From the Guidelines
Safe Sinus Medications During Pregnancy Pregnant women should use saline nasal sprays or drops, such as Ocean or Simply Saline, to help relieve sinus congestion. If medication is necessary, consider taking acetaminophen (Tylenol) at a dose of 650-1000mg every 4-6 hours as needed, but always consult with a healthcare provider before taking any medication during pregnancy 1.
- Topical corticosteroids, such as budesonide, fluticasone, and mometasone, are considered safe for CRS maintenance during pregnancy at recommended doses 1.
- Oral antibiotics, such as penicillin and cephalosporin, can be used for ABRS or acute exacerbations of CRS, but only under the guidance of a healthcare provider 1.
- Pseudoephedrine (Sudafed) should be avoided during the first trimester, but can be used after the first trimester at a dose of 30-60mg every 4-6 hours, only under the guidance of a healthcare provider 1.
- Oral decongestants and first-generation antihistamines should be avoided due to potential risks to the fetus 1.
- Allergen immunotherapy is likely safe to continue during pregnancy, but initiation or buildup of immunotherapy should not be conducted during pregnancy 1. Always prioritize caution and consult with a healthcare provider before taking any medication during pregnancy.
From the Research
Safe Sinus Medications During Pregnancy
The following sinus medications are considered safe during pregnancy:
- Topical corticosteroids, with budesonide having the strongest recommendations 2
- Loratadine and cetirizine, which are second-generation antihistamines 2
- Anticholinergics and cromones, which have shown no increased risk of teratogenicity 2
- Saline nasal irrigations, which are a safe and effective treatment option for pregnant women with seasonal allergic rhinitis 3
Medications to Avoid During Pregnancy
The following medications should be avoided during pregnancy:
- Oral decongestants, which have associations with cardiac, ear, gut, and limb abnormalities and are not recommended in the first trimester 2
- Oral corticosteroids, which should be avoided in the first trimester unless absolutely necessary 2
Alternative Treatment Options
Alternative treatment options for sinus symptoms during pregnancy include: