Which Drugs Are Safe Or Unsafe
editorial processVioletta Shamilova, PharmDMedical Review Board
Many women must continue taking medically necessary prescription drugs throughout their pregnancies, as failing to do so would endanger both mother and baby. But it’s smart to be concerned about the effects of medication on a growing fetus.
Different medications carry different risks. The importance of maternal comfort is also an important consideration. Allergies can make some women miserable, and medication may be needed so that allergy symptoms are not taking over their lives.
Safe Otc Allergy Meds To Take During Pregnancy
These over-the-counter allergy meds have no known harmful effects during pregnancy when you take them according to the package directions.
Note: Do not take the ‘D’ forms of these medications in your first trimester.
Check with your doctor before taking any medicines during your pregnancy. Be especially cautious in the first trimester, a crucial time for your baby’s development.
Is It Safe To Take Allergy Medications
In the vast majority of cases, the answer is yes. Its safe to continue taking your allergy medications the same way you were before you got pregnant. Its always wise to check with your doctor about medication use, and rarely is it necessary to discontinue allergy medications.
Antihistamines may be useful to treat nasal and eye symptoms caused by various allergies. As always, talk with your doctor or allergist to help you weigh the benefits against any possible risk to your baby. To ease your allergy symptoms, consider these options:
Sneezing Runny Nose And Watery Eyes
These symptoms are the result of histamine release, which isan immune response to an invading virus. Chlorpheniramine, such as TriaminicAllergy, and diphenhydramine, such as Benadryl, are safe to take duringpregnancy. However, both can cause drowsiness, so these are best taken atbedtime. The maximum dosage for chlorpheniramine is 32 mg in 24 hours.
When compared to placebos, antihistamines have the most successful resultswithin the first couple days of treatment. Patients didnt report any relief ofsymptoms between days three and 10. Newer antihistamines, such as loratadine, are approved for allergies, not colds, so there isnt informationabout how well they work for cold symptoms.
Treating Allergies During Pregnancy
As with any illness or condition that occurs while you’re pregnant, the goal of treatment is to maintain the health of both mother and baby. About half of all pregnant people take an OTC or prescription medication during pregnancy. Not all medications are safe to take while pregnant. The key is to weigh the risks against the benefits.
The good news is that environmental allergies, like seasonal and pet allergies, pose no risk to your developing fetus. But if allergy symptoms are driving you crazy, your doctor may recommend a few treatment options to help minimize your discomfort.
Can Allergy Medications Safely Be Used During Pregnancy
Antihistamines may be useful during pregnancy to treat the nasal and eye symptoms of seasonal or perennial allergic rhinitis, allergic conjunctivitis, the itching of urticaria or eczema, and as an adjunct to the treatment of serious allergic reactions, including anaphylaxis . With the exception of life-threatening anaphylaxis, the benefits from their use must be weighed against any risk to the fetus. Because symptoms may be of such severity to affect maternal eating, sleeping or emotional well-being, and because uncontrolled rhinitis may pre-dispose to sinusitis or may worsen asthma, antihistamines may provide definite benefit during pregnancy.
Chlorpheniramine , and diphenhydramine have been used for many years during pregnancy with reassuring animal studies. Generally, chlorpheniramine would be the preferred choice, but a major drawback of these medications is drowsiness and performance impairment in some patients.. Two of the newer less sedating antihistamines loratadine , and cetirizine have reassuring animal and human study data and are currently recommended when indicated for use during pregnancy.
When women with asthma and allergies get pregnant, one-third find their asthma and allergies improved, one-third find they worsen and one-third remain unchanged.
Allergist James Sublett, MD
Taking Hay Fever Medication In Pregnancy
If youre pregnant you should always try and seek advice from your GP or pharmacist before you take any sort of medication. Not all medications can be taken safely during pregnancy, as some may affect the development and growth of the baby.
If you have mild hay fever, or dont experience symptoms, its best to avoid taking medication, as its not necessary. Before taking medication there are some preventative measures that can be taken to avoid your exposure to pollen.
Can I Get Allergy Shots During Pregnancy
Pregnant women can continue with allergy shots they started before they were pregnant. They should stay at the current dose through pregnancy do not increase dosage. If theres any reactivity, the doctor may reduce the dosage of the shot.
Its not recommended to start allergy shots during pregnancy. This can trigger changes in an already-fluctuating immune system and may cause a systemic reaction.
What Are Some Alternatives For Treating Allergies While Pregnant
Even though for the most part Benadryl and many over-the-counter allergy medicines are possibly safe during pregnancy, natural alternatives may be something to explore as well. Some women may try to take no medications unless absolutely necessary during pregnancy. Medical professionals might also recommend trying alternatives to medicine first. One non-medication option for allergies is the use of a neti pot. With a neti pot, individuals can clear allergens and irritants from their nasal passage. Its also called sinus irrigation. Other allergy prevention strategies can include avoiding triggers or wearing a mask when certain allergen levels are high, or air quality is low. Some pregnant women may opt to stay indoors on days when there are high levels of pollen for example.
What Medicines Should You Avoid During Pregnancy
Some medicines are known to increase the chance of birth defects or other problems. But sometimes, stopping a medicine has greater risk to the mother and the baby than continuing to take the medicine. Talk to your doctor about any medicines you take if you are thinking about having a baby or if you are pregnant.
Some of the over-the-counter medicines that increase the chances of birth defects are:
- Bismuth subsalicylate .
- Phenylephrine or pseudoephedrine, which are decongestants. Avoid medicines with these ingredients during the first trimester.
- Cough and cold medicines that contain guaifenesin. Avoid medicines with this ingredient during the first trimester.
- Pain medicines like aspirin and ibuprofen and naproxen . The risk of birth defects with these medicines is low.
Some of the prescription medicines that increase the chances of birth defects are:
What Medicines Can You Take During Pregnancy
It can be hard to know if a medicine is safe for your baby. Most medicines are not studied in pregnant women, because researchers worry about how the medicines might affect the baby. But some medicines have been taken for so long by so many women that doctors have a good idea of how safe they are. Talk to your doctor or midwife before you take any medicines.
In general, doctors say it is usually safe to take:
- Acetaminophen for fever and pain.
- Penicillin and some other antibiotics.
- Some medicines for depression.
- Some medicines for heart burn.
If you are planning a pregnancy, talk to your doctor or midwife about any medicines you are taking, including over-the-counter ones. Some of them may be safe during pregnancy. But others may not be safe. Your doctor or midwife may have you stop taking a medicine or may switch you to another one. Some medicines that aren’t safe in the first trimester may be safe to use later in the pregnancy.
Itchy Eyes Sore Throat: How To Manage Allergies And Asthma During Pregnancy
May 15, 2018
This article is authored in part by Matthew Feldman, M.D.
April showers bring May flowers andallergies for 50 million people in the United States. Springis the peak of allergy and asthma season for many patients. The severity of seasonal allergy symptoms can range from hardly noticeable,to annoying, to intolerable without medication or other treatment.
Tomake matters worse, symptoms can become more severe during pregnancy. When notcontrolled, allergies and asthma can lead to the need for antibiotics orsteroids, which might cause health problems for a woman and her baby. Letsdiscuss what women should know about seasonal allergies and asthma duringpregnancy and what they can do to relieve symptoms safely.
Can I Use A Nasal Spray During Pregnancy
Some nasal sprays are safer than others. The good thing about nasal sprays is that the drug focuses primarily on the nose. It does not travel throughout the rest of the body.
Corticosteroid nasal sprays are mostly safe. They are prescribed to pregnant women with moderate to severe allergy symptoms that last longer than a few days. Budesonide is considered the safest. Mometasone and fluticasone are also considered safe.
Decongestant nasal sprays are more problematic. Some studies point to a risk of birth defects when expectant moms use these products. They are not typically recommended during pregnancy, especially during the first trimester.
Pregnant women should avoid antihistamine nasal sprays, as there is not enough research to prove their safety.
Always talk with your doctor about which nasal spray medication is right for you, as well as any medication risks to you and your baby.
Decongestants Expectorants And Antihistamines
Women commonly use cold medications during pregnancy. These medications, like most of the other OTC drugs, have not been studied well in pregnancy ., As a result, some physicians are disinclined to recommend any treatment for the common cold. The most commonly used cold medications include decongestants and expectorants such as pseudoephedrine , guaifenesin , and dextromethorphan , and the antihistamines diphenhydramine , chlorpheniramine , and clemastine fumarate .
The use of vasoconstrictive agents such as pseudoephedrine may activate alpha-adrenergic receptors, elevating blood pressure or causing vasoconstriction in the uterine arteries, and potentially adversely affecting blood flow to the fetus. This process could explain the reported association between the use of pseudoephedrine in the first trimester and the development of gastroschisis. This theory is debatable; evidence suggests that this effect is negligible at typical dosages.
Diphenhydramine is widely used in pregnancy as a sedative, an antihistamine, and an anti-nausea drug, although few data confirm its safety during pregnancy. The drug has been shown to have oxytocin-like effects, especially in high dosages. In addition, adverse drug interactions that do not occur in nonpregnant patients may occur in pregnant patients. For example, one study showed a significant increase in fetal morbidity when diphenhydramine was taken in combination with temazepam .
What About The First Trimester
Youre right to be careful throughout your entire pregnancy, especially in the first trimester. This exciting time when you havent even started showing yet is when a lot of the action quietly happens.
Although your little bean is only about 3 inches long by week 12, theyll have developed all their major organ systems the heart, brain, lungs, everything in the first trimester.
This also makes the first 12 weeks of pregnancy the riskiest. In the first trimester your baby is the most vulnerable to harm from alcohol, drugs, illness, and medications.
The Slone Centers Birth Defect Study interviewed almost 51,000 mothers over the span of about 40 years. It gave safety ratings to medications that were commonly used during pregnancy. The highest rating a drug can have is good and the lowest is none.
This big study gave diphenhydramine a high passing rate of fair. For this reason, your doctor will likely tell you its best to only take Benadryl if you absolutely must in your first trimester of pregnancy.
This might be because older studies reported that Benadryl might cause abnormalities at birth. More recent research has not found this to be the case.
Is Benadryl Safe To Take While Pregnant
When youre pregnant, you may have questions about the safety of certain medications, including medications available over-the-counter. Many over-the-counter medications are considered safe during pregnancy, while others arent. One medicine commonly used is Benadryl. However, is Benadryl safe to take while pregnant? In general, can you take allergy medicine while pregnant? Benadryl is a brand-name allergy medication, and its classified as an antihistamine. The active ingredient in Benadryl is called diphenhydramine. Diphenhydramine can help with symptoms of not only allergies but also a cold and hay fever. Some of the symptoms people might use Benadryl for can include itchy, watery eyes and nose, a cough and sneezing. In some cases, the active ingredient in Benadryl is also used to help people who struggle with nausea, vomiting and motion sickness. Benadryl and other similar allergy medicines are available as liquids, tablets or capsules.
What Pregnant Women Can Do
Pregnant women have many options forcontrolling allergy symptoms. The first step is to be proactive. Ideally, if awoman typically suffers from seasonal allergies, she should talk to her doctorabout starting a medication before symptoms begin. If she notices seasonalallergy symptoms for the first time during pregnancy, she should visit her doctorto determine the cause and manage symptoms, which can reduce the risk of asinus infection.
Types Of Allergy Medicine
There are three main types of allergy medicine:
- Antihistamines are the first line of defense for relieving a runny nose, sneezing, post-nasal drip, itchy eyes, and itchy skin.
- Nasal sprays can help reduce congestion and sneezing.
- Decongestants can help relieve a stuffy nose and sinus congestion.
While these medications will not cure your allergies, they can help manage symptoms and improve your quality of life, says Atul N. Shah, MD, an allergist and founder of the Center for Asthma & Allergy.
You may even find a combination of these medications helpful, as they each treat individual aspects of your allergy symptoms and can be taken for different reasons.
However, because over the counter medications may contain multiple ingredients, you should ask your doctor or pharmacist about which are safe to combine before you do so.
Is It Safer To Skip Allergy Medication Altogether When I’m Pregnant
If your symptoms aren’t bad, your doctor may suggest other treatments instead. You could allergy-proof your home or rely on saline nasal sprays.
But if allergy symptoms are a big problem — making it hard to sleep, for instance — taking medication may be better for your health and your baby’s.
If you have allergic asthma, you need to take the medication as prescribed. Uncontrolled asthma can cause serious problems during pregnancy.
Is It Okay To Take Natural Health Products
Talk to your doctor or midwife about any natural health products that you have been taking. Don’t take any natural health products unless you talk with your doctor or midwife first.
Folic acid is especially important before and in the first few weeks of pregnancy, because it prevents some birth defects. Take 400 mcg of folic acid every day for at least 2 to 3 months before trying to get pregnant and while you are pregnant.footnote 1 Some women need higher doses. Talk with your health professional about how much folic acid you need.
You can get folic acid in an over-the-counter multivitamin or in a multivitamin that your doctor or midwife prescribes. Follow your doctor’s advice about how to get higher amounts of folic acid. Don’t just take more multivitamins. You could get too much of the other substances that are in the multivitamin.
In some cases doctors and midwives prescribe extra iron.
If I Have Allergies During Pregnancy Will The Baby Have Allergies
Allergy symptoms during pregnancy are not believed to have any impact on whether your baby develops allergies. Genetics, however, are a major factor in the development of allergies in children. If a child has a parent or a sibling with allergies, then they are at increased risk of getting allergies, too.
An expectant mothers diet during pregnancy may be a factor in whether a child develops allergic rhinitis, food allergies, asthma or eczema. One study found that expectant moms who ate plenty of food-based vitamin D reduced their childs risk of getting allergic rhinitis. Foods with a lot of vitamin D include dairy products, cereals, fish, eggs and mushrooms. Learn more about the allergic march.
Allergy Medications To Avoid
While most antihistamines are safe to take during pregnancy, some other medications often used to treat allergy symptoms may not be. Expectant moms should be mindful of combination allergy formulas that include other ingredients unsafe for pregnant women, like aspirin or other NSAIDs, and some cough suppressants or expectorants.
You should also take care to avoid allergy medications with decongestants like pseudoephedrine , says Dr. Jones, unless your physician or midwife has approved it.
Although decongestants are unlikely to cause problems with the fetus, they can cause an increase in blood pressure in certain individuals, Dr. Jones explains.
There is some research suggesting a slightly higher risk of birth defects associated with pseudoephedrine, although so far, those possible risks have only been identified during the first trimester.
That means Sudafed may be a limited-use option for women in their second and third trimesters who do not have any previous hypertension issues .
Key Findings: Antihistamines And Birth Defects
Pregnant woman talking to her doctor about medication use.
In a new CDC study, researchers reviewed more than 50 published scientific articles to see if there was a risk of birth defects from using antihistamines, like allergy medication, during pregnancy. Researchers found the evidence to be generally reassuring: most antihistamines do not appear to be linked to birth defects. However, researchers need to study certain antihistamine medications further to determine if they increase the risk for birth defects. You can read the articles abstract hereexternal icon. Read more below for a summary of the findings from this article.
What About Allergy Shots And Flu Vaccines
Allergen immunotherapy, otherwise known as allergy shots, can make a big difference if nothing else helps to ease your symptoms. Its also a good idea to stay on track with your allergy shots while youre pregnant as long as youre not having any bad reaction to them.
Its also possible to develop allergies for the first time while pregnant.
And go ahead and get your flu shot. The Centers for Disease Control recommend it for all patients and theres no evidence of any risks to you or your baby. If you have moderate or severe asthma, its especially important to avoid the flu and a flu shot is your best defense.
Ways To Find Allergy Relief While Pregnant
Home » 5 Ways to Find Allergy Relief While Pregnant
Approximately a quarter of expectant mothers suffer from recurrent allergies or allergy symptoms while pregnant. If you find yourself a part of this group, dont worry! There are plenty of ways you can find allergy relief that is safe for you and your child:
How To Tell Which Medications Are Safe During Pregnancy
” is a category B medication, which means no evidence of risk in human pregnancies is known,” says Rac.
“B” is one of the five categories created by the US Food and Drug Administration to classify medications according to the risk they pose to a developing fetus. While drugs in categories A and B are safe, those in D and X should be avoided.
But most medications fall into the gray area of category C neither clearly safe nor harmful. In these cases, the benefits may outweigh the risks. “This should be a conversation between you and your obstetrician,” she says.
Mild And Severe Allergies
Mild allergies may respond well to lifestyle measures. If you need some extra help, the following OTC oral antihistamines are generally considered safe:
If your allergies are more severe, your doctor may suggest taking an OTC corticosteroid spray at a low dose along with an oral antihistamine. Options include:
- Avoid going outdoors or opening windows on high pollen days.
- Take off clothing youve been wearing outdoors. Rinse off pollen from skin and hair with a quick shower.
- Wear a mask while completing outdoor chores or enlist the help of someone else for tasks like mowing.
- Rinse nasal passages with saline spray or a neti pot.
Will Taking Benadryl Cause Birth Defects
The U.S. FDA classifies Benadryl as a Category B medication during pregnancy. Category B medications are ones that are believed to pose no risk to humans during pregnancy, including the fetus. It is important to realize that no medication is ever 100 percent safe. Benadryl isnt a Category A medicine. Category A medicines are the ones that are considered the safest during pregnancy with no known adverse reactions. While its unlikely Benadryl would cause birth defects, always consult a physician first. There are some instances where the use of Benadryl or diphenhydramine in the first trimester has been linked to an increased risk of a baby being born with a cleft lip or palate, although this risk is very low. Along with trying to avoid Benadryl during the first trimester, its also best to use allergy medications as minimally as possible during pregnancy.
Does A Stuffy Nose During Pregnancy Mean I Have Allergies
Pregnant women often develop stuffy noses. Nasal congestion usually starts sometime in the second trimester causing mucus membranes to swell and soften. Your doctor may refer to this as pregnancy rhinitis.
Pregnancy rhinitis can make you as stuffed up as if you had a cold or an allergy. It can result in nosebleeds during pregnancy and/or post nasal drip that may make you cough or even gag at night.
The good news is that pregnancy rhinitis typically goes away soon after pregnancy ends.
How can you tell the difference between allergies and a bad case of pregnancy congestion? If you have allergies, youll most likely experience symptoms such as congestion, coughing, sneezing and itchy eyes. If noticeable itchiness and sneezing arent plaguing you, it could be hormone-related congestion of pregnancy. If youre not sure, talk to your doctor.
What Can I Do To Reduce Allergy Symptoms During Pregnancy Without Taking Medications
Stay away from people who are smoking. Smoke can make allergies worse. Exposure to secondhand smoke during pregnancy isnt good for you or your baby.
If youre allergic to pollen, try to stay inside as much as possible. If you do go outside, try wearing wraparound sunglasses to keep pollen out of your eyes. When you come back inside, take off your shoes, wash your hands and face, and change clothes so the pollen doesnt stay with you. Then put your clothes in the wash. Shower and wash your hair before you go to sleep to help relieve nighttime symptoms.
If youre allergic to dust, make sure your house is cleaned regularly or hire someone to clean for you. Use a vacuum with a HEPA filter, a wet mop or a sweeper to avoid stirring up dust. A microfiber cloth is better than a traditional feather duster. Try to keep away from attics, basements and other musty places.
If youre allergic to pets, let your dog- and cat-owning friends know of your allergy before you drop by so they have time to make arrangements. If youre suddenly allergic to your own pet, try to make at least one room in your house pet-free.
Choosing An Allergy Medication
Once you know which medications are safe to take, youll have to figure out which one will work the best for you. If your allergies are chronic or environmental , you may want to find an antihistamine you can take every day, such as Claritin or Zyrtec.
Seasonal allergies can also be treated this way, but if your symptoms are very infrequent, Benadryl is a good, super-safe choice.
Benadryl can make you excessively drowsy, so be careful of when you take it; if youre not sure how it will affect you, dont take a dose before driving. If it makes you sleepy, save your dose for the evening hours, before bedtime.
If you suffer from sinus pain or pressure during allergies, one of the nasal steroid sprays can be a good option. Pregnant women often end up with excess nasal congestion anyway, thanks to an increase in fluid and blood volume ; a nasal steroid can help relieve some of these additional symptoms.