Nasal steroid sprays (also called intranasal glucocorticoid sprays) are effective for stuffy nose and itchy eyes related to allergies. Post nasal drip symptoms—chronic cough, hoarse voice and dripping down the back of your throat—are easily remedied with steroid nasal sprays.
If you’re pregnant though, you may wonder if they’re safe to use. Well, recent reassuring studies have shown us that nasal steroid sprays are safe to use during pregnancy for mild to moderate symptoms related to allergies. Keep this in mind though—while some are fine, not all nasal sprays are safe for use during pregnancy. Here is what you need to know:
What are some examples of intranasal steroid sprays?
Commonly used steroid nasal sprays include Flonase (fluticasone propionate), Nasacort AQ (triamcinolone), Nasonex (mometasone), Omnaris (ciclesonide), Rhinocort Aqua (budesonide) and Veramyst (fluticasone furoate). Many have over the counter versions, including Flonase Allergy Relief, Nasacort Allergy, Rhinocort Allergy, and the soon to be released Flonase Sensimist.
How do we know nasal steroid sprays are safe during pregnancy?
A study of 140,000 pregnant women, of whom 2502 were exposed to steroid nasal sprays during their pregnancy, found no increased rates of miscarriage or major birth defects compared to those not using nasal steroid sprays.
Which nasal steroid sprays can I use if I’m pregnant?
Rhinocort Aqua (budesonide) has been the best studied during pregnancy, so it’s recommended as a first line treatment. Budesonide nasal spray is available with a prescription, or over the counter as Rhinocort Allergy. Other options that are safe to use during pregnancy include Nasonex (mometasone) or Flonase (fluticasone propionate).
Nasacort AQ (triamcinolone) nasal spray, which is also available over the counter, was the only one of potential concern. It was associated with a slight increased risk of abnormalities of the respiratory system and of choanal atresia (narrowing or blockage of the nasal airway by tissue).
What about antihistamine nasal sprays?
Astelin and Astepro (azelastine) are also intranasal allergy medications (nasal sprays) but they have not been well studied and should be avoided until we know more. They are antihistamines, rather than steroids, and work in a different way.
What about over the counter decongestant nasal sprays?
Decongestant nasal sprays can be used very briefly during pregnancy (three days or less) for temporary relief of nasal congestion, but they also have not been well studied and are not for prolonged use. Examples of OTC nasal decongestants are Afrin, Mucinex, Vicks and Neo-synephrine. I’d say avoid these, you have better options.
I hate using nasal sprays, do I have other options for allergies during pregnancy?
Antihistamine tablets like Claritin (loratadine) and Zyrtec (cetirizine) are less effective compared to the nasal steroid sprays, but they are safe for use during pregnancy.
Intranasal triamcinolone use during pregnancy and the risk of adverse pregnancy outcomes.AU Bérard A, Sheehy O, Kurzinger ML, Juhaeri J
SO J Allergy Clin Immunol. 2016 Jul;138(1):97-104.e7. Epub 2016 Apr 1.