Syrups in pregnancy: which can and which cannot?

The most common question - what syrups can be taken during pregnancy - concerns cough syrups. It is commonly believed that since most of these syrups contain herbal extracts, it means that they can be taken by pregnant women without fear. But this is not the case.

Some pharmacopoeial plants contain biologically active substances that may cause harm, such as causing uterine contractions that may result in termination of pregnancy or disrupting the normal development of the embryo and fetus.

What syrup from dry and wet cough in pregnancy can be used?

Despite the fact that all indications for the use of syrups for dry cough are reduced to fight non-productive cough caused by inflammation of the upper respiratory tract (from colds to bronchitis and pneumonia), when prescribing drugs should take into account the need to liquefy and expectorate the sputum formed.

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

If you have a dry cough, pregnant women should take plantain syrup (a dessert spoonful three times a day), syrup with plantain Dr. Theiss and syrup Herbion with extract of plantain leaves (Plantago lanceolata) and mallow flowers (Malva silvestris). How to take it, see - Gerbion for dry and wet cough.

When the cough is moist, you need a secretomotor drug or expectorant - expectorant syrup in pregnancy, and here most often recommended remedy with an extract of the root of Althaea officinalis - syrup of althea. All the details of its use, including contraindications and possible side effects, are outlined in the material - Althaea cough syrup for bronchitis.

Traditionally, pharmacodynamics of syrups based on medicinal plants describes the final result of their action, without delving into its biochemical mechanism (which in many cases is unknown). However, the pharmacological effects are due to specific bioactive substances. For example, in plantain leaves, organic carboxylic and phenolic acids relieve inflammation, while anticatarrhal and antispasmodic effects are the result of the action of aucubin and its derivatives belonging to monoterpene compounds.

Softening of cough and facilitation of sputum expectoration with the use of marshmallow root is due to the action of flavonoids (kaempferol, hypolaetin-8-glucoside, isoquercitrin) and high molecular weight acidic polysaccharides - mucilages.

What cough syrups in pregnancy in the 1, 2, 3 trimesters do not need to use?

Unless absolutely necessary, you should not risk taking medicines whose instructions state that they should be used with caution in pregnancy or that there is no information on safety in pregnancy, i.e. The possibility of safe use has not been tested or confirmed in any way.

Without going into pharmaceutical details, it would be possible to simply list the names of such drugs, but - in order to understand why manufacturers make a reservation about their use during pregnancy - it is necessary to briefly characterize their composition.

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

To peppermint (Mentha piperita) phytotherapists have no complaints, but marsh mint (Mentha pulegium), especially its essential oil, causes a strong contraction of the uterus with the threat of miscarriage.

Read also - Herbs in pregnancy

Licorice syrup

Contraindications to the use of licorice during childbearing are related to the hormonal (estrogenic and anti-estrogenic) activity of its organic compounds of the flavone class.

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

Syrup Pertussin and its analogs

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

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

Syrups with ivy extract

Syrup Gederin with ivy extract, as well as its analogs - syrup Gedelix, Pectolvan, Prospan,Herbalor - relieve cough, having mucolytic, antispasmodic and expectorant action due to saponins α-hederin and hederacoside C, which indirectly enhance the response of β2-adrenoreceptors of bronchioles. But at the same time ivy promotes the excretion of salt and water from the body and reduces blood pressure.

The potential for adverse effects of these remedies in the treatment of coughs during pregnancy may also be related to the presence of significant amounts of steroids in ivy, including sitosterol, stigmasterol, and α-spinasterol. Specialists know the ability of these compounds to affect the metabolism of cholesterol, the level of which increases during pregnancy - to ensure the synthesis of hormones that support its normal development. And interference in this process is highly undesirable, which is why plant steroids are included in the list of contraindications for pregnant women.

Multicomponent cough syrups

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

• syrup Linkas from cough, which contains extracts of nine plants, including licorice root (it was mentioned above), leaves of Justicia vascularis (containing the alkaloid vasicine, which stimulates the uterine myometrium) and hyssop (blue St. John's wort), also contraindicated during pregnancy.
• Dr. MOM syrup containing justicia and turmeric, more - Dr. MOM in pregnancy in 1, 2, 3 trimesters.
• Ayurvedic Travisil syrup - because of its content of licorice, justicia and turmeric extracts.
• homeopathic syrup Stodal, among the active components of which are extract of black prostrate (Pulsatilla pratensis), the triterpenoid saponins of which are characterized by hemolytic activity and cytotoxicity; vomiting root (ipecacuana), containing plant sterols (α-spinosterol, stigmasterol, etc.); prohibited in pregnancy poisonous white staghorn (Bryonia).

Cough syrups with synthetic ingredients

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

Despite the significant mucolytic effect and facilitation of sputum expectoration, Bromhexine syrup is not prescribed for pregnant women during the 1st trimester. Bromhexine is a synthetic analog of the alkaloid of Justice, it penetrates through the placenta, and this is a good reason to refuse to take this syrup and later terms.

Omnitus syrup (other trade names: Synecod, Panatus) is used in the treatment of dry cough; its active ingredient, butamirate, acts on the area of the brain that controls the cough reflex and suppresses it. Although controlled studies have not been conducted, this drug 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 weigh the benefit to the pregnant woman against the potential risk to the child being carried. The single dose of syrup is 30 ml, the number of intakes during one day - no more than four. Side effects may be manifested by dizziness, nausea, intestinal disorders.

Similar recommendations have syrup Stoptussin, except butamirate, to facilitate the removal of bronchial secretion containing anxiolytic guaifenesin, and the means of this pharmacological group are contraindicated in pregnancy. In this case, the doctor, prescribing this drug, must be sure that the marginal benefit to the mother 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 fever in the 1st trimester increases the risk of neural tube defects in the fetus.

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

Prescribed for chronic bronchitis and bronchial asthma syrup Erespal contains antihistamine substance fenspiride, which may have teratogenic effect and is contraindicated in pregnant women.

Some other syrups in pregnancy

Painkillers and antipyretics may be needed during pregnancy. For headache and fever can be taken syrup Paracetamol, but it should be borne in mind that it is contraindicated in the 1st trimester of pregnancy. All details in the material - Paracetamol in pregnancy. Synonym of paracetamol, which contain the same active ingredient acetaminophen, syrup Panadol.

But syrup Nurofen Dr. Tyss (synonyms - Ibuprofen, Ibuprof, Ibufen, etc.) is contraindicated for pregnant women. The use of non-steroidal anti-inflammatory drugs during the entire gestation period is unsafe, even when, as written in the instructions, "the expected benefit to the mother exceeds the possible threat to the fetus". And the threat to the fetus consists of termination of pregnancy and birth defects (in the first three months) and premature closure of the ductus arteriosus and development of cardiac abnormalities in the child at later terms.

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

Bile stasis and cholecystitis require choleretic remedies:

• Rosehip syrup, for more information see - Rosehip in early and late pregnancy
• Holosas syrup (based on rosehip fruit extract)
• Hofitol syrup - Hofitol in pregnancy: why prescribed, how to take and how much to drink.

Canefron syrup with extracts of lobster root (Levisticum officinale), rosemary leaves (Rosmarinus officinalis) and goldenseal herb (Centaurium erythraea) is recommended for cystitis and kidney problems - Canefron in pregnancy. However, it should be borne in mind that goldenseal increases appetite and may stimulate intestinal motility and uterine muscle spasms.

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

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

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

Contraindicated for use during pregnancy any drugs and dietary supplements that stimulate immunity, including Citovir 3 syrup, which is positioned as an antiviral agent.

In pregnancy, it is inadmissible to use any medication based on positive reviews of others. Medicinal product, which lump helped, can cause serious harm to your health, because each organism and the effect of drugs on the fetus are individual. Therefore, it is strongly recommended not to take medicines on the advice of girlfriends, even if they were prescribed to them by a doctor.