Is Oscillococcinum safe during pregnancy?

What does the evidence say about oscillococcinum during pregnancy?

1. A Cochrane systematic review of 6 randomized trials, 2 looking at whether it helps people avoid illness with 327 participants and 4 looking at symptoms with 1,196 participants, concluded there is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum for influenza and influenza-like illness. The evidence was rated low quality. 1
2. The product is made from a 1 percent solution of wild duck heart and liver extract, serially diluted 200 times with water and alcohol. In the pooled analysis there was no statistically significant effect on avoiding illness (risk ratio 0.48, 95 percent CI 0.17 to 1.34), while a modest symptom benefit at 48 hours (RR 1.86, 95 percent CI 1.27 to 2.73) faded by days 3 to 5. 1
3. There are currently no homeopathic products approved by the FDA, and some products sold or labeled as homeopathic may contain substantial amounts of active ingredients that can cause side effects or drug interactions. There is little evidence to support homeopathy as effective for any specific health condition. 2
4. Adverse events are rare but not zero. A 2015 case report described a 34-year-old man who developed acute tongue swelling with stridor and drooling after taking Oscillococcinum, requiring intramuscular epinephrine, and the authors noted that of nine people who reported clinically significant adverse effects to the FDA, three had experienced angioedema. 3
5. The comparison that matters in pregnancy is the flu shot, which major medical groups recommend in the first, second or third trimester. It is inactivated and contains no live virus, and vaccination during pregnancy passes antibodies to the baby that help protect them through their first 6 months of life. 4

Is oscillococcinum safe in each trimester?

• First trimester. The trimester where people most want something that feels gentle, and where the evidence gap matters most. There are no pregnancy studies of Oscillococcinum at all, and there are currently no homeopathic products approved by the FDA.
• Second trimester. The flu shot is the option with pregnancy data behind it, and it is recommended in the first, second or third trimester. It is an inactivated vaccine and contains no live flu virus, which is the reason the nasal spray version is not used in pregnancy.
• Third trimester. Late-pregnancy flu is exactly the situation where waiting to see if something works costs the most, since named complications include respiratory distress and preterm delivery before week 37. This is a call-your-provider illness, not a self-care one.