Is it safe to take decongestants while pregnant? - Evidence Based Babies
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decongestant safe for pregnancy

Is it safe to take decongestants while pregnant?

If you’re a pregnant woman and you’re experiencing congestion, you may be tempted to reach for some over the counter medications. You may be wondering whether it’s safe to take decongestants while pregnant.

Some medications are considered safe to take while pregnant, while other may be considered unsafe due to potential harm to an unborn baby.

When possible, try to treat or reduce you cold and flu with some home remedies such as saline nose sprays, neti pots, saltwater gargles and getting some rest. If you feel like you need medication for your symptoms, contact your health care provider for the best information for you personally.

What is a decongestant? 

Decongestants are medicines that are mainly used to help with a stuffy nose for short-term use. These medicines help clear the nasal passages by reducing the swelling in the blood vessels in your nose, which, in turn, helps you to breathe better.

They also work to reduce the mucus in your nose and eyes and decrease inflammation as well. 

You can use decongestant medicine to help with cold and flu symptoms, as well as allergies. Most of the cold medications in your medicine cabinet could contain a decongestant as well as other active ingredients to help with numerous symptoms. 

Most decongestant medicines are OTC medications and are easy to have on hand during cold and flu season. 

What kind of decongestants are there? 

There are a few different types of decongestants. They can be taken orally or sprayed right into the nose. 

Oral Decongestants

You will find oral decongestants, such as Sudafed and Sudafed PE. These contain either phenylephrine or pseudoephedrine and are the most common over-the-counter medications for cold symptoms like nasal congestion. 

Claritin D also contains a decongestant. This is the most common allergy medicine and one of the newer antihistamines to help with a sore throat, hay fever, and many other symptoms other than a clogged nose. 

Nasal Sprays

Xylometazoline or Oxymetazoline are used in most of the nasal spray decongestants you will find. A saline nasal spray is a great alternative to cold medicines that can help clear your runny nose. 

Usually, nasal sprays will work faster at helping with your congestion and generally have fewer side effects than oral decongestants too. 

Is it safe to take decongestants while pregnant? 

Most people have no issues with these medicines, but is the use of decongestants safe for pregnant women? Because there is limited data, it is unknown whether using decongestants while pregnant is truly safe or not for your developing baby. 

Some decongestants can potentially be safe for pregnant people and their unborn babies outside the first trimester. However, it is always best to talk to your healthcare provider as everyone’s situation differs. You should especially reach out if you have any pregnancy complications, as that could change how safe these medications can be for you. 

The American College of Obstetricians has shared that some pregnancy-safe medications for allergies can include a nasal decongestant spray. However, it did mention that decongestants that contain pseudoephedrine should not be used in the first trimester. 

According to the American Pregnancy Association, different medications have different categories depending on their risk factors for pregnant women. This is controlled by the U.S. Food and Drug Administration (FDA). 

Category A means that there have been controlled studies that showed there is no harm in taking those medicines. 

Category B showed no risk in animal studies but has not had human studies. 

Category C shows a higher risk to an animal fetus, but no studies on humans. 

Category D means that there is evidence of risks to the baby, but it can be used in life-threatening cases for the mother. 

In general, most healthcare providers will say to use either Category A or B while pregnant. Many decongestants, such as phenylephrine or pseudoephedrine, are considered Category C and should not be used during the first trimester. 

The best way to help with your nasal congestion would be using nasal sprays or nasal strips that you can get over the counter. 

What are the risks of taking decongestants while pregnant? 

As with all medication, there are potential risks, and those risks are usually higher for pregnant mothers and their babies. 

In some studies, when a pregnant person in the first trimester used a decongestant such as phenylephrine or pseudoephedrine, they found an increased risk of birth defects.  However, other studies failed to show any increase in the risk of malformations or adverse effects for women or the developing fetus in the first or third trimester. 

In other human studies, pregnant women used Xylometazoline or Oxymetazoline in nasal decongestant sprays, and there were no known harmful effects on the mom or fetal development.

It is always a good idea to talk with your health care professional to see what decongestant options they think are best for your situation. 

Decongestants that contain Pseudoephedrine might also cause some issues with high blood pressure, so pregnant women who have blood pressure issues should not use decongestants. Some people who have heart problems or high blood pressure might have more risks if they take decongestants as well. 

Because these medications are for short-term use only, if you use them for longer periods of time, it can cause a rebound effect. This causes your initial congestion to immediately come back once you stop taking the medicine. 

You might experience some possible side effects from taking decongestants, such as a headache, dizziness, or feeling sleepy. If you’re worried, contact your medical provider immediately.

Safe Cough and Sore Throat Remedies During Pregnancy

  • Honey
  • Acetaminophen
  • Menthol rubs
  • Nasal strips
  • Plain cough syrup
  • Chloraseptic spray
  • Saltwater gargling
  • Nasal drops or sprays
  • Expectorant during the day
  • Cough drops or lozenges containing benzocaine
  • Dextromethorphan or Dextromethorphan-guaifenesin

Cough and Flu Medications to Avoid During Pregnancy

  • Aspirin
  • Codeine
  • Bactrim, an antibiotic
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve, Naprosyn)

Natural alternatives to help with congestion while pregnant 

There are a few different home remedies you can try to help with congestion while you are pregnant. Here are a few good options.

Vapor Rubs

Vapor rubs are generally considered a safe option for all weeks of pregnancy. Just follow the package directions and wash your hands thoroughly when you are finished. 

Neti Pots

Neti Pots uses a saline solution to wash your nasal passages, which is another one of the home remedies for congestion you may want to consider. In general, nasal irrigation is considered a safe option as well. 

Vitamin C

Vitamin C plays an important role in helping your immune system and can help when you are feeling sick. 

Most prenatal vitamins contain vitamin C, and you can get plenty from fruits and vegetables, so you may not need to take an extra supplement, just eat more foods that contain vitamin C like oranges. 

Nasal Strips

Nasal strips help hold open your nostrils and may be helpful for a stuffy nose, especially at night. 

Because there is no medication with these, they are a safe option to try, but they might not be as effective as other natural remedies. 

Drink Water

Make sure you are drinking plenty of fluids while you are feeling sick. This is one of the best ways to recover quickly. 

You can add some electrolytes to your water as well to help your body recover faster as you lose a lot of fluids when you are sick. 


Humidifiers are great at helping you decongest naturally, especially at night. 

You can also turn on a hot shower and shut your bathroom door to create a steamy room that also can have the same effect. 

Is it safe to take decongestants while breastfeeding?

Just like with pregnancy, certain medications are considered safe and unsafe for the baby and for the milk supply. It’s important to always check the active ingredients of medications and verify it’s safety by a trusted resource before using it.

Many people take decongestant tablets, powders and lemon drinks when they have a cold or flu, and although they are unlikely to affect a breastfeeding baby, they can potentially have a significant impact on milk supply.

It is recommended that breastfeeding women avoid decongestant tablets, powders or drinks.

Decongestant nasal sprays containing Xylometazoline, Oxymetazoline are effective in relieving nasal congestion and they don’t produce wakefulness or reduce the milk supply. They are safe and effective but should not be used long term.

Important notes medications while pregnant

As a pregnant mother you need to take caution with any medication you want to take, even if it’s an herbal medication. Always consult with your medical provider for the correct information regarding your health and pregnancy safe medications for you as an individual.

When possible, try home remedies as much as possible such as saline nose sprays and neti pots and getting as much rest as possible.

Once you give birth and decide to breastfeed, you will need to be careful with certain medications including herbal medications. Certain medications can be unsafe for your baby and others can reduce your milk supply. Always contact an International Board Certified Lactation Consultant (IBCLC) regarding anything breastfeeding.

Additional information and resources

Over-the-Counter Medications in Pregnancy

Treating the common cold during pregnancy

What medicine can I take for allergies while I’m pregnant?


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