What meds can i take while pregnant for allergies

There are a number of medications that are not safe to take during pregnancy. First among them are oral decongestants.

Oral decongestants are best avoided altogether during the first trimester because of an uncertain risk of several rare birth defects,” says Ciara Staunton, a family nurse practitioner and owner of Staunton Primary Care in Cincinnati. “However, Sudafed (pseudoephedrine), which is locked up behind the pharmacy counter, can be used in the second and third trimesters in women without hypertension.”

But Staunton warns that Sudafed-PE (phenylephrine), the over-the-counter option, should never be taken during pregnancy.

It is less effective than pseudoephedrine. But more importantly, its safety for pregnant women is questionable.

Ms. Staunton also recommends against using any herbal therapies during pregnancy. “In the United States and most other countries, herbal medicines are minimally regulated and not monitored for adverse events.”


Treatment of Rhinitis During Pregnancy

  1. Decongestants: Pseudoephedrine (Sudafed and numerous generic forms) is the preferred oral decongestant to treat allergic and non-allergic rhinitis during pregnancy, although should be avoided during the entire first trimester, as it has been associated with baby gastroschisis. This medication is pregnancy category C.
  2. Dzieciolowska-baran E, Teul-swiniarska I, Gawlikowska-sroka A, Poziomkowska-gesicka I, Zietek Z.

    Rhinitis as a cause of respiratory disorders during pregnancy. Adv Exp Med Biol. 2013;755:213-20. doi: 10.1007/978-94-007-4546-9_27

  3. FDA Pregnancy Categories. U.S. Department of Health and Human Services. Updated: Wed Jun 26 2019

  4. Pali-Schöll I, Namazy J, Jensen-Jarolim E. Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organ J. 2017;10(1):10. Published 2017 Mar 2. doi:10.1186/s40413-017-0141-8

  5. Medicated Nasal Sprays: Cromolyn nasal spray (NasalCrom®, generics) is helpful in treating allergic rhinitis if it is used before exposure to an allergen and prior to the onset of symptoms.

    This medication is pregnancy category B and is available over the counter. If this medication is not helpful, one nasal steroid, budesonide (Rhinocort Aqua®), received a pregnancy category B rating (all others are category C), and therefore would be the nasal steroid of choice during pregnancy. Rhinocort became available over-the-counter without a prescription in early 2016.

  6. FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy.

    U.S. Food and Drug istration. 01/19/2016

  7. Nasal Saline: Rhinitis of pregnancy tends not to reply to antihistamines or nasal sprays. This condition seems to reply temporarily to nasal saline (saltwater), which is safe to use during pregnancy (it is not actually a drug). Nasal saline is available over the counter, is inexpensive, and can be used as often as needed. Generally, 3 to 6 sprays are placed in each nostril, leaving the saline in the nose for up to 30 seconds, and then blowing the nose.
  8. Immunotherapy:Allergy shots can be continued during pregnancy, but it is not recommended to start this treatment while pregnant.

    Typically the dose of the allergy shots is not increased, and numerous allergists will cut the dose of the allergy shot by 50 percent during pregnancy. Some allergists feel that allergy shots should be stopped during pregnancy, given the risk of anaphylaxis and possible harm to the fetus as a result. Other than anaphylaxis, there is no data showing that the allergy shots themselves are actually harmful to the fetus.

  9. Antihistamines: Older antihistamines, such as chlorpheniramine and tripelennamine, are the preferred agents to treat allergic rhinitis during pregnancy, and are both category B medications. Newer antihistamines such as over-the-counter loratadine (Claritin®/Alavert® and generic forms) and cetirizine (Zyrtec® and generic forms) are also pregnancy category B medications.
  10. National Middle for Complimentary and Integrative Health.

    Is Rinsing Your Sinuses With Neti Pots Safe? September 24, 2017

Allergy skin testing is generally deferred during pregnancy, although a RAST would be a safe alternative if the results are needed during pregnancy.

Before any medication is taken during pregnancy, the doctor and patient must own a risk/benefit discussion.

What meds can i take while pregnant for allergies

This means that the benefits of the medication should be weighed against the risks—and the medication should only be taken if the benefits outweigh the risks.

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What meds can i take while pregnant for allergies

  • FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy. U.S.

    What meds can i take while pregnant for allergies

    Food and Drug istration. 01/19/2016

  • Category B medications own been studied in pregnant animals, which show that they are relatively safe, but no human studies are available.
  • Category A medications are medications in which there are excellent studies in pregnant women showing the safety of the medication to the baby in the first trimester. Few medications are in this category and no asthma medications are rated category A.
  • Category C medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may outweigh the potential risks in humans.
  • FDA Pregnancy Categories.

    U.S. Department of Health and Human Services. Updated: Wed Jun 26 2019

  • Category D medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans.
  • Dzieciolowska-baran E, Teul-swiniarska I, Gawlikowska-sroka A, Poziomkowska-gesicka I, Zietek Z. Rhinitis as a cause of respiratory disorders during pregnancy. Adv Exp Med Biol. 2013;755:213-20.

    doi: 10.1007/978-94-007-4546-9_27

  • National Middle for Complimentary and Integrative Health. Is Rinsing Your Sinuses With Neti Pots Safe? September 24, 2017

  • Pali-Schöll I, Namazy J, Jensen-Jarolim E. Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organ J. 2017;10(1):10.

    What meds can i take while pregnant for allergies

    Published 2017 Mar 2. doi:10.1186/s40413-017-0141-8

  • Category X medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.

It’s understandable that a lot of women don’t love to take unnecessary medicines when they’re pregnant. No mother-to-be would ever desire to put her baby at an increased risk of a birth defect caused by medication. However, allergies can make some lady so miserable that medications may be needed just so that allergy symptoms are not taking over their lives.

According to the Food and Drug istration (FDA), no medicines are considered completely safe in pregnancy.

This is because no pregnant lady would desire to sign up for a medication safety study while she is pregnant.

Therefore, the FDA has assigned risk categories to medications based on use in pregnancy:

  1. Category B medications own been studied in pregnant animals, which show that they are relatively safe, but no human studies are available.
  2. Category C medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may outweigh the potential risks in humans.
  3. Category D medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans.
  4. Category A medications are medications in which there are excellent studies in pregnant women showing the safety of the medication to the baby in the first trimester.

    Few medications are in this category and no asthma medications are rated category A.

  5. Category X medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.

Which Medications Are Safe in Pregnancy?

It’s understandable that a lot of women don’t love to take unnecessary medicines when they’re pregnant.

What meds can i take while pregnant for allergies

No mother-to-be would ever desire to put her baby at an increased risk of a birth defect caused by medication. However, allergies can make some lady so miserable that medications may be needed just so that allergy symptoms are not taking over their lives.

According to the Food and Drug istration (FDA), no medicines are considered completely safe in pregnancy. This is because no pregnant lady would desire to sign up for a medication safety study while she is pregnant.

Therefore, the FDA has assigned risk categories to medications based on use in pregnancy:

  1. Category B medications own been studied in pregnant animals, which show that they are relatively safe, but no human studies are available.
  2. Category C medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may outweigh the potential risks in humans.
  3. Category D medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans.
  4. Category A medications are medications in which there are excellent studies in pregnant women showing the safety of the medication to the baby in the first trimester.

    Few medications are in this category and no asthma medications are rated category A.

  5. Category X medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.

Which Medications Are Safe in Pregnancy?


How to safely treat allergies during pregnancy

While it would be best to avoid allergens that annoy you, that’s not always a possibility. Numerous pregnant women and their providers prefer to start with a non-pharmaceutical treatment plan whenever possible. Dr. Janelle Luk, medical director and co-founder of Generation Next Fertility in New York City, suggests an over-the-counter saline nasal spray.

Dr.

Luk also recommends physical activity to reduce nasal inflammation. In addition, she says patients with a stuffy nose might be capable to sleep better if they elevate the head of the bed by 30 to 45 degrees during sleep.

However, sometimes those non-pharmaceutical options just don’t do the trick, and you need something stronger (aka allergy medicine) to ease your distress. In that case, there are several options that are safe to try.

“For moderate to severe allergies, your physician may recommend a nonprescription corticosteroid spray or an oral antihistamine,” Dr.

Luk says. “Some nasal spray options include Rhinocort Allergy, Flonase, and Nasonex.”

For oral antihistamines, Staunton says she recommends Claritin (loratadine) or Zyrtec (cetirizine) because of their excellent safety history. Both are rated pregnancy category B by the FDA. This means that controlled studies in animals own shown no adverse effects to the developing fetus.

Benadryl (diphenhydramine) is considered fairly safe during pregnancy, according to the CDC. However, Benadryl Allergy Plus Congestion is not safe for pregnant women because it contains phenylephrine.

You can also take one of the oral antihistamines together with a nasal spray if neither one controls your symptoms on its own.

As for subcutaneous allergen immunotherapy (SCIT), aka allergy shots—if you were on them before pregnancy, your doctor may continue them.

But they wouldn’t be started during pregnancy because of “the potential harm that could result if a reaction were to occur,” Staunton says.

If you are suffering from allergy symptoms, speak with your provider about your best options for allergy medicine while pregnant.

allergyallergy medspregnancy

Rhinitis during pregnancy can be due to allergic rhinitis, sinusitis, or non-allergic rhinitis. If the lady has had allergic rhinitis prior to pregnancy, this could worsen, stay the same, or even improve. This change in symptoms may be dependent upon numerous factors, including the presence of seasonal allergens and increase in pregnancy hormones.

Non-allergic rhinitis in pregnancy may also be due to an increase in pregnancy hormones, leading to nasal congestion, runny nose, and postnasal drip. This is called “rhinitis of pregnancy”.

The symptoms may mimic allergies, but since they are non-allergic in nature, do not reply to anti-histamines.

The pregnant lady with rhinitis may be concerned about the safety of medications during pregnancy, and therefore avoid taking medications. If avoidance of allergic triggers is not possible or successful, medications may be needed to control symptoms.


Safety of Allergy Medications During Pregnancy

According to the Food and Drug istration (FDA), no drugs are considered completely safe in pregnancy. The organization advises that women carefully consider the use of any medications, especially pain medications. This is because no pregnant lady would desire to sign up for a medication safety study while she is pregnant.

Therefore, the FDA has assigned risk categories to medications based on use in pregnancy:

  1. Category “B” medications show excellent safety studies in pregnant animals but there are no human studies available.
  2. Category “C” medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may out weight the potential risks in humans.
  3. Category “D” medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans.
  4. Category “A” medications are medications in which there are excellent studies in pregnant women showing the safety of the medication to the baby in the first trimester.

    There are extremely few medications in this category and no asthma medications.

  5. Category “X” medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.


Antihistamines

Older antihistamines, such as chlorpheniramine, are the preferred agents to treat allergic rhinitis during pregnancy and are both Category B medications.

Newer antihistamines such as over-the-counter loratadine (Claritin, generic forms) and cetirizine (Zyrtec, generic forms) are also Pregnancy Category B medications. A newer prescription antihistamine that is Pregnancy Category B is Xyzal (levocetirizine).


Diagnosis of Allergic Rhinitis During Pregnancy

Allergy testing includes skin testing or blood tests, called a RAST.

In general, allergy skin testing is not done during pregnancy, given the little chance of anaphylaxis which may occur. Anaphylaxis during pregnancy, if severe, could result in a decrease in blood and oxygen to the uterus, possibly harming the fetus.


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