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Flonase, Rhinocort, and More: Which Nasal Allergy Sprays Can You Use While Pregnant?

Christina Aungst, PharmDAmy B. Gragnolati, PharmD, BCPS
Updated on January 17, 2025

Key takeaways:

  • Rhinocort (budesonide) is the preferred nasal allergy spray to use during pregnancy. Flonase Sensimist (fluticasone furoate), Flonase Allergy Relief (fluticasone propionate), and Nasonex (mometasone) are also safe and effective options.

  • Nasacort Allergy (triamcinolone) and Afrin (oxymetazoline) aren’t recommended during pregnancy. Some studies have suggested a link between these nasal sprays and certain birth defects.

  • Oral antihistamines, like Zyrtec (cetirizine), are safe alternatives to nasal sprays for allergy symptom relief during pregnancy.

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A pregnant woman using a nasal spray.
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Nasal allergy sprays treat stuffy noses and itchy eyes related to allergies. But if you’re pregnant, you may wonder if they’re safe to use.

Studies have shown that many nasal sprays, including Flonase and Rhinocort, are safe to use during pregnancy to treat allergies. But others, like Nasacort and Afrin, should be avoided.

What nasal allergy sprays are safe during pregnancy?

There are different types of nasal allergy sprays available. Below, we’ll run through which ones are considered safe to use during pregnancy.

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Most nasal steroid sprays

For most people, nasal steroid sprays are a first-choice option for treating and preventing allergies. This includes during pregnancy. Though, only some nasal steroid sprays are recommended if you’re expecting.

Nasal steroid sprays that are safe to use during pregnancy include:

It’s important to note that studies suggest both versions of Flonase are safe if you’re pregnant. But a small study found that Flonase Allergy Relief was no more effective than a placebo during pregnancy. In this case, a placebo is a nasal spray that contains no medication.

NasalCrom

NasalCrom (cromolyn) is a nasal spray that has been recognized as safe to use during pregnancy since the 1970s. This mast cell stabilizer is one of the safest nasal sprays to use if you’re pregnant. But it’s also one of the least effective. It takes several weeks to start working, and it provides less relief than nasal steroid sprays. But Nasalcrom might be an option if you can’t tolerate nasal steroids.

Nasal antihistamines

Nasal antihistamines are thought to be safe to use during pregnancy. But there are currently no pregnancy safety studies that have been conducted in humans. The two available nasal antihistamines are Astepro (azelastine) and Patanase (olopatadine). If you’ve been using one of these products, talk to your prenatal care team about whether it’s the best option for you.

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What nasal allergy spray medications are not safe during pregnancy?

There are a few nasal allergy sprays that generally aren’t recommended during pregnancy. Though, you can still discuss these options with your prenatal care team.

Nasacort Allergy

While most nasal steroid sprays are considered safe to use during pregnancy, there’s one that isn’t recommended: Nasacort Allergy (triamcinolone).

In one study, this nasal steroid spray was linked to lung and respiratory birth defects in a small number of pregnancies. Larger studies would be needed to confirm this information. However, many healthcare professionals recommend avoiding Nasacort during pregnancy to be safe.

Nasal decongestants like Afrin

Decongestants are generally considered unsafe to use during pregnancy. But most of the research in this area focuses on oral decongestants, like Sudafed (pseudoephedrine). The studies that have been done on nasal spray decongestants, like Afrin (oxymetazoline), are limited. One study found a link between Afrin use during pregnancy and certain birth defects. However, more studies would be needed to say for sure whether it's safe or unsafe.

Discuss whether it’s safe to use Afrin during pregnancy with your prenatal care team first. Some healthcare professionals may say a short course (no more than 3 consecutive days) is OK. Others may recommend avoiding Afrin altogether. Your prenatal specialist will weigh your unique risks when making a recommendation.

What else can you do to treat your allergies during pregnancy?

There are plenty of other ways to treat and manage allergy symptoms during pregnancy. Oral antihistamines, like Zyrtec (cetirizine) and Benadryl (diphenhydramine), are safe to take if you’re pregnant. Just be aware that some antihistamines can cause drowsiness. Nondrowsy options, like Claritin (loratadine), may be preferable.

If you want to avoid taking medication, consider trying these tips to combat allergies:

  • Watch pollen and mold counts in your area. This will help you know when your allergy symptoms are likely to be worse.

  • Stay inside when possible. When allergen counts are higher, try to stay inside if you can. Keep your doors and windows shut to help keep allergens out of your house.

  • Wash off after being outside. After coming inside, change your clothes and take a quick shower. This will help remove pollen and mold from your clothing and body.

  • Wear a mask while being exposed to allergens. Wearing a properly fitting mask when you’re outside can help reduce allergy symptoms. An N95 mask will provide better protection from allergens than surgical or cloth masks.

  • Consider a HEPA filter. If you have pet or indoor allergies, a HEPA filter may be helpful for lowering the allergen count in your house.

Frequently asked questions

What is safe to take for sinus issues while pregnant?

Most nasal steroid sprays, such as Rhinocort Allergy, are safe to use during pregnancy and work well for sinus congestion and infections. But avoid Nasacort Allergy, which isn’t considered safe to use while expecting. You can also ask a healthcare professional if it would be OK for you to take Tylenol (acetaminophen) for sinus pain relief.

What antihistamines are safe for treating rhinitis during pregnancy?

Most antihistamines are considered safe to take during pregnancy. But some have more studies to support their safety than others. Older antihistamines, such as chlorpheniramine (Aller-Chlor), have been well studied for safety during pregnancy. But they typically cause drowsiness for most people. So experts also recommend newer antihistamines that cause less drowsiness, such as Zyrtec and Claritin.

Is saline nasal spray safe to use during pregnancy?

Yes, saline nasal spray is safe to use during pregnancy. It doesn’t contain medication and can be used as often as needed. Experts recommend trying medication-free remedies, such as saline spray, before taking allergy medications during pregnancy.

The bottom line

Many nasal allergy sprays are safe to use during pregnancy. Popular options include nasal steroid sprays like Rhinocort (budesonide), Flonase Sensimist (fluticasone furoate), and Nasonex (mometasone). Nasalcrom (cromolyn) and Astepro (azelastine) are two other safe options if nasal steroids aren’t working for you.

In many cases, Nasacort Allergy (triamcinolone) and Afrin (oxymetazoline) should be avoided during pregnancy. These two nasal sprays may be linked to certain birth defects. Discuss nasal allergy spray options with your prenatal care team to find out the best options for you.

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Why trust our experts?

Christina Aungst, PharmD
Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.
Amy B. Gragnolati, PharmD, BCPS
Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

References

Alhussein, A. H., et al. (2017). Safety of intranasal corticosteroid sprays during pregnancy: An updated review. European Archives of Oto-Rhino-Laryngology.

Allergy & Asthma Network. (n.d.). Pregnancy and allergies.

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American College of Allergy, Asthma, and Immunology. (2017). Seasonal allergies.

American College of Obstetricians and Gynecologists. (2021). What medicine can I take for allergies while I'm pregnant?

Bérard, A., et al. (2016). Intranasal triamcinolone use during pregnancy and the risk of adverse pregnancy outcomes. Journal of Allergy and Clinical Immunology.

Caparroz, F. A., et al. (2015). Rhinitis and pregnancy: Literature review. Brazilian Journal of Otorhinolaryngology.

Dykewicz, M. S., et al. (2020). Rhinitis 2020: A practice parameter update. The Journal of Allergy and Clinical Immunology.

Greenberger, P., et al. (1978). Safety of therapy for allergic symptoms during pregnancy. Annals of Internal Medicine.

Haleon US Holdings. (2024). Flonase Sensimist Allergy Relief - fluticasone furoate spray, metered [package insert]. DailyMed.

Pfaller, B., et al. (2021). Management of allergic diseases in pregnancy. Allergy.

Yau, W. P., et al. (2013). Use of decongestants during pregnancy and the risk of birth defects. American Journal of Epidemiology.

Yawn, B., et al. (2007). Treating asthma and comorbid allergic rhinitis in pregnancy. Journal of the American Board of Family Medicine.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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