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Syrups during pregnancy: what can and what can not?

, medical expert
Last reviewed: 10.08.2022
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Most often, the question - what syrups can be used during pregnancy - concerns cough remedies. It is generally accepted that, since most of these syrups contain herbal extracts, it means that they can be safely taken by pregnant women. But it's not.

Some pharmacopoeial plants contain biologically active substances that can cause harm, for example, cause uterine contractions, fraught with abortion, or disrupt the normal development of the embryo and fetus.

What syrup for dry and wet cough can be used during pregnancy?

Despite the fact that all indications for the use  of dry cough syrups  are reduced to the fight against an unproductive cough caused by inflammation of the upper respiratory tract (from colds to bronchitis and pneumonia), when prescribing drugs, the need to thin and remove the resulting sputum should be taken into account.

In addition, when choosing a syrup for dry and wet cough during pregnancy, you need to focus not only on the nature of the cough, but also on the gestational age, since many of the mucolytic and expectorant drugs - including those of plant origin - are contraindicated for use during the 1st trimester, when all organs are laid and the life-supporting systems of the body of the unborn child are formed.

In the presence of a dry cough, pregnant women are advised to take plantain syrup (a dessert spoon three times a day), Dr. Theiss plantain syrup and Gerbion syrup with an extract of lanceolate plantain leaves (Plantago lanceolata) and mallow flowers (Malva silvestris). How to take it, see -  Herbion for dry and wet cough .

When the cough is wet, a secretory drug or expectorant is needed - an expectorant syrup during pregnancy, and here the remedy with Althaea officinalis root extract - marshmallow syrup is most often recommended. All the details of its use, including contraindications and possible side effects, are set out in the material -  Althea cough for bronchitis .

Traditionally, the pharmacodynamics of herbal syrups describes the end result of their action without delving into its biochemical mechanism (which is unknown in many cases). However, the pharmacological effect is determined by specific bioactive substances. For example, in plantain leaves, organic carboxylic and phenolic acids relieve inflammation, and anticatarrhal and antispasmodic effects are the result of exposure to aucubin and its derivatives related to monoterpene compounds.

Softening cough and facilitating expectoration of sputum when using marshmallow root is explained by the action of flavonoids (kaempferol, hypolaetin-8-glucoside, isoquercitrin) and high molecular weight acidic polysaccharides - mucus.

What cough syrups during pregnancy in the 1st, 2nd, 3rd trimesters do not need to be used?

Without extreme need, you should not take risks by taking drugs, the instructions of which indicate that they should be used with caution during pregnancy or that there is no information on safety during pregnancy, that is, the possibility of safe use has not been tested and has not been confirmed in any way.

Without touching on pharmaceutical details, one could simply list the names of such drugs, but - in order to understand why manufacturers make a reservation regarding their use during pregnancy - one should briefly characterize their composition.

So that expectorant syrup does not cause harm during pregnancy, it should not contain extracts of plants used in the treatment of cough, but contraindicated in pregnant women. These include licorice (Glycyrrhiza glabra), thyme or thyme (Thymus serpyllum), ivy (Hedera helix), oregano (Origanum vulgare), medicinal sage (Salvia officinalis), coltsfoot (Tussilago farfara), elecampane ( Inula helenium), turmeric (Curcuma longa).

Herbalists have no complaints about peppermint (Mentha piperita), but pennyroyal (Mentha pulegium), especially its essential oil, causes a strong contraction of the uterus with the threat of miscarriage.

Read also -  Herbs during pregnancy

Licorice syrup

Contraindications to the use of licorice during childbearing are associated with the hormonal (estrogenic and antiestrogenic) activity of its organic compounds of the flavone class.

In addition, the main active ingredient of the plant root and its extract - the saponin glycyrrhizin (a derivative of glycyrrhizic acid) is similar to the endogenous hormone adrenocorticotropin (ACTH) not only in structure, but in action, retaining sodium ions and water, causing edema, increased blood pressure, loss potassium ions and muscle weakness.

Syrup Pertussin and its analogues

Pertussin, which is used to treat cough in children from the age of three, is not suitable for pregnant women for two reasons. Firstly, the basis of this remedy is an extract of thyme (thyme), which is contraindicated for pregnant women due to the stimulating effect of its phytosterols (luteolin and apigenin) on the estrogen receptors of the uterine muscle tissue. Secondly, Pertussin contains potassium bromide, which has a sedative effect, slowing down the conduction of nerve signals to the central nervous system.

Thyme extract is included in such cough remedies as Bronchicum syrup, Altemix broncho,  Eucabal syrup  (except for thyme it contains plantain extract, synonymous with Stoptussin phyto), Bronchipret.

Syrups with ivy extract

Gederin syrup with ivy extract, as well as its analogues - syrup  Gedelix , Pectolvan, Prospan, Herbalor - relieve cough, having a mucolytic, antispasmodic and expectorant effect due to saponins α-hederin and hederacoside C, which indirectly enhance the response of β2-adrenergic receptors of bronchioles. But at the same time, ivy helps to remove salt and water from the body and lowers blood pressure.

The potential threat of the negative impact of these drugs in the treatment of cough during pregnancy may also be associated with the presence of a significant amount of steroids in ivy, including sitosterol, stigmasterol, α-spinasterol. Experts know the ability of these compounds to influence the metabolism of cholesterol, the level of which rises during pregnancy - to ensure the synthesis of hormones that support its normal development. And intervention in this process is highly undesirable, which is why herbal steroids are included in the list of contraindications for pregnant women.

Multi-ingredient cough syrups

Syrups containing many components of plant origin are also not recommended for pregnant women. On their list:

  • cough syrup  Linkas , which contains extracts of nine plants, including licorice root (it was mentioned above), leaves of justice vascular (containing the alkaloid vasicin, which stimulates the myometrium of the uterus) and hyssop (blue St. John's wort), also contraindicated during pregnancy.
  • Dr. MOM syrup containing justice and turmeric, more details -  Dr. MOM during pregnancy in the 1st, 2nd, 3rd trimesters .
  • Ayurvedic syrup Travisil - due to the content of extracts of licorice, justice and turmeric.
  • homeopathic syrup Stodal, among the active components of which is an extract of black lumbago (Pulsatilla pratensis), whose triterpenoid saponins are distinguished by hemolytic activity and cytotoxicity; emetic root (ipecac) containing plant sterols (α-spinosterol, stigmasterol, etc.); forbidden during pregnancy poisonous step white (bryonia).

Cough syrups with synthetic ingredients

Ambroxol syrup, as well as other trade names for mucolytic (thinning thick sputum) cough medicines based on ambroxol hydrochloride - Ambrobene, Ambrohexal, Lazolvan, Bronchoval, Koldak broncho, Halixol syrups - are contraindicated in the 1st trimester of pregnancy. Side effects, methods of administration and doses - in a detailed description of  Lazolvan syrup .

Despite a significant mucolytic effect and facilitating sputum excretion, Bromhexine syrup is not prescribed to pregnant women during the 1st trimester. Bromhexine is a synthetic analogue of the vascular alkaloid of justice, it crosses the placenta, and this is a good reason to refuse to take this syrup at a later date.

Omnitus syrup (other trade names - Sinekod, Panatus) is used in the treatment of dry cough; its active substance, butamirate, acts on the area of the brain that controls the cough reflex and suppresses it. Although controlled studies have not been conducted, this remedy is contraindicated in the 1st trimester of pregnancy, and in the 2nd and 3rd trimesters it is prescribed under the supervision of a physician who must balance the benefits for the pregnant woman with the potential risk for the child to be born. A single dose of syrup - 30 ml, the number of doses within one day - no more than four. Side effects can be manifested by dizziness, nausea, intestinal upset.

Stoptussin syrup has similar recommendations, except for butamirate, to facilitate the removal of bronchial secretions containing the anxiolytic guaifenesin, and the drugs of this pharmacological group are contraindicated during pregnancy. In this case, the doctor, prescribing this drug, must be sure that the marginal benefit to the mother obtained will be higher than the risk to the fetus, especially in the early stages, when it is most vulnerable. According to some foreign studies, the use of guaifenesin against the background of fever in the 1st trimester increases the risk of fetal neural tube defects.

As indicated in the instructions, Ascoril syrup, which contains bromhexine, salbutamol and guaifenesin, is contraindicated during pregnancy for obstructive bronchitis and bronchial asthma.

Erespal syrup, prescribed for chronic bronchitis and bronchial asthma, contains the antihistamine fenspiride, which can have a teratogenic effect and is contraindicated in pregnant women.

Some other syrups during pregnancy

During pregnancy, there may be a need for painkillers and antipyretics. Paracetamol syrup can be taken for headache and fever, but it should be borne in mind that it is contraindicated in the 1st trimester of pregnancy. Everything is detailed in the material -  Paracetamol during pregnancy . A synonym for paracetamol, which contain the same active ingredient acetaminophen, panadol syrup.

But Nurofen syrup Dr. Theiss (synonyms - Ibuprofen, Ibuprof, Ibufen, etc.) is contraindicated for pregnant women. The use of non-steroidal anti-inflammatory drugs during the entire gestation period is not safe, even when, as the instructions say, "the expected benefit to the mother outweighs the possible threat to the fetus." And the threat to the fetus is the termination of pregnancy and the appearance of birth defects (in the first three months) and the premature closure of the arterial duct and the development of cardiac pathologies in the child at a later date.

Gaviscon heartburn syrup (sodium alginate + potassium bicarbonate) refers to antacids, all information in the article is  Gaviscon forte mint suspension .

With stagnation of bile and cholecystitis, choleretic agents are needed:

For cystitis and kidney problems, Canephron syrup with extracts of lovage root (Levisticum officinale), rosemary leaves (Rosmarinus officinalis) and centaury grass (Centaurium erythraea) is recommended -  Canephron during pregnancy . However, it should be borne in mind that centaury promotes appetite and can stimulate intestinal motility and spasms of the muscular lining of the uterus.

It is not yet known whether cooking  maple syrup  helps fight infections and whether it is safe for pregnant women to use it.

Is it possible to use the hyperosmotic laxative Dufalac syrup (containing lactulose, which breaks down in the intestine, increasing the volume of its contents), in detail in the material -  Dufalac during pregnancy .

During pregnancy, iron deficiency in the body is unacceptable, and preparations containing this important trace element are used to cover it. One of them is Ferrum lek syrup with iron polyisomaltose. A detailed description can be found in the publication about the drug  Maltofer , which is a synonym (another trade name) Ferrum lek.

Any drugs and dietary supplements that stimulate the immune system are contraindicated for use during pregnancy, including Cytovir 3 syrup, which is positioned as an antiviral agent.

During pregnancy, it is unacceptable to use any drugs, focusing on the positive reviews of others. A drug that has helped someone can cause serious harm to your health, because each organism and the  effect of drugs on the fetus is  individual. Therefore, it is highly recommended not to take medicines on the advice of friends, even if they were prescribed by a doctor.

Attention!

To simplify the perception of information, this instruction for use of the drug "Syrups during pregnancy: what can and what can not?" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.

Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.

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