Hayfever in pregnancy: what medication is safe to take?

The expert view

If you're pregnant and have hayfever symptoms, try the natural remedies suggested below. If they don't bring you relief, the best thing to do is talk to your GP. Many of the antihistamine tablets that you can normally buy for hayfever, such as Piriton, cannot be sold for use during pregnancy without a prescription.

If your doctor thinks your hayfever symptoms need treatment, they'll usually advise you to try a nasal spray, nose drops or eye drops first.

Your GP may recommend:

Eye drops, such as Optilast or sodium cromoglycate eye drops
A corticosteroid nasal spray, such as Flixonase, Beconase or Nasonex. Steroid nasal sprays medicines can help unblock your nose and sinuses by reducing inflammation, and are safe to use in pregnancy.

So, is it ever safe to take antihistamine tablets if I'm pregnant?

Only with your doctor's explicit approval. If the nasal sprays don't work, then, after discussion and depending on how far along you are in your pregnancy, your doctor may agree to prescribe you antihistamine tablets.

The tablets most often prescribed in these circumstances include Loratadine (also sold under brand names that include Allereze and Clarityn) and Cetirizine (also sold under brand names that include Piriteze, Benadryl Allergy and Allacan). None of these cause drowsiness and many doctors consider them to be suitable for use during pregnancy.

Antihistamines that cause drowsiness, such as those containing chlorphenamine under brand names such as Piriton, Allerief and Hayleve, can also be prescribed for use during pregnancy but may not be your doctor's first choice because of the drowsy side effects.

Why the caution? It’s because there is still some uncertainty around antihistamine use in pregnancy. In an academic review of the use of antihistamines in pregnancy,¹ published in the Journal of Pharmacology & Pharmacotherapeutics, researchers point out that no antihistamines have formally been categorised as safe during pregnancy.

This doesn't mean they are unsafe but it does explain why doctors like me prefer to do a careful risk/benefit assessment before prescribing them to a pregnant woman.

What are the best natural remedies for hayfever in pregnancy?

There are lots of non-medical strategies you can employ to reduce the triggering effect of pollen on your body:

Apply a little smear of petroleum jelly or a nasal barrier balm under your nose. This can help to trap some of the pollen when you're out and about, and stop it going up your nos.
Wear wraparound sunglasses. They can help prevent pollen entering your eyes
Keep an eye on the pollen count (you can usually see this on good weather reports) and avoid going out when the pollen count is very high
Keep your windows closed in the morning and evening when pollen counts are at the highest and even if it's hot (sorry!)
Dry your clothes, towel and bedsheets inside to help prevent pollen sticking to the fabric
Keep the windows closed when driving in a car
Try to avoid sitting outside in areas near lots of the kind of pollen-spraying grass or trees that set off your symptoms
Use a sinus rinse to wash the pollen out of your passages, and clean your eyelids and lashes at night to remove any pollen before bed
Wash and brush your pet's hair as often as possible to remove pollen from their coat
Take a shower before you go to bed to help wash any stray pollen from your hair and skin

Do hayfever symptoms change in pregnancy?

Maybe. I'm afraid there's no clear answer on this one. If you already suffer from hayfever and you become pregnant, you may notice no change in the severity of your symptoms at all or you may notice that they are worse or better than usual.

Can you get hayfever for the first time in pregnancy?

Yes but it's not likely to be linked to your pregnancy. You can develop hayfever at any point in life – and it's estimated that 1 in 4 people suffers at some point from hayfever. If you do develop hayfever for the first time in pregnancy, you may notice that the symptoms go away or lessen after your baby is born, but not always.

If you're really suffering, the best thing to do is talk to your GP. If your doctor thinks your hayfever symptoms need treatment, you'll usually be advised to try a nasal spray, nose drops or eye drops first, as I've outlined above.

However, not all runny or stuffy noses in pregnancy are due to hayfever! Pregnancy hormones affect all areas of the body, including increasing the amount of blood flowing around the body and the mucous membranes in your nose can also be affected. This means that it is common to get a stuffy or runny nose in pregnancy, as well as nose bleeds. But this is not associated with the itchy eyes and other symptoms of hayfever.

Please note: this advice is not personalised or meant to replace individual advice given to you by your doctor or medical team.

References:

^{1. Summit Car et al. A Review of Antihistamines Used During Pregnancy. J Pharmacol Pharmacother. 2012 Apr-Jun; 3(2): 105–108. doi: 10.4103/0976-500X.95503}

About our expert Dr Philippa Kaye

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

Dr Philippa KayeGP

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