Are cough drops safe during pregnancy?

What does the evidence say about cough drops during pregnancy?

1. Benzocaine, the numbing ingredient in some sore-throat lozenges, hasn't been well studied in pregnancy on its own, but very little of it is absorbed when used as directed, and the few available reports on first-trimester use haven't found a higher chance of birth defects. 1
2. For any cough or cold product, including lozenges, doctors generally suggest picking one with only the ingredients that match your actual symptom instead of a multi-symptom combination, since extra ingredients mean extra things to check. 2
3. Menthol, the ingredient that gives most cough drops their cooling effect, has a gentler safety profile than camphor, since menthol overdose hasn't been linked to the seizures that camphor can cause. 3
4. Methemoglobinemia, a rare blood disorder, has been linked to benzocaine use, including a reported case in a postpartum patient who used a topical benzocaine spray, so this risk comes from the ingredient itself and isn't limited to one specific product. 4
5. A large study found that sugar from solid foods wasn't linked to a higher chance of gestational diabetes the way sugar from sweetened drinks was, but cough drops still add a little sugar, so it's worth mentioning your usual brand to your care team if you're managing gestational diabetes. 5

Is cough drops safe in each trimester?

• First trimester. Occasional cough drops are fine in the first trimester. Strong mint or menthol flavors can feel harsh on top of nausea, so a milder honey or fruit-flavored drop may sit better if smells and tastes feel off right now.
• Second trimester. The same guidance carries into the second trimester, which is often when your provider screens for gestational diabetes around 24 to 28 weeks. If that screening comes back positive, switching to a sugar-free cough drop is a simple, easy change.
• Third trimester. A cough that keeps you up at night, or comes with fever, chest tightness, or shortness of breath, is worth a call to your provider rather than reaching for more lozenges. If you're already managing gestational diabetes, keep counting cough drop sugar toward your day's total.