What allergy medicine can you take when your pregnant

Older antihistamines, such as chlorpheniramine, are the preferred agents to treat allergic rhinitis during pregnancy and are both Category B medications.

Newer antihistamines such as over-the-counter loratadine (Claritin, generic forms) and cetirizine (Zyrtec, generic forms) are also Pregnancy Category B medications. A newer prescription antihistamine that is Pregnancy Category B is Xyzal (levocetirizine).


How to safely treat allergies during pregnancy

While it would be best to avoid allergens that annoy you, that’s not always a possibility.

Numerous pregnant women and their providers prefer to start with a non-pharmaceutical treatment plan whenever possible. Dr. Janelle Luk, medical director and co-founder of Generation Next Fertility in New York City, suggests an over-the-counter saline nasal spray.

Dr. Luk also recommends physical activity to reduce nasal inflammation. In addition, she says patients with a stuffy nose might be capable to sleep better if they elevate the head of the bed by 30 to 45 degrees during sleep.

However, sometimes those non-pharmaceutical options just don’t do the trick, and you need something stronger (aka allergy medicine) to ease your distress.

In that case, there are several options that are safe to try.

“For moderate to severe allergies, your physician may recommend a nonprescription corticosteroid spray or an oral antihistamine,” Dr.

What allergy medicine can you take when your pregnant

Luk says. “Some nasal spray options include Rhinocort Allergy, Flonase, and Nasonex.”

For oral antihistamines, Staunton says she recommends Claritin (loratadine) or Zyrtec (cetirizine) because of their excellent safety history. Both are rated pregnancy category B by the FDA. This means that controlled studies in animals own shown no adverse effects to the developing fetus.

Benadryl (diphenhydramine) is considered fairly safe during pregnancy, according to the CDC.

However, Benadryl Allergy Plus Congestion is not safe for pregnant women because it contains phenylephrine.

You can also take one of the oral antihistamines together with a nasal spray if neither one controls your symptoms on its own.

As for subcutaneous allergen immunotherapy (SCIT), aka allergy shots—if you were on them before pregnancy, your doctor may continue them. But they wouldn’t be started during pregnancy because of “the potential harm that could result if a reaction were to occur,” Staunton says.

If you are suffering from allergy symptoms, speak with your provider about your best options for allergy medicine while pregnant.

allergyallergy medspregnancy

It’s understandable that a lot of women don’t love to take unnecessary medicines when they’re pregnant.

No mother-to-be would ever desire to put her baby at an increased risk of a birth defect caused by medication. However, allergies can make some lady so miserable that medications may be needed just so that allergy symptoms are not taking over their lives.

According to the Food and Drug istration (FDA), no medicines are considered completely safe in pregnancy. This is because no pregnant lady would desire to sign up for a medication safety study while she is pregnant.

Therefore, the FDA has assigned risk categories to medications based on use in pregnancy:

  1. Category C medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may outweigh the potential risks in humans.
  2. Category B medications own been studied in pregnant animals, which show that they are relatively safe, but no human studies are available.
  3. Category A medications are medications in which there are excellent studies in pregnant women showing the safety of the medication to the baby in the first trimester.

    Few medications are in this category and no asthma medications are rated category A.

  4. Category D medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans.
  5. Category X medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.

Which Medications Are Safe in Pregnancy?


Medicated Nasal Sprays

Cromolyn nasal spray is helpful in treating allergic rhinitis if it is used before exposure to an allergen and prior to the onset of symptoms.

This medication is Pregnancy Category B and is available over the counter.

If Cromolyn is not helpful, a nasal steroid spray called Rhinocort Aqua (budesonide) received a Pregnancy Category B rating. Every other steroid nasal sprays are category C) and should be avoided during pregnancy.


Avoid certain allergy medicine while pregnant

There are a number of medications that are not safe to take during pregnancy. First among them are oral decongestants.

Oral decongestants are best avoided altogether during the first trimester because of an uncertain risk of several rare birth defects,” says Ciara Staunton, a family nurse practitioner and owner of Staunton Primary Care in Cincinnati.

What allergy medicine can you take when your pregnant

“However, Sudafed (pseudoephedrine), which is locked up behind the pharmacy counter, can be used in the second and third trimesters in women without hypertension.”

But Staunton warns that Sudafed-PE (phenylephrine), the over-the-counter option, should never be taken during pregnancy. It is less effective than pseudoephedrine. But more importantly, its safety for pregnant women is questionable.

Ms.

Staunton also recommends against using any herbal therapies during pregnancy. “In the United States and most other countries, herbal medicines are minimally regulated and not monitored for adverse events.”


Antihistamine tablets (oral antihistamines)

Antihistamine tablets can assist relieve itchy eyes, a runny nose and sneezing, but not every types are suitable to take during pregnancy, so always check with a GP beforehand.

Pharmacists are unlikely to sell antihistamines without a prescription for use in pregnancy because of manufacturers’ restrictions.

If you cannot use nasal sprays or eyedrops or they do not work for you, a GP may recommend an antihistamine tablet that does not cause drowsiness, such as:

  1. loratadine – this is generally the first choice for pregnant women because of the quantity of safety data available for it
  2. cetirizine – if loratadine is not suitable or does not work for you, a GP may recommend cetirizine, another antihistamine tablet that does not cause drowsiness

Chlorphenamine is also considered one of the safer antihistamines to take during pregnancy, but because it can cause drowsiness, loratadine and cetirizine are generally the preferred options.

For information about taking specific medicines in pregnancy, see the bumps (best use of medicines in pregnancy) website.

Here are answers to some of the most common questions pregnant patients enquire their allergist.

Immunotherapy and influenza vaccine

Allergen immunotherapy (allergy shots) is often effective for those patients in whom symptoms persist despite optimal environmental control and proper drug therapy.

Allergen immunotherapy can be carefully continued during pregnancy in patients who are benefiting and not experiencing adverse reactions. Due to the greater risk of anaphylaxis with increasing doses of immunotherapy and a delay of several months before it becomes effective, it is generally recommended that this therapy not be started during pregnancy.

Patients receiving immunotherapy during pregnancy should be carefully evaluated. It may be appropriate to lower the dosage in order to further reduce the chance of an allergic reaction to the injections.

Influenza (flu) vaccine is recommended for every patients with moderate and severe asthma.

There is no evidence of associated risk to the mom or fetus.

Can allergy medications safely be used during pregnancy?

Antihistamines may be useful during pregnancy to treat the nasal and eye symptoms of seasonal or perennial allergic rhinitis, allergic conjunctivitis, the itching of urticaria (hives) or eczema, and as an adjunct to the treatment of serious allergic reactions, including anaphylaxis (allergic shock). With the exception of life-threatening anaphylaxis, the benefits from their use must be weighed against any risk to the fetus. Because symptoms may be of such severity to affect maternal eating, sleeping or emotional well-being, and because uncontrolled rhinitis may pre-dispose to sinusitis or may worsen asthma, antihistamines may provide definite benefit during pregnancy.

Chlorpheniramine (ChlorTrimeton®), and diphenhydramine (Benadryl®) own been used for numerous years during pregnancy with reassuring animal studies.

Generally, chlorpheniramine would be the preferred choice, but a major drawback of these medications is drowsiness and performance impairment in some patients.. Two of the newer less sedating antihistamines loratadine (Claritin®), and cetirizine (Zyrtec®) own reassuring animal and human study data and are currently recommended when indicated for use during pregnancy.

The use of decongestants is more problematic. The nasal spray oxymetazoline (Afrin®, Neo-Synephrine® Long-Acting, etc.) appears to be the safest product because there is minimal, if any, absorption into the blood stream. However, these and other over-the-counter nasal sprays can cause rebound congestion and actually worsen the condition for which they are used.

Their use is generally limited to extremely intermittent use or regular use for only three consecutive days.

Although pseudophedrine (Sudafed®) has been used for years, and studies own been reassuring, there own been recent reports of a slight increase in abdominal wall defects in newborns.

What allergy medicine can you take when your pregnant

Use of decongestants during the first trimester should only be entertained after consideration of the severity of maternal symptoms unrelieved by other medications. Phenylephrine and phenylpropanolamine are less desirable than pseudophedrine based on the information available.

A corticosteroid nasal spray should be considered in any patient whose allergic nasal symptoms are more than mild and final for more than a few days. These medications prevent symptoms and lessen the need for oral medications. There are few specific data regarding the safety of intranasal corticosteroids during pregnancy.

However, based on the data for the same medications used in an inhaled form (for asthma), budesonide (Rhinocort®) would be considered the intranasal corticosteroid of choice, but other intranasal corticosteroids could be continued if they were providing effective control prior to pregnancy.

When women with asthma and allergies get pregnant, one-third discover their asthma and allergies improved, one-third discover they worsen and one-third remain unchanged.

Allergist James Sublett, MD

Should I continue my allergy shots during pregnancy?

It is appropriate to continue allergy shots during pregnancy in women who are not having reactions to the shots, because they may lessen your allergic or asthma symptoms.

There is no evidence that they own any influence on preventing allergies in the newborn. It is not generally recommended that allergy shots be started during pregnancy.

To summarize: It is extremely significant to monitor closely any asthma or allergic problems during your pregnancy. In the vast majority of cases, you and your kid can glance forward to a excellent outcome, even if your asthma is severe, so endless as you follow your doctor’s instructions carefully. At the extremely first signs of breathing difficulty, call your doctor.

Remember the harm of providing an inadequate supply of oxygen to your baby is a much greater risk than taking the commonly used asthma medications.

The best way to take control of your allergies and own a healthy pregnancy is to speak with an allergist.

This sheet was reviewed for accuracy 4/17/2018.


Decongestants

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

What allergy medicine can you take when your pregnant

Classified as Pregnancy Category C, pseudoephedrine is known to hazardous in certain situations.


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, and numerous 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.

What allergy medicine can you take when your pregnant

Other than anaphylaxis, no data shows that the allergy shots themselves are actually harmful to the fetus.

How to Treat Allergies During Pregnancy

Generally speaking, allergy medications are classified as either Pregnancy Category B or Category C.

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

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles.

Read our editorial policy to study more about how we fact-check and hold our content precise, dependable, and trustworthy.

  • stay indoors whenever possible
  • Allergen Immunotherapy Practice Parameters. Ann Allergy Asthma Immunol. 2003; 90:S1-40.
  • Kar S, Krishnan A, Preetha K, Mohankar A. A review of antihistamines used during pregnancy. J Pharmacol Pharmacother. 2012;3(2):105–108. doi:10.4103/0976-500X.95503

  • Dykewicz MS, Fineman S, editors. Diagnosis and Management of Rhinitis: Finish Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology.
  • wear wraparound sunglasses to stop pollen getting into your eyes
  • keep windows and doors shut as much as possible

Additional Reading

  1. Allergen Immunotherapy Practice Parameters.

    Ann Allergy Asthma Immunol. 2003; 90:S1-40.

  2. Dykewicz MS, Fineman S, editors.

    What allergy medicine can you take when your pregnant

    Diagnosis and Management of Rhinitis: Finish Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology.

Get advice first

Although you can purchase numerous hay fever medicines over the counter, it’s best to get advice from a pharmacist or GP before taking any medicine when you’re pregnant.

They’ll assess your symptoms and the benefits of taking a medicine against the risk of any side effects.

To ease your symptoms when the pollen count is high, it helps to:

  1. stay indoors whenever possible
  2. wear wraparound sunglasses to stop pollen getting into your eyes
  3. keep windows and doors shut as much as possible

If you decide to take hay fever medicine, you’ll generally be advised to attempt a nasal spray or eyedrops first.

Additional Reading

  1. Allergen Immunotherapy Practice Parameters.

    Ann Allergy Asthma Immunol. 2003; 90:S1-40.

  2. Dykewicz MS, Fineman S, editors. Diagnosis and Management of Rhinitis: Finish Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology.

Get advice first

Although you can purchase numerous hay fever medicines over the counter, it’s best to get advice from a pharmacist or GP before taking any medicine when you’re pregnant.

They’ll assess your symptoms and the benefits of taking a medicine against the risk of any side effects.

To ease your symptoms when the pollen count is high, it helps to:

  1. stay indoors whenever possible
  2. wear wraparound sunglasses to stop pollen getting into your eyes
  3. keep windows and doors shut as much as possible

If you decide to take hay fever medicine, you’ll generally be advised to attempt a nasal spray or eyedrops first.


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