Allergy Medicines During Pregnancy

Which drugs are safe or unsafe?

Many women must continue taking medically necessary prescription drugs throughout their pregnancies, as failing to do so would endanger both mother and baby. But it's smart to be concerned about the effects of medication on a growing fetus.

Different medications carry different risks. The importance of maternal comfort is also an important consideration. Allergies can make some women miserable, and medication may be needed so that allergy symptoms are not taking over their lives.

Pregnant woman having cold
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Drug Safety During Pregnancy

According to the Food and Drug Administration (FDA), no medicines are considered completely safe during pregnancy. This is because most medications have not been tested in pregnant women. Pregnant women are, naturally, reluctant to sign up for medication safety studies.

Therefore, the FDA has created pregnancy registries that help inform clinicians about the relative safety of specific medications. These registries contain observational information that doctors have gleaned from observing their patients taking medications during pregnancy.

Your doctor can use this information, along with informative prescription labeling, to help you decide whether a medication is right for you.

It is your doctor's responsibility to talk to you about the risks and benefits of continuing, stopping, or starting a medication while pregnant. Because every woman is different, these risks and benefits must be gauged on an individual basis.

Every pregnancy is different. Talk to your doctor about the risks and benefits of medications for you.

The newer prescription labeling system replaced the old system of putting drugs into categories labeled A, B, C, D, and X. Newer prescription labels provide more detailed information about the potential risks to expectant mothers, developing fetuses, and breastfeeding babies.

Antihistamines

Older antihistamines, such as chlorpheniramine, are the preferred agents to treat allergic rhinitis during pregnancy.

Newer antihistamines, such as over-the-counter Claritin (loratadine) and Zyrtec (cetirizine), are also an option for pregnant women. Xyzal (levocetirizine) is a newer prescription antihistamine to consider.

If you're pregnant, talk to your doctor before starting or stopping any prescription or over-the-counter medications.

Medicated Nasal Sprays

Nasalcrom (cromolyn) nasal spray prevents the symptoms of allergies if it is used before exposure to an allergen and prior to the onset of symptoms.

Nasal steroid sprays like Rhinocort Aqua (budesonide) may also be considered for use during pregnancy.

Decongestants

Pseudoephedrine (known by the brand name Sudafed and others) is the preferred oral decongestant to treat allergies during the second and third trimesters of pregnancy.

Pseudoephedrine should not be used during the entire first trimester as it has been linked to a birth defect called gastroschisis in which the baby's intestines are found outside of the body.

Immunotherapy

Allergy shots can be continued during pregnancy, but it is not recommended to start this treatment while pregnant. Typically, the dose of the allergy shots is not increased. Many allergists will cut the dose of the allergy shot by 50% during pregnancy.

Some allergists feel that allergy shots should be stopped during pregnancy given the risk of anaphylaxis and the resulting harm to the fetus. Other than anaphylaxis, no data shows that the allergy shots themselves are actually harmful to the fetus.

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  1. U.S. Food and Drug Administration. Pregnant? Breastfeeding? Better drug information is coming. Updated December 17, 2014.

  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. Cleveland Clinic. Cromolyn sodium nasal spray.

  4. The American College of Obstetricians and Gynecologists. What medicine can I take for allergies while I'm pregnant? Updated February 2021.

  5. American College of Allergy, Asthma & Immunology. Pregnancy and allergies. Updated April 17, 2018.