Dextromethorphan and Pregnancy: Your Comprehensive Safety Guide

Pregnancy introduces an entirely new set of guidelines that affect major areas of your life, including exercise, diet, and managing any existing health concerns.  Women who use over-the-counter (OTC) medications for cough need to consider alternative options.

Can dextromethorphan and pregnancy mix? It is not recommended, no. The best option is to consult your provider for the best plan for you.

What Is Dextromethorphan?

Dextromethorphan is a cough suppressant sold over-the-counter by itself or as an active ingredient in combined medications.

While dextromethorphan doesn’t address the underlying cause of the cough, it reduces your urge to cough.[1] Considering the pitfalls of prolonged coughing, including lung irritation, headaches, and more, suppressing this symptom can make a major difference in comfort.

Popular products containing dextromethorphan include Robitussin DM, Delsym, and the expectorant medication Mucinex DM.

How Dextromethorphan Works

Dextromethorphan’s precise mechanism of action is only partially understood. It’s believed that this medication interferes with the signal that the brain sends to the muscles involved in coughing, including the chest wall and diaphragm.[2]

Common Side Effects of Dextromethorphan

Dextromethorphan is a generally well-tolerated drug when used properly. Severe side effects are very rare.

However, any drug can cause some side effects. Dextromethorphan is associated with the following side effects:[3]

• Drowsiness: The most common side effect, affecting daily activities
• Dizziness: May increase fall risk, especially during pregnancy
• Nausea: Can worsen pregnancy-related morning sickness
• Stomach upset: May compound digestive issues common in pregnancy
• Confusion: Rare but possible, particularly with higher doses

Potential for Misuse

Dextromethorphan is not as popularly misused as prescription opioids, but misuse is still possible. Large doses of dextromethorphan can cause euphoria and hallucinations.[4]

Sometimes referred to as “robotripping,” the recreational use of dextromethorphan comes with potentially serious adverse effects like high fevers, seizures, and irregular heartbeat.[5]

Can Dextromethorphan Be Used During Pregnancy?

Taking Dextromethorphan during pregnancy is advised against. More investigation is needed to accurately determine the risks it poses to developing fetuses before it can be safely prescribed during pregnancy, if ever.

Dextromethorphan (DXM) was officially categorized by the FDA as a category C medicine before they changed this system in 2015, though there is insufficient evidence that DXM in pregnancy is not risky.[6] Before 2015, the FDA placed medications into five categories (A, B, C, D, and X) based on their potential to harm the developing fetus.

Drugs in category A were demonstrated through a robust set of well-controlled studies to not cause harm to the fetus in the first trimester of pregnancy. Drugs in category X demonstrated a significant risk for fetal harm or abnormalities.

This finding concluded that dextromethorphan use did not increase the rate of malformations beyond the normal range, but larger and more comprehensive studies on humans are still needed.[7]

Second and Third Trimester Safety Considerations

Dextromethorphan is never recommended during pregnancy. Regular monitoring and full transparency with your healthcare provider may be helpful, but this just means you’ll see the damage when it occurs. It doesn’t change the biochemistry and physiology of the drug.

Safe Alternatives to Dextromethorphan During Pregnancy

While natural remedies are often not as effective as dextromethorphan, they can still get you through a difficult coughing spell when used properly. Always consult with your primary care provider before adding or removing substances to your regimen.

Honey offers proven cough-suppressing properties without side effects. In fact, honey can be as effective as some over-the-counter cough medications. Take one to two teaspoons as needed for symptom relief.[8]

Warm salt water gargles soothe throat irritation naturally by soothing that sharp, scratchy sensation and breaking down irritating mucus. Mix half a teaspoon of salt in eight ounces of warm water and gargle gently.

Hydration and Humidification

Staying well-hydrated helps thin mucus naturally. Aim for eight to ten glasses of water daily during pregnancy.

Humidifiers add moisture to dry air that can worsen coughs. Use clean, distilled water to prevent bacterial growth in the humidifier.

Meanwhile, breathing steam from hot showers provides temporary relief. The warm moisture soothes irritated respiratory passages.

Lifestyle Modifications

Elevating your head while sleeping reduces nighttime coughing. Use extra pillows to create a comfortable, angled position.

Avoiding irritants like smoke and strong fragrances helps prevent cough triggers. Keep your environment as clean as possible.

When to Seek Medical Attention for a Persistent Cough

If your cough persists for days, is accompanied by a fever, or causes breathing difficulties, seeking professional treatment is always a wise practice to protect you and your baby.

Fever combined with cough may signal an infection that requires antibiotic treatment. Breathing difficulties may indicate respiratory complications.

Professional Cough Treatment Approaches

Healthcare providers can prescribe pregnancy-safe cold medications when necessary. They’ll weigh benefits against potential risks carefully. The underlying cause of the cough may significantly influence their treatment approach.

Prescription cough medicines may be used in severe cases after other options have been exhausted. Close monitoring is vital to ensure your baby’s and your own safety.

In other words, professional guidance ensures the safest treatment approach. Your provider understands your unique medical situation best.

Making Informed Decisions About Dextromethorphan Use

It is not recommended to take this cough suppressant while pregnant. Your health history, pregnancy complications, and the severity of the cough must be carefully considered when making decisions about any cough suppressants while pregnant.

Discussing Options with Your Healthcare Provider

Share all symptoms and concerns honestly during appointments with your care provider.

Bring medication bottles to show exactly what you’re considering taking. This helps providers assess ingredients and dosing accurately.

By now, you understand that pregnancy care requires collaborative decision-making. Your input and the provider’s expertise create the safest approach.

Weighing Risks and Benefits

Every medication decision during pregnancy involves careful risk-benefit analysis. Consider both immediate symptom relief and potential risk of birth defects or complications.

Severe, persistent coughing can affect sleep and well-being significantly. These factors can also impact fetal development.

However, unnecessary medication exposure should always be avoided. Precautions guide pregnancy medication decisions.

Moving Forward: Your Health Journey

If you experience any issues regarding persistent cough, substance use, or anything else during pregnancy, finding a professional solution is absolutely essential for the health of your baby.

Pregnancy can feel overwhelming at times, which is why pregnant mothers should take advantage of professional support services as soon as an issue surfaces. With the right support, you can navigate difficult decisions.

Healthcare providers and substance use specialists are just as committed to your health and well-being as they are to your baby’s. Get the help you need, safeguard your and your baby’s future well-being, and enjoy motherhood.