Can you take antihistamines when pregnant?

According to the American College of Obstetricians and Gynecologists (ACOG), several over-the-counter (OTC) antihistamines may be taken during pregnancy.

Older, first-generation antihistamines can be taken, but they may cause drowsiness.

Newer, second-generation antihistamines can also be taken and have less risk of drowsiness.

Oral decongestant medication should be avoided in the first three months of pregnancy.

Allergy or cold symptoms, allergic reactions, and allergic skin rashes may occur during pregnancy. You and your pregnancy care provider may weigh the benefits and possible risks of taking medication.

According to ACOG, the safest first-generation antihistamines for pregnant women are:

• Chlorpheniramine
• Dexchlorpheniramine

The American College of Allergy, Asthma, and Immunology (ACAAI) suggests Chlor-Trimeton (chlorpheniramine) as the first choice for pregnancy. ACAAI recommends two second-generation antihistamines if drowsiness is a problem:

• Claritin (loratadine)
• Zyrtec (cetirizine)

Both ACOG and ACAAI say to avoid OTC oral decongestants during your first three months of pregnancy due to a possible risk of abdominal wall birth defects. These include the decongestant Sudafed (pseudoephedrine) and other decongestants, such as phenylephrine and phenylpropanolamine.

Nasal spray for allergic rhinitis may be another option. Decongestant nasal sprays like Afrin and Neo-Synephrine appear to be safe in pregnancy, but can cause rebound nasal congestion if used for more than a day or two. Steroid nasal sprays may be more effective. ACAAI recommends starting with Rhinocort® (budesonide).

Always check with your pregnancy care provider before starting any OTC medication.