Allergy Medicines During Pregnancy

Which drugs are safe or unsafe?

You may need to keep taking prescription drugs during pregnancy. Stopping a medically necessary medication could endanger both you and your baby. Still, it's smart to be concerned about how a drug might affect a growing fetus.

Different drugs carry different risks. Your comfort is also an important thing to consider. Allergies can be miserable, and medication can help keep allergy symptoms at bay.

This article looks at the safety and use of different allergy medications during pregnancy.

Pregnant woman having cold
vadimguzhva / Getty Images

Drug Safety During Pregnancy

The Food and Drug Administration (FDA) does not consider any drug completely safe during pregnancy. This is because of the ethical problems with testing drugs in pregnant women.

Instead, the FDA has created pregnancy registries. These are studies that help doctors understand how safe certain drugs might be. They contain information that doctors have gained while observing pregnant patients who take medications. You and your doctor can use this information to decide if a drug is right for you.

It is your doctor's responsibility to talk to you about drug risks and benefits. This includes continuing, stopping, or starting a medication while pregnant. Every person is different, so the decision is always based on individual needs.

Every pregnancy is different. Talk to your doctor about medication risks and benefits and how they might apply to you.

Drugs used to be put into categories labeled A, B, C, D, and X. For example, low-risk drugs were in category A; those proven harmful were in category X. Today, a new prescription labeling system has replaced the old one. These new labels provide more detailed information about the risks to mothers, fetuses, and breastfeeding babies.


Older antihistamines like Chlor-Trimeton (chlorpheniramine maleate) are preferred for use during pregnancy. Newer ones are also an option. This includes the prescription drug Xyzal (levocetirizine) and over-the-counter (OTC) drugs like:

When Should You See an Allergist?

  • If your symptoms make it hard to breathe or are otherwise interfering with your quality of life
  • If your allergies are causing chronic sinus infections
  • If you have allergies during a large part of the year
  • When your OTC allergy medication isn't working or is causing intolerable side effects
  • If you have symptoms that might be asthma-related, like wheezing or coughing

Medicated Nasal Sprays

Nasalcrom (cromolyn) nasal spray prevents allergy symptoms. It is used before exposure to an allergen and before the onset of symptoms. Another option during pregnancy is a nasal steroid spray like Rhinocort Aqua (budesonide).


During the second and third trimesters only, Sudafed (pseudoephedrine) is the preferred oral decongestant.

Pseudoephedrine can increase the risk of a birth defect called gastroschisis and should be avoided, especially during the first trimester.


Allergy shots can be continued during pregnancy, though many allergists will cut the dose by 50%. Starting this treatment while pregnant isn't recommended.

Some allergists feel you should stop allergy shots during pregnancy. This is because there is a risk of anaphylaxis, a whole-body allergic reaction that may also harm the fetus. Other than anaphylaxis, no data shows that allergy shots are harmful to a fetus.

Remember that even OTC drugs can harm your baby. Some can interfere with your baby's development. Others are associated with birth defects or may increase the risk of miscarriage. If you're pregnant, always talk to your doctor before starting, stopping, or continuing any prescription or OTC drug.


If you are pregnant and have allergies, talk to your doctor. No drug is considered completely safe during pregnancy. There is good evidence, however, that some allergy medications are okay to use when you are pregnant.

Options include certain antihistamines, nasal sprays, and decongestants. If you are already receiving allergy shots, you should be able to continue them. Always check with your doctor before starting or stopping any medication during pregnancy.

Frequently Asked Questions

  • Is it safe to take over-the-counter allergy medication while pregnant?

    No drug is considered completely safe during pregnancy. Many OTC allergy drugs seem to be safe, but because of limited data, they haven't been proven safe.

    Older antihistamines like Chlor-Trimeton (chlorpheniramine maleate) are preferred, but newer drugs like Zyrtec (cetirizine) and Claritin (loratadine) are other options. Talk to your doctor before starting or stopping any drug while you are pregnant.

  • What are the risks of taking certain allergy medications while pregnant?

    There is evidence that some allergy medications might harm a developing fetus. Allegra (fexofenadine), for example, may carry a risk of miscarriage. Decongestants like Sudafed (pseudoephedrine) are also not safe in the first trimester. Always check for decongestant ingredients in OTC allergy medication.

  • What are some home remedies to treat allergies while pregnant?

    Saline nasal sprays and humidifiers can help relieve allergy symptoms. It may also be helpful to use adhesive strips to help you breathe through your nose while sleeping. You can also try limiting allergens in your home by keeping your windows closed, washing your bedding often, and airing out damp rooms.

  • Can pregnant women take Benadryl?

    Benadryl (diphenhydramine) is widely used in pregnancy and is generally thought to be safe. Keep in mind that there is some evidence it may cause uterine contractions at high doses. Some older studies have also found associations between Benadryl use and the birth defect cleft lip and palate, but newer studies have not supported this.

7 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.
  1. U.S. Food and Drug Administration. Pregnant? Breastfeeding? Better drug information is coming.

  2. Kar S, Krishnan A, Preetha K, Mohankar A. A review of antihistamines used during pregnancyJ Pharmacol Pharmacother. 2012;3(2):105–8. doi:10.4103/0976-500X.95503

  3. U.S. National Library of Medicine. NASALCROM- cromolyn sodium spray.

  4. The American College of Obstetricians and Gynecologists. What medicine can I take for allergies while I'm pregnant?

  5. American College of Allergy, Asthma & Immunology. Pregnancy and allergies.

  6. Servey JT, Chang JG. Over-the-counter medications in pregnancy. Am Fam Physician. 2014;90(8):548-55.

  7. Li Q, Mitchell AA, Werler MM, Yau WP, Hernández-Díaz S. Assessment of antihistamine use in early pregnancy and birth defects. J Allergy Clin Immunol Pract. 2013;1(6):666-74. doi:10.1016/j.jaip.2013.07.008

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.