Taking Allergy Medicine While Pregnant

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Taking allergy medications is often a concern during pregnancy. Some drugs are safer than others, and it pays to know that before allergy season sets in.

Your allergies may not change while you're pregnant. However, sometimes pregnancy makes allergies worse or causes pregnancy-related sinus issues (pregnancy rhinitis). That makes it harder to cut out allergy medications.

This article will walk you through non-drug ways to manage symptoms and what allergy pills and nasal sprays are effective for you and safe for your baby.

Pregnant woman sneezing
fizkes / iStock / Getty Images

Non-Drug Treatments

Want to avoid the worry over medications? Try treating your allergies in other ways that are safe during pregnancy:

  • Saline nasal sprays
  • A humidifier to prevent dry nasal passages
  • Exercise, which reduces nasal inflammation
  • Adhesive strips (like Breathe Right) that open your nostrils
  • Raise the head of your bed or use an extra pillow to help sinuses drain
  • Acupuncture

What About Supplements?

Some nutritional or herbal supplements may help ease allergy symptoms. But don't assume they're safe just because they're natural. Plenty of natural products can harm you and your baby. Always check with your healthcare provider before starting supplements.

Also, do what you can to limit contact with allergens:

  • Use dust-proof covers on bedding
  • Wash bedding frequently
  • Keep windows closed
  • Shower after spending time outside
  • Keep damp areas of the home (bathroom, kitchen, basement) clean and well aired

It's a bad idea to let your allergy symptoms go unchecked. If these methods don't work, safeguard your health by knowing what you can take when symptoms crop up.

Stopping Medications

Don't stop any prescription allergy or asthma medications without talking to your healthcare providers. Leaving symptoms untreated can open up you and your baby to serious risks.

Medications

Two different types of medications are used to treat allergies. Antihistamines counter the allergic response happening in your body. Decongestants narrow blood vessels in your nose, which widens nasal passages.

Antihistamines

When you encounter something you're allergic to, your body releases a chemical called histamine. That's what leads to allergy symptoms as your body tries to flush out the allergen.

Antihistamines have long been used during pregnancy. Many of them are generally considered safe.

Chlor-Trimeton (chlorpheniramine) and Benedryl (diphenhydramine) have the longest record of use and are considered first-line treatments.

The newer drugs Claritin (loratidine) and Zyrtec (cetirizine) are the next best options.

Some drugs in this class need more research. Others have tentative links to birth defects if they're taken during the first trimester.

The U.S. Food and Drug Administration (FDA) ranks medications' pregnancy rest using letters A through D, with A being the safest, and X to mean they shouldn't be taken.

Most antihistamines are classified as B or C:

  • B - No first-trimester risk found in animal studies OR first-trimester risks found in animal studies that didn't show up in human studies; No evidence of risk later in pregnancy.
  • C - Animal studies reveal risk and no human studies have been done OR no studies are available.
 BRAND GENERIC RISK PROBLEMS 
Benedryl diphenhydramine B High doses may cause uterine contractions
Zyrtec cetirizine B No known problems
Claritin loratidine B One study suggests risks, not confirmed by others
Chlor-Trimeton chlorpheniramine C No known problems
Ala-Hist, Veltane brompheniramine C No known problems; Limited data
Allegra fexofenadine C Limited data shows risk of miscarriage. May be discouraged.
Bromfed, Vituz, Zutripo pheniramine C Risk unlikely with limited use

Decongestants

Decongestants aren't considered as safe as antihistamines during pregnancy. The most common ones include Sudafed (pseudoephedrine) and Suphedrin PE/Sudafed PE (phenylephrine).

The overall safety of decongestants isn't established. Studies have suggested possible links between first-trimester use and birth defects including:

  • Gastroschisis: Intestines and possibly other organs protruding through an opening near the belly button
  • Small intestinal atresia: A blockage in the small intestine
  • Hemifacial macrosomia: One side of the face doesn't develop or grow properly

It's considered safest to not take these drugs during the first trimester. Talk to your healthcare provider about whether they're safe for you later in your pregnancy.

Recap

Pregnancy may make allergy symptoms worse. Some allergy treatments are safer than others. Some non-drug options may help. Most antihistamines are considered generally safe, especially Benedryl, Zyrtec, and Claritin. Decongestants are less safe and may be linked to serious birth defects.

Nasal Sprays

Nasal sprays work directly on the inflamed tissues in your nose to help you breathe better. Their safety during pregnancy varies.

A benefit of sprays is that they work quickly and at the site of the problem. Many of them don't get into your blood at all.

Some of the less-safe ones are absorbed into the bloodstream in small amounts. That raises the possibility that they'll have an impact on your baby.

BRAND GENERIC RISK PROBLEMS
NasalCrom cromolyn B No known problems
Atrovent ipratropium
bromide
B Data limited, no known problems
Flonase fluticasone C Side effects in animal studies
Nasacort triamcinolone C Data limited, some risk possible
Afrin oxymetazoline  C Systemic effects possible, some evidence of birth defects
Triaminic xylometazoline C Systemic effects possible, some evidence of birth defects

Oxymetazoline and xylometazoline aren't recommended. That's not solely due to risks to your baby, though. Regular use of these medications can cause rebound congestion that may worsen your symptoms.

Recap

Nasal sprays can help you breathe better and most of them are considered safe. However, Afrin and Triaminic sprays may be absorbed into your bloodstream and therefore pose a threat to your baby. They can also make your congestion worse with prolonged use.

Pregnancy Rhinitis

Rhinitis is inflammation of the mucous membranes in your nose. It's usually caused by allergies or a viral illness like the common cold.

But it can also strike when you're pregnant and has nothing to do with allergies or acute illness.

Research shows this type of rhinitis affects between 20% and 40% of pregnancies. Symptoms include:

  • Nasal congestion
  • Sneezing
  • Runny nose

The suspected cause of pregnancy rhinitis is hormonal changes. Researchers say they cause an increase in the activity of some mucus-producing glands.

Also, your blood volume increases during pregnancy. That means blood vessels widen and take up more space. In a tight space like nasal passages, the difference is noticeable.

Pregnancy rhinitis is defined as:

  • Present during the last six or more weeks of pregnancy
  • Without signs of a respiratory tract infection
  • With no known allergic cause
  • Disappearing in the two weeks after delivery

If you have rhinitis symptoms but antihistamines aren't helping, talk to your healthcare provider about the possibility of pregnancy rhinitis.

Can I Keep Getting Allergy Shots?

Allergy shots, also called immunotherapy, are considered safe to continue when you get pregnant.

They're usually not started during pregnancy due to the risk of anaphylaxis (a severe allergic reaction).

Summary

You have several options for safe allergy treatments during pregnancy. Non-drug options include saline nasal spray, exercise, acupuncture, and avoiding allergens.

Antihistamines are the drug of choice for pregnancy. They're not all equal, though. The safest ones are Chlor-Trimeton, Benedryl, Claritin, and Zyrtec. Oral decongestants are less safe.

However, some decongestant nasal sprays are considered safe. The favored ones are NasalCrom and Atrovent. Afrin and Triaminic spays are discouraged as they pose possible problems for you and your baby.

A Word From Verywell

It's scary to take medications when you're pregnant. But that doesn't mean you have to avoid all of them and suffer from allergy symptoms.

Work with your healthcare team, including your pharmacist, to learn what medications are considered safest. That way, you can protect both yourself and your baby.

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10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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