifenesin pregnancy third trimester can cause harm to an unborn child.

Guaifenesin (Mucinex) is the expectorant typically found in most OTC cold medications. Its use appears to be safe during pregnancy, with the exception of the first trimester.9

Pain

Acetaminophen is the most commonly used OTC analgesic in pregnancy, with at least 65.5% of women taking it at some point during pregnancy and 54.2% taking it during the first trimester.12 The use of single-ingredient acetamino-phen products during pregnancy has not been associated with increased risk of a broad range of birth defects.13-15 Due to its antipyretic effects, single-ingredient acetaminophen products have been associated with a decreased risk of some birth defects arising from febrile infection during pregnancy.14

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided if possible during pregnancy. A recent study found that although the use of NSAIDs in early pregnancy does not appear to be a major risk factor for birth defects, there were a few moderate associations between NSAIDs and specific birth defects.16 Another major concern is the increased risk of miscarriage that has been associated with the use of nonaspirin NSAIDs during pregnancy.17 The use of NSAIDs during pregnancy is also associated with premature closure of the ductus arteriosus, fetal renal toxicity, and inhibition of labor.4,15,18 Although there are limited reproductive studies involving the use of narcotic analgesics in human pregnancies, these drugs have been used in therapeutic doses for many years by pregnant women without a link to an elevated risk of birth defects.15,19 The use of opioids should be reserved for pain that is not managed with acetaminophen and, when possible, the lowest effective dose should be used.15

GI Issues

The most common GI problems that occur during pregnancy include nausea, vomiting, acid reflux, diarrhea, and constipation. Drug therapy may be required when lifestyle modifications cannot provide adequate relief of symptoms.

While nausea and vomiting are common indicators of early pregnancy, an extreme manifestation of the condition is termed hyperemesis gravidarum. Severe hyperemesis gravidarum complications—including weight loss >5% of initial body weight, electrolyte imbalance, and dehydration— are the second most common reason for prenatal hospitalization.20 A variety of medications with different mechanisms of action that have been used to treat nausea and vomiting of pregnancy are listed in TABLE 3.20-22

Acid reflux is another common problem estimated to occur in 30% to 50% of all pregnancies.23 Due to the pressure on the uterus, acid reflux during pregnancy is less likely to respond to lifestyle modifications such as elevation of the head when sleeping, eating small frequent meals, or avoiding eating within 3 hours of bedtime.24 OTC antacids are considered the agents of first choice with the exception of magnesium trisilicate (Gaviscon) and sodium bicarbonate (Neut), which should be avoided during pregnancy. Long-term use of high-dose magnesium trisilicate has been associated with increased risk of fetal nephrolithiasis, hypotonia, and respiratory distress; sodium bicarbonate has been associated with metabolic acidosis and fluid overload.23 A variety of agents that have been used to treat acid reflex during pregnancy are listed in TABLE 3.20-22

Diarrhea and constipation are also frequent problems associated with pregnancy. TABLE 3 lists agents used to treat these conditions.20-22 Castor oil and mineral oil should be avoided for the treatment of constipation. Alosetron (Lotronex) is only indicated for irritable bowel syndrome (IBS)–associated diarrhea. Bismuth subsalicylate (Pepto-Bismol, Kaopectate) should be avoided in pregnancy because the salicylate moiety can lead to increased perinatal mortality.21

Immunizations

Women who are considering pregnancy or those already pregnant should be advised on the importance of receiving vaccines. Informing these patients of the benefits of receiving certain vaccinations can significantly reduce the occurrence of preventable diseases. With the many vaccines available, and pharmacists at the front lines as immunizers, it is important to discuss the agents utilized for specific groups of patients. The following are a few of the current recommendations for vaccine use during pregnancy.

The most current update to the immunization schedule was the recommendation to administer tetanus, diphtheria, and acellular pertussis (Tdap) vaccine with each pregnancy during the 27th to 36th week of gestation. This is different from prior recommendations that were dependent upon previous vaccination history. Waiting until the second trimester is reasonable to minimize concerns about possible adverse reactions.25 Healy et al concluded that the infants of mothers immunized either before their pregnancy, or in early gestation, displayed insufficient antibodies to aid in infant protection from disease.26 Furthermore, the antibodies that were transferred were lost within a 6-week period, which could possibly place the infant at risk of infection.26

Influenza vaccination should be recommended for all pregnant women for prevention of seasonal influenza and can be administered in any trimester. It is most beneficial when given as early as available in the flu season.27 The immunizations contraindicated during pregnancy are live vaccinations, which include influenza (LAIV); measles, mumps, and rubella (MMR); varicella; and zoster.25

Conclusion

Most women will take medications at some point during pregnancy. It is important to consider the risks and benefits of drug therapy to both mother and fetus. The decision to treat should be based on a number of factors, including the safety profile of the drugs in question, symptom severity, and potential for quality-of-life improvement.

Safe Cough Syrup in Pregnancy

Coughing

5 Common home remedies that can help your mild cough while pregnant.

A few home remedies may work on the mild cough if you do not want to start medications right away. These can be tried provided the symptoms are not very severe. These are as follows:

  • The use of humidifiers in the house can soothe the dry throat and relieve throat irritation.
  • Drinking hot tea with honey, having hot soups or broths, and sipping warm water with a pinch of turmeric may help relieve cough and chest congestion in many women.
  • Avoidance of smoking including second-hand smoke is an important tip to get better quickly.
  • Getting enough rest and drinking enough fluids throughout the day are important.
  • Medications

The following medications are considered safe for pregnant women:

  • Acetaminophen (paracetamol) can be safely taken twice a day for sore throat and headache due to cold and cough.
  • Antihistaminics can relieve the symptoms of a runny nose and an itchy throat in individuals having seasonal flu. Older antihistamines such as chlorpheniramine and cetirizine can be taken in prescribed doses by pregnant women. Newer antihistamines such as fexofenadine are not backed by enough studies; hence, it is better to avoid these.
  • Saline nasal irrigation or spray can be instilled in the nostrils to relieve nose block and clear the dried secretions. It may be used thrice a day.
  • The 0.06% ipratropium bromide nasal spray is very effective as two 42 mcg sprays in each nostril three to four times a day to relieve nasal congestion. Xylometazoline nasal drops may provide relief, but they often cause severe rebound nasal congestion; hence, it is better to avoid them.
  • Guaifenesin syrup is a cough expectorant that acts by increasing moisture in the respiratory tubes and improving phlegm removal by natural processes. At the standard over the counter (OTC) doses, guaifenesin syrup is generally considered acceptable for use in pregnancy. You must always check the label and avoid Guaifenesin products containing alcohol or propylene glycol that may be harmful to the fetus.
  • Decongestants such as Pseudoephedrine can relieve the congestion in the sinuses and the throat by narrowing the swollen blood vessels in the nose, throat, and sinuses. Pseudoephedrine should be avoided in the first trimester of pregnancy because of an increased risk of birth defects. In the next two trimesters (after the first 13 weeks), it is probably the preferred oral agent among oral decongestants because it is less likely to increase blood pressure than the other oral decongestants.
  • Steroid nasal sprays containing budesonide, beclomethasone, and fluticasone are preferred among the inhaled glucocorticoids to relieve the symptoms of sinusitis and a blocked nose.
  • Antibiotics may be needed in special cases when you have yellow- or greenish-colored sputum, wheezing, constant fever, and body ache. Antibiotics must always be taken after consultation with your doctor and in doses specified. Your doctor is the person to guide you regarding the most effective antibiotic, given your history and culprit organism. Many antibiotics are prohibited in pregnancy due to a high risk of birth defects, so always make sure your doctor is aware of your pregnancy.

How do I prevent getting a cough or cold during pregnancy?

Building a healthy immune system is the first step to prevent any infection during pregnancy. You must adopt and maintain a healthy lifestyle during your pregnancy. Eat clean, well-cooked food, and make sure you maintain your weight within the limits advised to you. Regular light exercises such as walking or stretching are good for your body. Get enough sleep and take your vitamins as prescribed. Wash your hands regularly with clean water and soap. Avoid contact with someone who is suffering from flu, cold, or cough. Drink plenty of fluids to stay hydrated. Avoid touching your face without washing your hands.

Guaifenesin Pregnancy Dosage

Is Mucinex DM available as a generic drug?

Yes

Do I need a prescription for Mucinex DM?

No

What brand names are available for Mucinex DM?

  • Robitussin DM Maximum Strength (liquid),
  • Robitussin DM Maximum Strength (capsules),
  • Mucinex DM,
  • Mucinex DM Maximum Strength,
  • Mucinex Fast-Max DM

Why is Mucinex DM prescribed to patients?

Guaifenesin and dextromethorphan temporarily relieve cough due to minor throat and bronchial irritations that are associated with cold. Guaifenesin/dextromethorphan also help loosen mucus and thin bronchial secretions.

What are the side effects of Mucinex DM?

Side effects of guaifenesin and dextromethorphan are:

What is the dosage for Mucinex DM?

Adults and children 12 years of age and older:

  • Robitussin DM and Robitussin DM Maximum Strength (liquid): Take 10 ml by mouth every 4 hours as needed. No more than 6 doses in 24 hours.
  • Mucinex Fast-Max DM: Take 20 ml by mouth every 4 hours. No more than 6 doses in 24 hours.
  • Robitussin DM Maximum Strength (capsules): Take 2 capsules by mouth every 4 hours as needed. No More than 12 capsules in 24 hours.
  • Mucinex DM: Take 1 or 2 tablets by mouth every 12 hours. No more than 4 tablets in 24 hours.
  • Mucinex DM Maximum Strength: Take 1 tablet by mouth every 12 hours. No more than 2 tablets in 24 hours.

Safe and effective use of guaifenesin and dextromethorphan is not established for children under 12 years of age.

Which drugs or supplements interact with Mucinex DM?

Guaifenesin/dextromethorphan should not be used with MAO inhibitors like phenelzine (Nardil), selegiline (Zelapar, Emsam, and Eldepryl), tranylcypromine (Parnate), procarbazine (Matulane), rasagiline (Azilect) and isocarboxazid (Marplan). Such combinations increase the risk of serious side effects. Guaifenesin/dextromethorphan should not be used within 14 days of using a MAO inhibitor.

Is Mucinex DM safe to use during pregnancy or while breastfeeding?

There are no adequate studies done on guaifenesin and dextromethorphan determine safe and effective use in pregnant women.

It is not known whether guaifenesin and dextromethorphan enter breast milk; therefore, it is best to be cautious before using it in nursing mothers.

What else should I know about Robitussin DM?

What preparations of Mucinex DM are available?

Robitussin DM, Robitussin DM Maximum Strength, and Mucinex Fast-Max DM are available as oral liquid form.

  • Robitussin DM contains 100 mg of guaifenesin and 10 mg of dextromethorphan in each 5 ml of liquid.
  • Robitussin DM Maximum Strength and contains 400 mg of guaifenesin and 20 mg of dextromethorphan in each 10 ml of liquid.
    • Robitussin DM Maximum Strength is available in 4 fluid ounce (120 ml) and 8 fluid ounce (240 ml) bottles. Mucinex Fast-Max DM is available in 6 fluid ounce (180 ml) bottles.
    • Robitussin DM Maximum Strength is also available as liquid-filled capsules, containing 200 mg of guaifenesin and 10 mg of dextromethorphan in each capsule. Robitussin DM Maximum Strength is available in a package of 20 capsules.
  • Mucinex Fast-Max DM contains 400 mg of guaifenesin and 20 mg of dextromethorphan in each 20 ml of liquid.
    • Mucinex DM and Mucinex DM Maximum Strength are available as extended-release oral tablet form.
    • Mucinex DM contains 600 mg of Guaifenesin and 30 mg of Dextromethorphan in each tablet, available as 20 tablets per package.
    • Mucinex DM Maximum Strength contains 1200 mg of Guaifenesin and 60 mg of Dextromethorphan in each tablet, available as 14 tablets per package.
How should I keep Mucinex DM stored?

Store at room temperature between 15 C and 30 C (59 F and 86 F). Do not store liquid formulations in the refrigerator.

How does Mucinex DM work?

Guaifenesin is an expectorant, which works by thinning oral mucus and increasing mucus volume. Dextromethorphan works on the cough center in the brain. It disrupts sensitivity of cough receptors and interrupts transmission of cough impulses.

Summary

Guaifenesin and dextromethorphan hydrobromide (Robitussin DM, Robitussin DM Maximum Strength (liquid), Robitussin DM Maximum Strength (capsules), Mucinex DM, Mucinex DM Maximum) is an OTC used to temporarily relieve cough due to minor bronchial and throat irritation associated with the common cold. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.

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