Is Coricidin HBP safe during pregnancy?

What does the evidence say about coricidin HBP during pregnancy?

1. Coricidin HBP Cold and Flu is acetaminophen 325 mg plus chlorpheniramine maleate 2 mg per tablet, labeled as decongestant-free cold symptom relief for people with high blood pressure, at 2 tablets every 4 to 6 hours and no more than 12 tablets in 24 hours. 1
2. The Maximum Strength Multi-Symptom Flu version is a different formula: acetaminophen 325 mg, chlorpheniramine maleate 2 mg, and dextromethorphan HBr 10 mg per tablet, capped at 10 tablets in 24 hours. 2
3. Most studies find no overall increased chance of birth defects with the use of chlorpheniramine in pregnancy, and it can cause sleepiness in adults and might do the same in a nursing infant. 3
4. At recommended dosages acetaminophen has not been shown to increase the chance of birth defects, and because it appears in many combination products, every label needs checking so you do not take it twice. 4
5. Dextromethorphan, the added ingredient in the multi-symptom version, is not expected to increase the chance of birth defects when taken as directed for cough in pregnancy. 5

Is coricidin HBP safe in each trimester?

• First trimester. The individual ingredients read reassuringly this early: most studies find no overall increased chance of birth defects with chlorpheniramine, and acetaminophen at recommended dosages has not been shown to increase that chance either.
• Second trimester. If you are being monitored for blood pressure, this is where the decongestant-free framing earns its place. The label markets itself as cold symptom relief for people with high blood pressure precisely because it leaves the decongestant out.
• Third trimester. Sedation is the practical issue late on. Chlorpheniramine can cause sleepiness in adults, and the maximum-strength version stacks a cough suppressant on top of that.

What is in each Coricidin HBP box