Is Zicam safe during pregnancy?

What does the evidence say about zicam during pregnancy?

1. Intranasal zinc carries a documented smell-loss signal. Researchers describe strong clinical evidence that intranasal zinc gluconate gel used for colds causes anosmia, the loss of the sense of smell, in humans, and the large number of anosmia reports led to intranasal zinc sprays being removed from store shelves. 1
2. A systematic review and meta-analysis of 3 randomized trials with 451 participants found intranasal zinc results for symptom relief at day three were not statistically significant, and flagged unquantified concerns about permanent anosmia following intranasal zinc use. 2
3. The zinc RDA in pregnancy is 11 mg a day for ages 19 and over and 12 mg for ages 14 to 18, while the tolerable upper intake level is 40 mg a day in pregnancy and lactation, counting food, prenatal and lozenges together. 3
4. A 2024 Cochrane Review found zinc may shorten symptoms by about 2 days in people who already have a cold, while making little to no difference to whether someone catches one. High zinc intakes can cause nausea, dizziness, headaches, gastric distress, vomiting and loss of appetite, and doses of 50 mg or more can interfere with copper absorption. 3
5. Products sold in the homeopathic aisle sit outside normal drug review: there are currently no homeopathic products approved by the FDA, and some products sold or labeled as homeopathic can contain substantial amounts of active ingredients that may cause side effects or drug interactions. 4

Is zicam safe in each trimester?

• First trimester. The trimester where you are most likely to reach for something at the first sniffle, and the one where the route question matters most. Nothing about zinc changes by trimester, but the smell-loss evidence for the nasal route does not depend on pregnancy at all, which is why it leads the answer.
• Second trimester. Cold season does not pause. If you are using an oral zinc lozenge, add it to the zinc already in your prenatal: the pregnancy RDA is 11 mg a day and the upper limit is 40 mg from all sources combined.
• Third trimester. Repeated courses through a long winter are where the ceiling gets crossed quietly. Doses of 50 mg zinc or more can interfere with copper absorption, and high zinc intakes can cause nausea, vomiting, headaches and loss of appetite, which are hard to tell apart from late-pregnancy symptoms.

Zinc ceilings that apply whatever the box says