Can I take Zyrtec while pregnant?

For many, spring brings sneezing, runny nose, and itchy eyes. Oral antihistamines like Zyrtec (cetirizine) relieve these allergy symptoms. But is Zyrtec safe during pregnancy? Generally, yes. Most OTC antihistamines—Zyrtec, Claritin (loratadine), Allegra (fexofenadine)—are considered safe in pregnancy when needed. Always discuss with your healthcare provider before starting any medication.

What is Zyrtec?

Zyrtec is a second-generation H1-antihistamine with less drowsiness and fewer side effects than first-generation antihistamines (e.g., chlorpheniramine, hydroxyzine, diphenhydramine). It blocks histamine’s effects to relieve allergy symptoms.

Is Zyrtec safe during pregnancy?

Zyrtec is considered safe in all trimesters. Studies of over 1,300 first‑trimester exposures found no increased birth defect risk. ACOG lists Zyrtec as acceptable for use in pregnancy. Take only if necessary and under your provider’s guidance.

Alternatives if you cannot take Zyrtec

• Allegra (fexofenadine) or Claritin (loratadine)
• Chlorpheniramine or prescription hydroxyzine (first-generation, but ACOG‑approved)
• Nasal steroid sprays (Flonase, Rhinocort, Nasonex) — shown to be safe in pregnancy

Natural allergy relief in pregnancy

• Saline nasal spray or rinse (use distilled or boiled, cooled water)
• Avoid high‑pollen times; change clothes and shower after outdoor exposure
• Identify and avoid triggers (dust mites, pet dander, mold)
• Clean with wet mop/cloth and use HEPA filters
• Wash linens in hot water every 2 weeks and dry on high heat
• Elevate head of bed 30–45° for nighttime relief
• Moderate exercise may reduce allergy and asthma risk

Allergy medications to avoid in pregnancy

• Oral decongestants (pseudoephedrine) and nasal decongestant sprays — avoid in first trimester per ACOG
• Nasacort (triamcinolone) — small study suggests lung birth defect risk
• Herbal supplements and essential oils — safety not well studied

Zyrtec during breastfeeding

Zyrtec may slightly reduce milk supply, though unproven. It causes less drowsiness than older antihistamines. If taken daily, watch your baby for increased sleepiness or feeding changes and notify your pediatrician if concerned.

Sources

• Mother To Baby. Cetirizine (Zyrtec®) Fact Sheet. OTIS; Nov 2022. Accessed Apr 10, 2025.
• American College of Obstetricians and Gynecologists. Allergy medications in pregnancy. Accessed Apr 10, 2025.
• Bérard A et al. Intranasal triamcinolone and pregnancy outcomes. J Allergy Clin Immunol. 2016. Accessed Apr 10, 2025.
• Alhussien AH et al. Safety of intranasal corticosteroids in pregnancy. Eur Arch Otorhinolaryngol. 2018;275(2):325–333. Accessed Apr 10, 2025.
• Prossegger J et al. Winter exercise reduces allergic inflammation. Int J Environ Res Public Health. 2019;16(11):2040. Accessed Apr 10, 2025.