5 Allergy Medications That Are Safe During Pregnancy (Plus, Medications to Avoid)

1. Most steroids nasal sprays, such as Rhinocort

Corticosteroid (steroid) nasal sprays are a first-choice option for allergy treatment and prevention. Many are available over the counter (OTC). And almost all of them are safe to use if you’re pregnant.

Steroid nasal sprays that are safe to use during pregnancy include:

• Rhinocort Allergy (budesonide)

• Flonase Sensimist (fluticasone furoate)

• Nasonex (mometasone)

• Flonase Allergy Relief (fluticasone propionate)

Of these, Rhinocort is the preferred steroid nasal spray to use during pregnancy.

2. Most oral antihistamines, such as Zyrtec

Oral antihistamines are often a go-to choice for allergy symptoms, since they start working within a few hours. Research suggests that it’s likely safe to take most oral antihistamines during pregnancy. Studies have found no evidence that these allergy medications cause harm to a human fetus. But some antihistamines have more safety data available than others.

Well-studied antihistamines that are safe to take during pregnancy include:

• Benadryl (diphenhydramine)

• Chlorpheniramine

• Claritin (loratadine)

• Hydroxyzine

• Xyzal (levocetirizine)

• Zyrtec (cetirizine)

Allegra (fexofenadine) is also likely safe to take during pregnancy. But this antihistamine hasn’t been as well studied as those listed above. Let your prenatal care team know if you’re already taking Allegra. They can determine if you should continue taking it or switch to another antihistamine.

Good to know: Older oral antihistamines, such as Benadryl, can cause dizziness and drowsiness. These side effects can raise your risk of falls or accidental injury. Newer antihistamines, such as Claritin, are less likely to cause drowsiness, however.

3. Antihistamine nasal sprays, such as Astepro

Antihistamine nasal sprays are another type of allergy medication that are likely safe during pregnancy. These medications work faster than oral antihistamines. But only Astepro (azelastine) is available OTC.

Antihistamine nasal sprays haven’t been as well studied for use during pregnancy as oral antihistamines. Based on available animal studies, and what we know about oral antihistamines, experts believe they’re likely safe. But it’s a good idea to double check with your prenatal care team about whether antihistamine nasal sprays are a good option for you.

4. Singulair (montelukast)

Singulair (montelukast) is a leukotriene receptor antagonist. It’s typically prescribed when other allergy medications haven’t worked well enough. It can also be helpful for people who have both allergies and asthma.

Small studies suggest that Singulair doesn’t appear to cause any major birth defects. Larger studies are needed to confirm this. But Singulair could be a possible second-choice option if other allergy medications aren’t effective enough or if you have both allergies and asthma.

5. NasalCrom

NasalCrom (cromolyn) is a mast cell stabilizer that has been around for several decades. It’s one of the safest allergy medications to take during pregnancy. But it’s less effective than the medications discussed above.

Nasalcrom also takes several weeks to start working. But it could be an option to consider if you’re unable to take other allergy medications.

Nasal decongestants

It’s typically recommended to avoid nasal decongestants, such as Sudafed (pseudoephedrine), unless told otherwise by your prenatal care team. This includes decongestant nasal sprays, such as Afrin (oxymetazoline).

The studies on taking nasal decongestants during pregnancy are limited and conflicting. Some studies show a higher rate of birth defects, while others don’t. The American College of Obstetricians and Gynecologists recommends avoiding decongestants during your first trimester (the first 3 months of a pregnancy). But it’s possible your prenatal care team may recommend avoiding them throughout your entire pregnancy.

Nasacort

As discussed earlier, most nasal steroid sprays are safe to use during pregnancy. But Nasacort (triamcinolone) may not be. A small study suggests Nasacort may raise the risk for certain lung birth defects. Larger studies would be needed to confirm this. But, to be safe, it’s recommended to avoid Nasacort during pregnancy.

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