What allergy medicine can i take while pregnant first trimester

Seasonal allergies can be tricky to manage in the best of times, but when you’re pregnant (and sniffling, and sneezing, and itchy all over), staying on top of your allergy symptoms feels like a major effort. 

You don’t want to take anything that could harm your baby, but you also can’t spend any more days walking around in an allergy-induced fog. What is safe to take for your allergies while pregnant and what isn’t? Here’s a breakdown of your options.

What Allergy Medications Are Safe?

Thankfully, there are more allergy medications that are safe to take than ones that aren’t, so you don’t have to suffer with miserable allergy symptoms just because you’re pregnant. Many over-the-counter antihistamine medications and nasal steroid sprays are safe to take in pregnancy, says OBGYN Danielle Jones, MD, of Mama Doctor Jones.

Oral Tablets

• loratadine (Claritin)

• cetirizine (Zyrtec)

• fexofenadine (Allegra)

• diphenhydramine (Benadryl)

Nasal Sprays

• budesonide (Rhinocort)

• mometasone (Nasonex)

• fluticasone (Flonase/Veramyst)

“Most allergy medications listed above will have relatively little effect on the pregnancy and contain the same risk and benefit profile for the person taking it as if they were not pregnant,” says Dr. Jones.

Choosing an Allergy Medication

Once you know which medications are safe to take, you’ll have to figure out which one will work the best for you. If your allergies are chronic or environmental (like mold or pet dander, for example), you may want to find an antihistamine you can take every day, such as Claritin or Zyrtec.

Seasonal allergies can also be treated this way, but if your symptoms are very infrequent, Benadryl is a good, super-safe choice.

Benadryl can make you excessively drowsy, so be careful of when you take it; if you’re not sure how it will affect you, don’t take a dose before driving. If it makes you sleepy, save your dose for the evening hours, before bedtime. (As an added bonus, it may help you sleep better!)

If you suffer from sinus pain or pressure during allergies, one of the nasal steroid sprays can be a good option. Pregnant women often end up with excess nasal congestion anyway, thanks to an increase in fluid and blood volume (it can cause swelling everywhere, not just in your ankles!); a nasal steroid can help relieve some of these additional symptoms.

Allergy Medications to Avoid

While most antihistamines are safe to take during pregnancy, some other medications often used to treat allergy symptoms may not be. Expectant moms should be mindful of combination allergy formulas that include other ingredients unsafe for pregnant women, like aspirin or other NSAIDs, and some cough suppressants or expectorants. 

You should also take care to avoid allergy medications with decongestants like pseudoephedrine (Sudafed), says Dr. Jones, unless your physician or midwife has approved it. 

“Although decongestants are unlikely to cause problems with the fetus, they can cause an increase in blood pressure in certain individuals,” Dr. Jones explains. 

There is some research suggesting a slightly higher risk of birth defects associated with pseudoephedrine, although so far, those possible risks have only been identified during the first trimester.

That means Sudafed may be a limited-use option for women in their second and third trimesters who do not have any previous hypertension issues (but only if your doctor says it’s OK).

What About Nasacort?

You may have noticed that Nasacort (triamcinolone), was left off Dr. Jones’ list of safe nasal steroids. It wasn’t an oversight: it’s not recommended for use during pregnancy.

A 2018 review of intranasal steroid use during pregnancy published in the European Archives of Oto-Rhino-Laryngology found it to be the only spray associated with a higher risk of respiratory birth defects among those studied in the review.

Skip the Nasacort and choose one of the other recommended sprays if you need it.

Additionally, the steroid-free OTC nasal spray Astepro (azelastine hydrochloride) may be an option if your doctor gives their OK. The medication is approved to treat seasonal allergies and allergic rhinitis in people ages six and up and has not been shown to be harmful for pregnant people or their babies. However, there is only limited data available and some studies on animals have shown potential issues in offspring when exposed to very large doses.

How to Reduce Your Symptoms While Pregnant

Unfortunately, one of best ways to reduce allergy symptoms is to avoid your triggers, but that’s often easier said than done. You can’t just lock yourself inside your house during ragweed season! 

But there are a few alternative remedies for cutting down on your exposure to allergens, says Dr. Jones. You can:

• Change your clothes after spending time outside or exposed to allergy triggers.
• Run a humidifier to remove allergens and impurities from the air.
• Stay hydrated.
• Use nasal saline irrigation.
• Utilize air conditioning in your car and home instead of keeping the windows open.

Of course, if you’re still struggling with your allergy symptoms, you should reach out for additional help. 

“Don't hesitate to chat with your physician or midwife regarding your symptoms and seek their expert advice [on] what can be done,” says Dr. Jones. 

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Yau W-P, Mitchell AA, Lin KJ, Werler MM, Hernández-Díaz S. Use of decongestants during pregnancy and the risk of birth defects. Am J Epidemiol. 2013;178(2):198-208.

2. Alhussien AH, Alhedaithy RA, Alsaleh SA. Safety of intranasal corticosteroid sprays during pregnancy: an updated review. Eur Arch Otorhinolaryngol. 2018;275(2):325-333.

3. DailyMed. Azelastine hydrocloride spray, metered.

By Sarah Bradley
Sarah Bradley is a freelance health and parenting writer who has been published in Parents, the Washington Post, and more.

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