Safely Treat Allergies During Pregnancy

Happy spring allergy season! Seasonal allergies affects up to 30% of the world's population. Allergies during pregnancy can feel extra annoying since pregnancy often causes swollen nasal passages even without allergies. You may be wondering which medications are safe to take to alleviate allergy symptoms, or if you can take medication at all! Thankfully, there are lots of options.

With the help of MotherToBaby -- the professional scientific society of experts that provides the most cutting-edge and up-to-date information about the risks of medications, chemicals, herbal products, illicit drugs, diseases and much more during pregnancy and while breastfeeding -- we provide a list of the allergy medications considered safe to take in pregnancy.

How to Ease Allergy Symptoms During Pregnancy

Researchers at MotherToBaby have found that first generation antihistamines (i.e. the ones that have been around the longest, like chlorpheniramine or diphenhydramine) have relatively reassuring pregnancy profiles, and are often preferred for having the most pregnancy data. Claritin (loratadine) is a second generation antihistamine, but has still been around for a long time and its overall pregnancy data has been reassuring. For people whose allergies trigger asthmatic symptoms, it is especially important to find an effective treatment. It is recommended however to skip the "D" component (oral decongestant) of antihistamines during the first trimester due to possible, but unproven, small concerns.

Of course, as with anything taken in pregnancy, talk to your doctor or midwife before starting, continuing, or discontinuing any medications. The following breakdown provides more details on specific over-the-counter allergy medication. 

Loratadine (Claritin)

Risk of fertility issues? "One animal study did not report fertility issues in females exposed to loratadine. There are no other studies available."

Risk of miscarriage? "A study of 161 women taking loratadine during the first trimester did not show any differences in the rates of miscarriage."

Risk of birth defects? "It is unlikely that loratadine would cause an increased chance for birth defects. One study with several limitations suggested a small risk for hypospadias (a condition where the opening of the penis is on the underside of the penis instead of at the tip). After collecting more data, this study author published another paper that admitted the increased risk originally seen may have been due to study limitation. In addition, additional studies of pregnant women taking loratadine have not supported an increased risk of any type of birth defect, including hypospadias. Also, studies involving infants with hypospadias did not find that their mothers used loratadine more frequently during pregnancy."

Risk of other pregnancy problems? "Loratadine is not expected to cause other pregnancy problems. A study of 161 women taking loratadine during the first trimester did not show any differences in the rates of delivery age, or birthweight compared to women who did not take loratadine."

To learn more details about loratadine, check out the MotherToBaby fact sheet.

Cetirizine (Zyrtec)

Risk of fertility issues? "One report involving one man suggested that exposure to cetirizine may be associated with decreased sperm movement, but more studies need to be done to confirm this finding. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. "

Risk of miscarriage? "Cetirizine is not expected to cause other pregnancy problems. Studies on a small number of pregnancies showed no increase in miscarriage, premature delivery (having the baby before 37 weeks), or low birth weight."

Risk of birth defects? "Studies involving over 1,300 babies born to mothers who took cetirizine in the first trimester did not show an increased chance of birth defects."

Risk of other pregnancy problems? "Cetirizine is not expected to cause other pregnancy problems. Studies on a small number of pregnancies showed no increase in miscarriage, premature delivery (having the baby before 37 weeks), or low birth weight."

To learn more details about cetirizine, check out the MotherToBaby fact sheet.

Diphenhydramine (Benadryl)

Risk of birth defects? "There are no published studies looking at whether diphenhydramine increases the chance of miscarriage. This does not mean there is an increased chance or that there is no increased chance, it only means that this question has not been answered."

Risk of other pregnancy problems? "Occasional use of diphenhydramine at recommended doses have not been shown to cause problems in pregnancy. There are rare reports of problems with the use of diphenhydramine in the third trimester. These reports usually involve using more of the medication than is recommended or using it for long-term (chronic) use. High levels of diphenhydramine could cause uterine hyperstimulation (contractions that are too long or too often). Uterine contractions can also lead to serious complications, including preterm delivery, uterine rupture (a tear in the uterus) or placental abruption (when the placenta pulls away from the wall of the uterus before the baby is born).

Also, there are a few reports of withdrawal symptoms (tremors and diarrhea) in infants whose mothers took diphenhydramine daily throughout pregnancy."

To learn more details about diphenhydramine, check out the MotherToBaby fact sheet.

Fexofenadine (Allegra)

Risk of fertility issues? "Studies on women have not been done to see if fexofenadine could make it harder for a woman to get pregnant. In animal studies, there was no evidence that suggested taking fexofenadine will make it harder to become pregnant."

Risk of miscarriage? "Studies have not been done to see if fexofenadine increases the chance for miscarriage."

Risk of birth defects? "Studies on both fexofenadine and terfenadine have not found an increase chance of birth defects with the use of these medications during pregnancy."

Risk of other pregnancy problems? "There are no studies that have looked at whether fexofenadine causes other pregnancy complications or long-term problems for the baby. A study on terfenadine found no increase in premature delivery or low birth weight when used during pregnancy."

To learn more details about fexofenadine, check out the MotherToBaby fact sheet.

Chlorpheniramine (Chlor-Trimeton)

Risk of fertility issues? "Studies have not been done to see if chlorpheniramine could make it harder for a woman to get pregnant."

Risk of miscarriage? "We have not located studies that try to see if chlorpheniramine has any effect on human fertility."

Risk of birth defects? "It is unlikely that chlorpheniramine would cause an increased chance for birth defects. Most studies find no overall increased chance of birth defects with the use of chlorpheniramine in early pregnancy. While two studies found a small increased chance for different types of birth defects, no pattern has been detected. At this time, reports describing birth defects with first trimester chlorpheniramine cannot be considered proof of risk and it is likely that these problems were due to chance."

Risk of other pregnancy problems? "Studies have not been done to see if chlorpheniramine might increase the chance for pregnancy complications."

To learn more details about chlorpheniramine, check out the MotherToBaby fact sheet.

There are, of course, many non-drug, natural remedies, prevention strategies, and treatments for allergies. For more information, check out this article from Reader's Digest or this one, from Wellness Mama. Even with natural treatments, like those that recommend the use of dietary changes or essential oils, it's best to talk first with your care provider. If all else fails, there are simple changes you can make like limiting time outdoors, not opening your house windows when the pollen count is high, and taking a shower and/or changing clothes after spending time outdoors, all of which can help reduce your seasonal allergy symptoms.