Is It Safe to Take Allergy Medication While Pregnant? Experts Weigh In

Being pregnant is tough, in more ways than one. It's so draining that it almost feels unfair that you can get sick while being pregnant. Especially considering that when you're under the weather, many of the medicines that you'd normally reach for are totally off limits. Case in point: allergy medications. More than 50 million people in the US experience allergies yearly, according to the American College of Allergy, Asthma & Immunology, and those allergies don't go away during the nine-plus months you're pregnant. In fact, while as many as 33 percent of people say their symptoms lessen during pregnancy, the other two-thirds say they stay the same or get worse, according to the Allergy & Asthma Network. That group are left wondering: can you take allergy medicine while pregnant?

The reality is that not all medications are safe or recommended for pregnant people to take. That's why it's so important to talk to your doctor about the best options for your symptoms. We asked experts to give us an overview of taking allergy medicine while pregnant, but every person is different and nothing beats getting individualized advice.

Editor's note: This information in this article is not medical advice. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment, especially when you're pregnant.

The good news is that there are allergy medications available that are safe for pregnant people to take, according to experts. "Many over-the-counter allergy medications can be used to safely treat allergy symptoms during any trimester of pregnancy," Sarah McBane, PharmD, a clinical professor at UC Irvine's School of Pharmacy & Pharmaceutical Sciences, tells PS.

A 2021 article in the journal Allergy reports similarly, citing several studies that show antihistamines are "widely prescribed during pregnancy for various indications" and "that the literature regarding antihistamine safety . . . is reassuring" for second-generation antihistamines, a medication classification used to treat symptoms of allergies. Likewise, there are some cases where first-generation antihistamines might be favored despite having more sedating properties.

But Dr. McBane also emphasizes that other options exist. "The best medication for a pregnant or breastfeeding individual with allergy symptoms is not always an oral medication," she says. Instead, she suggests talking to your care team about eye drops or nasal sprays to treat your most irritating symptoms, which might be a better and lower-risk option.

"Since these medications are not taken by mouth, much less of them gets into a pregnant or breastfeeding individual's system and therefore lessens any potential exposure to a developing fetus or breastfeeding infant," she says. Dr. McBane emphasizes it's "always best to speak with a pharmacist or physician before taking any medications during pregnancy or while breastfeeding."

Worth mentioning: when it comes to the safety of allergy-medication use during pregnancy, vague language like "may be safe" is often used. The Association of American Medical Colleges explains that because pregnant people are generally excluded from clinical trials, safety data is often collected through retrospective analysis. However, that doesn't mean there aren't safe options available — but it does indicate that it's always a good idea to check in with your doctor or pharmacist, who can weigh in on your specific circumstances on which medications, if any, would be best.

Find more info on specific oral medications below.

"Benadryl, also called diphenhydramine, is a first-generation antihistamine," Dr. McBane says. "It tends to make people drowsy and may cause side effects such as dry mouth or constipation."

She explains that taking Benadryl is considered to be safe during pregnancy; however, she notes that "there are other medications that would be a better choice for allergies," with fewer side effects.

Claritin, also known as loratadine, is a second-generation antihistamine. Dr. McBane says that since this medication "has been around longer and has more information on its use in pregnant and breastfeeding individuals, it's often the recommended oral allergy medication."

While it's still important to talk to your doctor before taking Claritin during pregnancy, the American College of Allergy, Asthma & Immunology notes that Claritin has "reassuring animal and human study data and [is] currently recommended when indicated for use during pregnancy."

Zyrtec, the brand name for cetirizine, is classified as a second-generation antihistamine. According to an article in the journal American Family Physician, which cited four studies examining its effects, this medicine "[does] not appear to increase overall fetal risk." And the American College of Allergy, Asthma & Immunology notes that cetirizine has been studied in animals and humans with "reassuring" data suggesting it's safe to use in pregnancy.

In addition, a 2018 study published in the Journal of Obstetrics and Gynaecology, which conducted a retrospective analysis of cetirizine use during pregnancy, concluded that exposure to cetirizine "during pregnancy is not associated with adverse outcomes" for the pregnant person or baby.

Xyzal, the brand name for levocetirizine, is a second-generation antihistamine; however, it doesn't have as much data on its use as other options, so it shouldn't be your first-line option unless your doctor tells you otherwise.

"Although it's probably safe, not much information is available on the use of Xyzal in pregnant or breastfeeding individuals," Dr. McBane says. In these cases, doctors tend to err on the side of caution and recommend medicines that have been more thoroughly studied.

Allegra, the brand name for fexofenadine, is another second-generation antihistamine. The American Family Physician article states, "Studies on the safety of terfenadine (which fexofenadine is a metabolite of) in human pregnancy did not show a significant risk of congenital malformation," noting the drug didn't appear to increase "overall fetal risk." A 2020 study in JAMA Pediatrics came to the same conclusion.

While the American Family Physician article states that fexofenadine is considered mostly safe, it also notes that the drug "has been associated with early pregnancy loss in animal studies but has not been studied in human pregnancy." As always, make sure to talk to your doctor before taking this antihistamine to get a sense of your individual risk.

You should ask your doctor before taking any medicine if you're breastfeeding your child, but in general, most antihistamines are thought to be safe to use while breastfeeding, Dr. McBane shares.

A 2010 article published in the Canadian Family Physician Journal explains this further, noting that "minimal amounts (of antihistamines) are excreted in the breast milk." And because these medications don't cross into the breast milk, they "would not cause any adverse effects on a breastfeeding infant."

Devan McGuinness (she/they) is a Canadian disabled writer, editor, and social strategist who covers politics, entertainment, parenting, and lifestyle. Devan has contributed to POPSUGAR, Fatherly, Parents, Scary Mommy, Mom.com, and more over her 10-plus years in digital media, specializing in stories that matter most to families.