Table of ContentsView AllTable of ContentsDuring PregnancyWhich Antihistamines Are Safe to Use in Pregnancy?Antihistamines and Birth DefectsAlternatives
Table of ContentsView All
View All
Table of Contents
During Pregnancy
Which Antihistamines Are Safe to Use in Pregnancy?
Antihistamines and Birth Defects
Alternatives
If you’re pregnant, you may wonder if it’s safe to useantihistamines. An estimated 10% to 15% of pregnant people do use these drugs to treatallergic rhinitis(runny nose) as well ashives, nausea and vomiting,asthma,indigestion, and more.
Studies have shown that most antihistamines do not appear to be linked to birth defects and that certain medications, such asZyrtec(cetirizine) andClaritin(loratadine), may be safe to use during pregnancy. However, researchers often note that more study is needed, and caution is urged especially during the first trimester of pregnancy.
This article discusses antihistamine use and safety during pregnancy, according to research, evidence, and health professionals' recommendations.
skynesher / Getty Images
Is It Safe to Take Antihistamines During Pregnancy?
A group of researchers from the United States and Singapore sought to determine the safety of antihistamines taken during the first trimester of pregnancy.The researchers examined data collected over a 12-year period, from 1998 to 2010, on over 13,000 babies born with birth defects, and compared them to nearly 7,000 babies without birth defects.
However, in an attempt to assess the risk of developing other common birth defects, the researchers did find an association between the use of chlorpheniramine and neural tube defects (which forms the early brain and spine), and various congenital heart malformations.
The 2018 treatment guidelines from the World Allergy Organization and European experts note that no birth defects have been reported in people taking second-generation antihistamines. However, they add caution given the limited research data on Claritin and small-sample studies of Zyrtec.
They found that the use of most types of antihistamines during pregnancy is not linked to birth defects. However, the researchers noted that certain antihistamine medications need to be further studied to determine their safety in pregnancy.
Oral decongestants also should be avoided during the first trimester.It’s recommended that you consult with your healthcare provider before taking any over-the-counter medications, to ensure that you understand the effects and any risks.
That’s also true forallergy shots, which are generally considered safe during pregnancy but should be evaluated in each case.
According to the American College of Obstetricians and Gynecologists (ACOG), studies show that the following over-the-counter antihistamine medications may be safe to use while pregnant:ChlorphenamineDexchlorpheniramineHydroxyzineClaritin and Zyrtec may be safe to use, but ACOG warns that Sudafed and otherpseudoephedrinedrugs (decongestants often found in allergy medication) should be avoided during the first trimester. There’s some evidence they contribute to birth defects affecting the abdominal wall.
According to the American College of Obstetricians and Gynecologists (ACOG), studies show that the following over-the-counter antihistamine medications may be safe to use while pregnant:
Claritin and Zyrtec may be safe to use, but ACOG warns that Sudafed and otherpseudoephedrinedrugs (decongestants often found in allergy medication) should be avoided during the first trimester. There’s some evidence they contribute to birth defects affecting the abdominal wall.
Common Allergy Treatments
Possible Associations Between Antihistamines and Birth Defects
Previously reported associations (possible links but not necessarily the cause) between antihistamines taken during the first trimester of pregnancy and certain birth defects include:
A 2022 update based on the National Birth Defects Prevention Study (NBDPS) looked at exposure for 14 different antihistamines and 64 birth defect categories. It found some consistent patterns, with possible links between:
The evidence wasn’t especially strong, though, and the study authors call for more research.
Promethazine is the most commonly used antihistamine in pregnant people.Most antihistamines are available OTC without a prescription but you should seek the advice of a healthcare provider before taking this or other drugs.
Any medication taken during pregnancy is best taken for the shortest amount of time, and at the lowest dose that is effective for treating symptoms. The benefit of taking any medication needs to be weighed against the risk of not taking the medication.
Alternatives to Antihistamines During Pregnancy
During pregnancy, antihistamines aren’t the only treatment option for symptom relief. You can also try natural antihistamines such as:
Be sure to discuss use of these options with your healthcare provider, too.
Summary
Antihistamine drug use is common, with medications like Claritin and Benadryl used to relieve allergy and cold symptoms, improve sleep, reduce nausea and vomiting, and more. Yet pregnant people may need to be more cautious about antihistamine use.
Study results on antihistamines and birth defects remain inconclusive, but there’s general consensus that their use should be avoided during the first trimester of pregnancy. Decongestants should be avoided, too, and second-generation antihistamines may pose less risk.
Talk to your healthcare provider to discuss your options before taking an antihistamine while pregnant.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Khalili A, Sadeghi B.Chronic Urticaria in Pregnancy: Physiologic and Hormonal Background for an Immune Skin Disease.Journal of South Asian Federation of Obstetrics and Gynaecology, (2024): 10.5005/jp-journals-10006-2381Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B,et al.The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria.Allergy. 2018 Jul;73(7):1393-1414. doi: 10.1111/all.13397.Li Q, Mitchell AA, Werler MM, Yau WP, Hernández-Díaz S.Assessment of antihistamine use in early pregnancy and birth defects.J Allergy Clin Immunol Pract. 2013;1(6):666–74.e1. doi:10.1016/j.jaip.2013.07.008Gilboa SM, Ailes EC, Rai RP, Anderson JA, Honein MA.Antihistamines and birth defects: a systematic review of the literature.Expert Opinion on Drug Safety. 2014;13(12):1667-1698. doi:10.1517/14740338.2014.970164Dykewicz MS, Wallace DV, Amrol DJ, et al.Rhinitis 2020: a practice parameter update.J Allergy Clin Immunol. 2020;146(4):721-767. doi:10.1016/j.jaci.2020.07.007American College of Obstetricians and Gynecologists (ACOG).What medicine can I take for allergies while I’m pregnant?Hansen C, Desrosiers TA, Wisniewski K, Strickland MJ, Werler MM, Gilboa SM.Use of antihistamine medications during early pregnancy and selected birth defects: The National Birth Defects Prevention Study, 1997-2011.Birth Defects Res. 2020 Oct;112(16):1234-1252. doi: 10.1002/bdr2.1749.Luo C, Peng S, Li M, Ao X, Liu Z.The efficacy and safety of probiotics for allergic rhinitis: a systematic review and meta-analysis.Front Immunol.2022;13:848279. doi:10.3389/fimmu.2022.848279Seidman MD, Gurgel RK, Lin SY, et al.Clinical practice guideline: allergic rhinitis.Otolaryngol Head Neck Surg. 2015;152(1_suppl):S1-S43. doi:10.1177/0194599814561600
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Khalili A, Sadeghi B.Chronic Urticaria in Pregnancy: Physiologic and Hormonal Background for an Immune Skin Disease.Journal of South Asian Federation of Obstetrics and Gynaecology, (2024): 10.5005/jp-journals-10006-2381Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B,et al.The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria.Allergy. 2018 Jul;73(7):1393-1414. doi: 10.1111/all.13397.Li Q, Mitchell AA, Werler MM, Yau WP, Hernández-Díaz S.Assessment of antihistamine use in early pregnancy and birth defects.J Allergy Clin Immunol Pract. 2013;1(6):666–74.e1. doi:10.1016/j.jaip.2013.07.008Gilboa SM, Ailes EC, Rai RP, Anderson JA, Honein MA.Antihistamines and birth defects: a systematic review of the literature.Expert Opinion on Drug Safety. 2014;13(12):1667-1698. doi:10.1517/14740338.2014.970164Dykewicz MS, Wallace DV, Amrol DJ, et al.Rhinitis 2020: a practice parameter update.J Allergy Clin Immunol. 2020;146(4):721-767. doi:10.1016/j.jaci.2020.07.007American College of Obstetricians and Gynecologists (ACOG).What medicine can I take for allergies while I’m pregnant?Hansen C, Desrosiers TA, Wisniewski K, Strickland MJ, Werler MM, Gilboa SM.Use of antihistamine medications during early pregnancy and selected birth defects: The National Birth Defects Prevention Study, 1997-2011.Birth Defects Res. 2020 Oct;112(16):1234-1252. doi: 10.1002/bdr2.1749.Luo C, Peng S, Li M, Ao X, Liu Z.The efficacy and safety of probiotics for allergic rhinitis: a systematic review and meta-analysis.Front Immunol.2022;13:848279. doi:10.3389/fimmu.2022.848279Seidman MD, Gurgel RK, Lin SY, et al.Clinical practice guideline: allergic rhinitis.Otolaryngol Head Neck Surg. 2015;152(1_suppl):S1-S43. doi:10.1177/0194599814561600
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Khalili A, Sadeghi B.Chronic Urticaria in Pregnancy: Physiologic and Hormonal Background for an Immune Skin Disease.Journal of South Asian Federation of Obstetrics and Gynaecology, (2024): 10.5005/jp-journals-10006-2381Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B,et al.The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria.Allergy. 2018 Jul;73(7):1393-1414. doi: 10.1111/all.13397.Li Q, Mitchell AA, Werler MM, Yau WP, Hernández-Díaz S.Assessment of antihistamine use in early pregnancy and birth defects.J Allergy Clin Immunol Pract. 2013;1(6):666–74.e1. doi:10.1016/j.jaip.2013.07.008Gilboa SM, Ailes EC, Rai RP, Anderson JA, Honein MA.Antihistamines and birth defects: a systematic review of the literature.Expert Opinion on Drug Safety. 2014;13(12):1667-1698. doi:10.1517/14740338.2014.970164Dykewicz MS, Wallace DV, Amrol DJ, et al.Rhinitis 2020: a practice parameter update.J Allergy Clin Immunol. 2020;146(4):721-767. doi:10.1016/j.jaci.2020.07.007American College of Obstetricians and Gynecologists (ACOG).What medicine can I take for allergies while I’m pregnant?Hansen C, Desrosiers TA, Wisniewski K, Strickland MJ, Werler MM, Gilboa SM.Use of antihistamine medications during early pregnancy and selected birth defects: The National Birth Defects Prevention Study, 1997-2011.Birth Defects Res. 2020 Oct;112(16):1234-1252. doi: 10.1002/bdr2.1749.Luo C, Peng S, Li M, Ao X, Liu Z.The efficacy and safety of probiotics for allergic rhinitis: a systematic review and meta-analysis.Front Immunol.2022;13:848279. doi:10.3389/fimmu.2022.848279Seidman MD, Gurgel RK, Lin SY, et al.Clinical practice guideline: allergic rhinitis.Otolaryngol Head Neck Surg. 2015;152(1_suppl):S1-S43. doi:10.1177/0194599814561600
Khalili A, Sadeghi B.Chronic Urticaria in Pregnancy: Physiologic and Hormonal Background for an Immune Skin Disease.Journal of South Asian Federation of Obstetrics and Gynaecology, (2024): 10.5005/jp-journals-10006-2381
Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B,et al.The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria.Allergy. 2018 Jul;73(7):1393-1414. doi: 10.1111/all.13397.
Li Q, Mitchell AA, Werler MM, Yau WP, Hernández-Díaz S.Assessment of antihistamine use in early pregnancy and birth defects.J Allergy Clin Immunol Pract. 2013;1(6):666–74.e1. doi:10.1016/j.jaip.2013.07.008
Gilboa SM, Ailes EC, Rai RP, Anderson JA, Honein MA.Antihistamines and birth defects: a systematic review of the literature.Expert Opinion on Drug Safety. 2014;13(12):1667-1698. doi:10.1517/14740338.2014.970164
Dykewicz MS, Wallace DV, Amrol DJ, et al.Rhinitis 2020: a practice parameter update.J Allergy Clin Immunol. 2020;146(4):721-767. doi:10.1016/j.jaci.2020.07.007
American College of Obstetricians and Gynecologists (ACOG).What medicine can I take for allergies while I’m pregnant?
Hansen C, Desrosiers TA, Wisniewski K, Strickland MJ, Werler MM, Gilboa SM.Use of antihistamine medications during early pregnancy and selected birth defects: The National Birth Defects Prevention Study, 1997-2011.Birth Defects Res. 2020 Oct;112(16):1234-1252. doi: 10.1002/bdr2.1749.
Luo C, Peng S, Li M, Ao X, Liu Z.The efficacy and safety of probiotics for allergic rhinitis: a systematic review and meta-analysis.Front Immunol.2022;13:848279. doi:10.3389/fimmu.2022.848279
Seidman MD, Gurgel RK, Lin SY, et al.Clinical practice guideline: allergic rhinitis.Otolaryngol Head Neck Surg. 2015;152(1_suppl):S1-S43. doi:10.1177/0194599814561600
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