Ah, allergies. Unless you have them, very few people can appreciate how awful they can be. So if you need to take allergy medication during pregnancy, you can imagine how uptight some people get about it and wonder why you don't just suffer through it. To these people I say, "suck my snot."
Not unlike cold medication, the trick here is to take medication that has been around a long time. Nobody has ever raised their hand and said, "use me and my unborn child as guinea pigs to test your fine medication, my good sir," so all the data has to be collected over years and years of medical findings to see if kids are growing seven belly buttons from a medication.
What's Generally Considered Safe
The ones that have been deemed low risk (no risk would be taking nothing and sitting in a puddle of snot) are:
Diphenhydramine (Benadryl) seems to be the across-the-board favorite as a safe medication for allergies when you're pregnant. It's been around since 1946 and it's a first-generation antihistamine. The downside is it will make you groggy because the newer drugs (second-generations) are the ones with non-drowsy formulas, but they aren't as tried and true. It's a bit of a kick in the ass because you're probably already tired, but it may be a good nighttime option if you're just looking to get some sleep.
Loratadine (Claritin) and Cetirizine (Zyrtec) are newer antihistamines that many healthcare providers now consider safe during pregnancy.
Pseudoephedrine (Sudafed) has mixed reviews. Some sites say it's okay if you're out of your first trimester, but others say to stay away from it altogether. Recent reports show a slight increase in abdominal wall defects when used during the first trimester, so it's best to avoid it during this time.
Natural Remedies
There are quite a few non-medical, natural remedies out there as well:
Neti pots are awesome. They are kind of freaky the first time you use them, but they're great for nasal congestion. Just make sure to use distilled or previously boiled water, not regular tap water. As great as they are, if you're really stuffed up, you'll still probably have to get out the big antihistamine guns.
Saline nasal sprays have been given the thumbs up. Everybody gets really pissy about the good stuff like Otrivin because even though they haven't been shown to cause birth defects, they haven't been shown not to either.
I couldn't find any herbal remedies that everyone could agree on, which isn't surprising because of the lack of research behind most herbs.
Corticosteroid Nasal Sprays
For moderate to severe symptoms, your doctor might recommend a steroid nasal spray along with an antihistamine. Options include budesonide (Rhinocort), fluticasone (Flonase), and mometasone (Nasonex). Based on available data, budesonide would be considered the intranasal corticosteroid of choice during pregnancy.
The Bottom Line
At the end of the day, if you can handle your allergies by having a hot shower and blowing your nose, great. But if you're congested to the point where you think your head is going to roll off or you sound like Darth Vader when you're lying in bed, take something.
I'm sure all parties involved would be happier if you could breathe and have a full night of sleep.
Always check with your OB-GYN or your pharmacist before taking any over-the-counter allergy medication.
Gesundheit!
Related: Is Using Cold Medicine While Pregnant Safe?
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