Emily Oster

2 min Read Emily Oster

Emily Oster

Is It Safe to Take Decongestants During Pregnancy?

Q&A on allergy relief

Emily Oster

2 min Read

A question about Claritin-D: I went to see a fertility specialist, and she told me that it was not safe to take decongestants while pregnant or even during that ambiguous two-week wait period. (She did say it was okay to drink lightly during the two-week wait, so I know she isn’t totally strict on every aspect.) But my allergies are really bad! I asked her if the risk was just because it hadn’t been tested, and she said no, that this one is well documented. Is that true? I’d love some insight.

—Allergy Sufferer

As a fellow allergy sufferer (and mom to allergy sufferers), I feel you. Your specialist is right, though. The decongestant part of Claritin-D is not recommended due to birth defect risk.

Stepping back: One important component of allergy treatment is antihistamine. In Claritin, this is delivered by the active ingredient of loratadine; in Zyrtec it is cetirizine. These are both category B drugs, meaning we have compelling evidence of safety for them during pregnancy. If they work for you, you should feel comfortable taking them. 

However, many people find that their allergies respond better if they combine the antihistamine with a decongestant. In Claritin-D, the loratadine is combined with pseudoephedrine. Although the data is ambiguous, there is some evidence that use of this in the first trimester of pregnancy is linked to several rare birth defects. The numbers here are very small, but with enough data, there is an effect, and that is why your fertility specialist told you this. Avoiding it during the two-week wait likely reflects our imperfect understanding of how long these medications stay around in our system.

What can you do? First, regular Claritin is okay, so maybe that will give you some relief. Second, steroid-based nasal sprays (e.g. Flonase) are considered safe. Finally, in the second and third trimester, Claritin-D is more accepted, unless you’ve got hypertension. Talk to your doctor if you have any questions on the right regimen and timing.

Hang in there!

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