Safe Antihistamines for Pregnancy: Your Quick Guide

Pregnancy can make allergies feel extra annoying, but you don’t have to suffer in silence. The good news is that a few antihistamines have been studied and are generally accepted as safe for expectant moms. Below you’ll get the rundown on which ones to consider, how to take them, and the red flags to watch for.

First‑Generation Antihistamines You Can Trust

Older antihistamines like diphenhydramine (Benadryl) and chlorpheniramine have the longest safety record in pregnancy. Doctors often recommend them for short‑term relief of sneezing, itchy eyes, or a runny nose. They cross the placenta, but studies haven’t shown a higher risk of birth defects when used at normal doses.

When you pick one of these, start with the lowest effective dose. For diphenhydramine, that’s usually 25 mg every 6–8 hours. Chlorpheniramine works at 4 mg every 4–6 hours. Because they can make you drowsy, it’s wise to take them at night or when you don’t need to drive.

Second‑Generation Options and What to Watch

Newer, non‑sedating antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) are also considered low‑risk in pregnancy. They cause less sleepiness, which many pregnant women appreciate. Research from the FDA’s pregnancy category B places them on a relatively safe shelf, meaning animal studies didn’t show harm and there’s no clear human risk.

Typical dosing is loratadine 10 mg once a day or cetirizine 10 mg once a day. Stick to the recommended amount—there’s no benefit in doubling up, and higher doses could increase the chance of side effects like dry mouth or mild headache.

Fexofenadine (Allegra) is a bit more controversial. Some experts say it’s safe, but the data isn’t as strong as for loratadine or cetirizine. If you’re already comfortable with a proven option, you might skip fexofenadine during pregnancy.

Regardless of the antihistamine you choose, always talk to your healthcare provider first. They’ll check your medical history, any other meds you’re taking, and make sure the drug won’t interfere with prenatal vitamins or other supplements.

Here are a few quick tips to keep in mind:

• Never self‑prescribe a prescription antihistamine; get a doctor’s OK.
• Use the smallest dose that controls your symptoms.
• Watch for side effects like extreme drowsiness, rapid heartbeat, or stomach upset and report them.
• Stay hydrated and pair medication with saline nasal rinses for extra relief.
• If you’re in the third trimester, double‑check with your OB‑GYN before starting any new drug.

Allergies don’t have to ruin your pregnancy. With the right antihistamine and a bit of caution, you can breathe easy and focus on the exciting months ahead.