Hay Fever in Pregnancy: Which Antihistamines Are Safe?

Written by Dr. Simon Khela MBChB MRCGP, GMC Registered Doctor

Last reviewed: 10-06-2026

__________________________________________________________________________________________________________________________________

The pregnancy is a source of challenges, without adding irritation to the eyes, constantly sneezing, and a blocked nose on top of the other issues. But for some women, signs of hayfever can be more intense during pregnancy than they ever were before.

One of the biggest questions is whether the medication for hayfever is safe to use when pregnant.

The good news is that certain antihistamines are used during pregnancy for a lengthy period of time and are supported by more safety data for pregnant women than others. Cetirizine, as well as chlorphenamine and loratadine, are all considered by health experts when they consider the most effective treatment options for symptoms of pregnancy-related allergies.

Every pregnancy is different. The best method of treatment will depend on your health history and stage of your pregnancy, as well as the other medications you may be taking.

This guide will provide information on which antihistamines are commonly used in the course of pregnancy. The guide also discusses what research indicates that certain treatments need greater care, as well as what alternative options could be beneficial if medication doesn’t provide sufficient relief.

Can You Take Antihistamines During Pregnancy?

Yes, certain antihistamines can be frequently used during pregnancy. However, the treatment decision must always be made on an individual basis, and pregnant women should consult a medical specialist prior to attempting or changing medications.

The symptoms of Hayfever can have a profound impact on your daily life. Constant sneezing, nasal congestion, as well as itchy eyes and sleep issues can affect the general health, concentration, and productivity.

The healthcare professionals consider a variety of aspects when evaluating treatment

• Intensity of symptoms.
• Pregnancy stage.
• Previous reactions to medication.
• Other health issues.
• Potentially positive and risky.

Many antihistamines do not have similar amounts of safety information for pregnant women. Certain ones have been extensively used for years, while others have fewer safety data available.

This is why medical professionals typically prefer to use drugs that have a long history of use and more dependable evidence.

Why Hay Fever Can Be More Difficult During Pregnancy

Hormonal Changes and Nasal Symptoms

The hormonal changes that occur during pregnancy are significant, which affect blood circulation throughout the body, including the nasal passages.

The higher levels of hormones can cause the tissue inside the nose to constrict and swell. This could make hay fever symptoms get worse and make it hard to differentiate between pregnancy and seasonal allergic rhinitis.

A lot of women suffer from nasal congestion during pregnancy, even in the absence of hay fever prior to.

Sleep Disturbance and Fatigue

Sleep problems are already common during pregnancy.

If hay fever-related symptoms add to the mix, sleeping at night can be difficult to achieve.

An unclean nose, itchy eyes, and frequent sneezing can be a contributing factor to:

• Daytime fatigue.
• Concentration of less.
• Irritability.
• Lower productivity.
• A lower quality of life.

This is a reason why medical professionals take control of symptoms extremely during pregnancy.

When Hay Fever Symptoms Affect Daily Life

Mild symptoms can be managed by non-medication methods.

Some women, however, find that their symptoms start to manifest:

• Sleep quality.
• Performance at work.
• Exercise.
• Family life.
• Mental wellbeing.

If you notice that symptoms have an impact on your everyday activities, it’s recommended to discuss treatments with a healthcare expert.

Which Antihistamines Are Commonly Used During Pregnancy?

Antihistamines block histamine, which is a chemical that is released in allergic reactions.

They generally fall into two types:

First-Generation Antihistamines

Antihistamines older than 10 years tend to trigger the onset of drowsiness.

Examples include:

• Chlorphenamine.

Second-Generation Antihistamines

Antihistamines with a newer design that is less likely to cause sedation.

Examples include:

• Cetirizine.
• Loratadine.
• Fexofenadine.

Although all antihistamines are effective in improving allergic symptoms, they differ in their adverse-effect profile and the quantity of information on pregnancy safety available.

Cetirizine During Pregnancy

Cetirizine is among the most frequently used second-generation antihistamines to treat hay fever.

It is often talked about during pregnancy since an abundance of information about safety is accessible, in comparison to many of the latest allergy medicines.

The potential benefits are:

• Usually non-drowsy.
• Once-daily dosing.
• Accessible in a variety of ways.
• Effectively relieves sneezing, eye itching, and watery eyes.

Potential side effects include:

• Drowsiness is not severe.
• Headache.
• Dry mouth.

Since cetirizine has been extensively utilized, it is usually included in the list of antihistamines to consider when allergic symptoms need treatment during pregnancy.

Loratadine During Pregnancy

Loratadine is a second-generation antihistamine that is commonly used to treat seasonal allergies.

As with cetirizine, it has amassed a lot of pregnancy-related safety information over the course of many years of usage.

Some of the reasons to consider it may include:

• The risk of being drowsy is low.
• Convenient dosing.
• Effective symptom control.
• A vast amount of clinical experience.

Many health professionals consider the drugs loratadine or cetirizine to be similar alternatives, but individual factors and the preferences of patients can influence treatment choices.

Chlorphenamine During Pregnancy

Chlorphenamine is among the oldest antihistamines used daily.

The long-standing history of the practice means that medical professionals have years of expertise in the field of medicine.

Possibilities for benefit could include:

• Long-established use.
• A safety profile that is familiar to everyone.
• Effective allergy symptom relief.

But chlorphenamine is more likely to cause:

• Drowsiness.
• A decreased alertness.
• Fatigue.

This is why some find it less suitable for use in the daytime.

Fexofenadine During Pregnancy

Fexofenadine is a second-generation antihistamine that is used to treat hay fever.

As compared to cetirizine, loratadine, and chlorphenamine more evidence that is pregnancy-specific.

It is not a sign of the existence of a security issue.

Instead, it suggests that doctors may prescribe medications that have more detailed pregnancy information where alternatives are readily available.

The individual assessment is especially important when it comes to medicines, with more than a few studies.

Antihistamine Comparison Table

‍

Which Antihistamines Should Be Avoided or Used With Caution?

Why Evidence Matters

Pregnancy medicine decisions are usually dependent on the quantity and quality of evidence available.

Health professionals typically prefer to use medicines that contain:

• More long-lasting histories of use.
• Larger safety databases.
• More pregnancy-specific evidence.

This aids in making more informed decisions regarding treatment and gives greater confidence.

Decongestants Are Different From Antihistamines

One of the most common reasons for confusion is the fact that people frequently believe that decongestants and antihistamines are one and the same.

They’re not.

Antihistamines reduce the symptoms of allergies, for example:

• Sneezing.
• Itching.
• Nasal runny.
• Eyes watery.

Decongestants perform differently.

They can reduce nasal congestion by reducing the blood vessels within the nose.

Common decongestants include:

• Pseudoephedrine.
• Xylometazoline.

Because they function differently, decongestants could require a separate evaluation during pregnancy.

Women are advised to seek professional help before taking decongestant medication during pregnancy.

What If Antihistamines Don’t Control Your Hay Fever Symptoms?

Women continue to suffer from difficult symptoms even after taking antihistamines.

If this occurs, further treatment options may help.

Nasal Sprays

Nasal sprays can treat symptoms better than oral medications for certain people.

A variety of nasal sprays are widely employed to treat allergic rhinitis and hayfever symptoms.

Since different sprays have different ingredients, professional guidance is suggested when selecting products for use during pregnancy.

Eye Drops

For women with symptoms that primarily concern the eyes, eye drops can offer relief specific to the eye.

This may help to reduce the need for further medications.

Non-Medication Strategies

Simple measures to protect the environment can drastically reduce the exposure to pollen and the severity of symptoms.

Many women during pregnancy benefit from the combination of medication and useful strategies to avoid the onset of pregnancy.

Non-Medication Ways to Manage Hay Fever During Pregnancy

Monitoring Pollen Counts

The ability to check predictions of pollen can help you plan outdoor activities during times when the pollen count is lower.

This is particularly helpful in the peak season of pollen.

Reducing Pollen Exposure

Practical methods can include:

• Keeping windows closed during high pollen days.
• Wearing sunglasses outside.
• Showering after spending time outside.
• Dressing for outdoor activities after changing.
• Drying your clothes indoors, especially during high pollen times.

Saline Nasal Irrigation

Saline rinses are a great way to remove pollen particles that have accumulated in the nasal passages.

Many people have found that regular saline irrigation increases the quality of life and eases congestion.

Barrier Balms Around the Nostrils

Balms that block the nostrils could help to filter out pollen before it gets into the nose.

Although they are not a substitute for prescription medication, some can use them as a part of a wider symptom management strategy.

Antihistamines vs Nasal Sprays: Which Works Better for Hay Fever?

There isn’t a single answer.

Antihistamines are frequently particularly useful to:

• Sneezing.
• Itchy eyes.
• Nose irritated and runny.

Nasal sprays can be particularly beneficial to:

• Nasal obstruction.
• Congestion.
• Persistent nasal symptoms.

For certain individuals, the combination approach can provide the most effective control of symptoms.

The treatment decisions must always be discussed with a medical professional.

Is Pregnancy Rhinitis the Same as Hay Fever?

No.

Although symptoms may be similar with hay fever, pregnancy rhinitis as well as hay fever are two distinct conditions.

Pregnancy Rhinitis

It is a result of hormonal changes, rather than allergies.

The symptoms typically include:

• Nasal congestion.
• Blocked nose.
• Airflow is reduced.

Hay Fever

Hay Fever is an allergy that is caused by exposure to pollen.

The symptoms typically include:

• Sneezing.
• Itchy eyes.
• Nasal runny.
• Itchy throat.

Certain women suffer from both at the same time.

Are Antihistamines Different in Each Trimester?

First Trimester

In the first trimester, it is where women tend to be concerned about the use of medication.

If you require treatment, doctors typically look at treatments that have the most established medical information regarding safety.

Second Trimester

In the second trimester, most women gain weight, but the symptoms of hayfever may remain unsettling.

The treatment decisions will continue to be based on the severity of symptoms and any available safety information.

Third Trimester

The third trimester is the time to be concerned; managing symptoms remains crucial, particularly if hayfever affects sleep or well-being.

Women should continue to discuss their use of medication with their medical team.

When Should You Speak to a Healthcare Professional?

Medical advice is highly recommended when:

• The symptoms can affect sleep.
• The symptoms are becoming more severe..
• If you suffer from asthma, you’re in the right place.
• It is not clear if the symptoms are caused by allergies like hay fever.
• The treatment currently being used is not working.
• You are concerned about the safety of medications.

An assessment by a professional can help to ensure that symptoms are effectively controlled while taking into account both the well-being of the mother and fetus.

Frequently Asked Questions