Can You Take Allergy Medicine While You’re Pregnant?

The good news is that some—although not all—allergy medications are safe during pregnancy. 1 However, you need to do your due diligence on which ones will get the job done without compromising you and your baby’s health.

Here’s what you need to know about how your allergies will probably behave while you’re pregnant and what medications are safe to take for them.

Unfortunately, yes, you might find that your allergy symptoms feel more intense during pregnancy, although that isn’t guaranteed. 2

One-third of expecting moms’ allergies get worse. On the other hand, one-third of moms-to-be actually find that their allergies improve, and the remainder experience no changes.

Allergy-like hormonal symptoms

It’s also possible that while you’re pregnant, you’ll get allergy-like symptoms that have another cause entirely. Nasal congestion is one of the earliest pregnancy symptoms that many moms experience. 3

Pregnancy rhinitis or “pregnancy nose” also causes similar symptoms to allergies due to changes in your level of the hormone estrogen. These symptoms may include: 4

• Congestion
• Sneezing
• Runny nose
• Post-nasal drip (feeling mucus going down the back of your throat)

Many pregnant women who experience these hormonal and physical changes tend to breathe through their mouths, which can also lead to dryness and exacerbate allergy symptoms.

Yes, several over-the-counter (OTC) allergy medications are generally considered safe for use during pregnancy. However, some aren’t recommended in the first trimester due to the possibility of harming your baby’s development, something we’ll explore more further down. 1

Some of the most common allergy medicines you’ve probably heard of include antihistamines and eye drops for sneezing and itching, decongestants for stuffy noses, and corticosteroids in nasal sprays or creams to reduce inflammation. 1 5

Again, not all are safe during pregnancy. Here are some popular options you can ask your doctor about trying:

Antihistamines you can take while pregnant

Research has consistently shown that taking first-generation (i.e., older) antihistamines doesn’t significantly increase your baby’s risk of developing birth defects. 6 In fact, up to 15% of moms-to-be use antihistamines to alleviate their allergy symptoms and morning sickness. 6

However, older options can make you drowsy, including: 1 6 7

• Diphenhydramine (Benadryl)
• Chlorpheniramine (Chlor-Trimeton, Piriton, Allerief, Pollenase) 8
• Hydroxyzine (Vistaril and Atarax)

This isn’t dangerous—as long as you aren’t planning on driving or operating other heavy machinery—but it can be inconvenient. Newer antihistamines have a good safety profile while also being nondrowsy: 1

• Fexofenadine (Allegra)
• Cetirizine (Zyrtec)
• Loratadine (Claritin)
• Levocetirizine (Xyzal)

Note that heavily using some antihistamines like diphenhydramine (Benadryl) and hydroxyzine during pregnancy may cause your newborn to exhibit withdrawal symptoms (tremors and diarrhea). 7 9 Only use them when you need to, and again, talk to your doctor before taking them.

Nasal steroid sprays you can use while pregnant

Some older studies indicate that oral steroid medications can harm your baby’s growth and increase her risk of developing a cleft lip or palate, but more recent research hasn’t confirmed these findings. 1

To the contrary, the medication in nasal sprays doesn’t easily get absorbed into your bloodstream, so you’re not exposing yourself (or your baby) to excessive steroids during your pregnancy if you use them as directed.

Some OTC options include: 1 10

• Budesonide (Rhinocort)
• Triamcinolone (Nasacort)
• Fluticasone (Flonase)
• Mometasone (Nasonex)

Eye drops you can use while you’re pregnant

For itchy, watery eyes, allergy eye drops can be helpful, and they’re generally safer than taking oral medications because less medicine gets to your baby. 1

However, not all eye drops are created equal when it comes to pregnancy, and some have been studied more than others. Before you reach for your usual brand, give your doctor a call so they can help you find the safest option for you and your little one.

If you were already receiving allergy shots before becoming pregnant, you can probably continue them, but your allergist will avoid increasing the dosage. 1

This is because if you’re building up your dosage (or are completely new to allergy shots), you have a small chance of experiencing anaphylaxis, a life-threatening allergic reaction.

If you develop new allergy symptoms during pregnancy, consult your doctor to determine the best course of treatment.

Avoid products labeled “cold relief,” “congestion relief,” or that have names that feature a “D” (like Claritin-D or Zyrtec-D), as they contain decongestants, which are generally not recommended during pregnancy, especially in the first trimester.

The American College of Obstetricians and Gynecologists (ACOG) doesn’t recommend oral decongestants like pseudoephedrine (Sudafed), as they’ve been linked to potential birth defects. 11 12

You also shouldn’t take pseudoephedrine if you have high blood pressure without first talking to a doctor. This medication can elevate your blood pressure, which can cause jitters, a racing heartbeat, and other concerns during pregnancy. 13

Short-term use (3 days or less) of nasal decongestants may not be as much of an issue when compared to oral decongestants, but these medications narrow your blood vessels, which could cut off the oxygen supply to the placenta and your baby. 1

Before resorting to medication, try making lifestyle adjustments to manage your symptoms.

For example, regular exercise can help reduce nasal inflammation. At night, use nasal strips to keep your passages open and keep your head elevated to promote better drainage. 1

Consider these drug-free strategies for managing allergy symptoms: 14

• Avoid triggers: Limit your exposure to known allergens, such as pollen. Stay indoors when pollen counts are high (check the Air Quality Index in your area), keep your windows closed, and shower after spending time outside.
• Try a saline nasal rinse: Use a neti pot or saline nasal spray to flush out allergens and keep your nasal passages moist. Be sure to use water that’s distilled, sterilized, or boiled (for at least 5 minutes) to avoid introducing any irritants. 15
• Use a humidifier or dehumidifier: Dry air can worsen your allergies and asthma. A humidifier can moisten the air and soothe your irritated nasal passages. 16 On the other hand, dehumidifiers also work well if you live in a humid area and your allergies are caused by dust mites and mold (which thrive in moist air). 16

For days when you’re stuck indoors with the AC running, consider getting a high-efficiency particulate air (HEPA) filter if your AC doesn’t already have one.

When you have allergies, getting quick relief can be tempting. Still, you should talk to your doctor first before taking any medications, even ones you were taking before you became pregnant.

They’ll weigh the risks and benefits of your treatment options while prioritizing you and your baby’s well-being.