Taking Allergy Medicine While Pregnant

Can I take allergy medicine while pregnant to prevent pregnancy-induced asthma symptoms? This is a common question for patients during pregnancy, especially if you are a pregnant asthmatic with the watery, itchy eyes, and runny nose of hay fever or allergic rhinitis.

If allergies are not controlled it can lead to poor asthma control and uncontrolled asthma symptoms such as:

• Wheezing
• Chest tightness
• Cough
• Shortness of breath

There are several things that you can do to deal with allergy and runny nose symptoms. Saline or salt water nasal sprays are one of the most effective treatments for rhinitis in either a pregnant or non-pregnant patient.

All pregnant patients should talk with their doctor about appropriate amounts of exercise, but physical activity leads to constriction of blood vessels in the nose and decreased nasal symptoms. Adhesive strips that cause a mechanical dilatation and raising the head of the bed at night has also been associated with decreased allergy with asthma and pregnancy.

When allergy symptoms do not respond to allergen avoidance or non-pharmacologic measures, cromolyn sodium may be used. Eye drops may be tried for eye allergy symptoms and a nasal spray is available for nasal symptoms. The treatment has not been associated with any pregnancy complications or congenital malformations in reported studies. One additional benefit is the nasal spray is available over the counter without a prescription.

In addition to hay fever, pregnant asthmatics may have other allergy manifestations leading to pregnancy-induced asthma symptoms such as:

• Allergic conjunctivitis or watery, itchy eyes
• Eczema or dry, itchy skin
• Nasal symptoms

Chlorpheniramine (ChlorTrimeton®), and diphenhydramine (Benadryl®) have been the mainstay of allergic treatment for many years. Given the long-standing history of use in pregnancy and animal studies that have not had worrisome results, most providers are comfortable with these medications if their patient has bothersome symptoms. However, older antihistamines have higher rates of drowsiness and preventing patients from performing their normal activities. Loratadine (Claritin®) and cetirizine (Zyrtec®) are newer antihistamines with fewer side effects. Human studies are reassuring in that there a large number of human patients having used the drug in pregnancy and its use appears safe.

Decongestants are not as reassuring as antihistamines for an allergy medication during pregnancy. Topical nasal sprays are problematic because of rebound congestion that may make the symptoms worse. This is not just a pregnancy issue, but also is a reason to not use these medications in non-pregnant patients. If a topical nasal spray is going to be used to contact your doctor as you will want to pick one that is not absorbed into the bloodstream. Finally, topical nasal sprays should not be used for more than 3 days in a row.

Pseudoephedrine orally is a commonly used decongestant but there are reports of abdominal wall problems, especially with first-trimester use. Because of this, it should not be used in the first trimester and only after that if other treatments have not worked.

Allergy shots are not generally started during pregnancy due to concerns over a possible anaphylactic reaction. However, patients using immunotherapy without problem before getting pregnant may elect to continue treatment.

We want to help you get control of your asthma. I want to hear about your biggest asthma problem so that we can try to help you develop a solution or better understand how to help. You are probably not the only one with the problem.