Is cetirizine (Zyrtec) safe to use during pregnancy?

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Last updated: June 20, 2025View editorial policy

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From the Guidelines

Cetirizine (Zyrtec) is generally considered safe to use during pregnancy, as it is classified as a pregnancy category B medication, which means animal studies have not shown harm to the fetus, and there are no adequate well-controlled studies in pregnant women showing adverse effects. According to the most recent study 1, cetirizine is considered "probably safe" for use during pregnancy, with a low risk of fetal malformations or harmful effects. The study suggests that cetirizine can be used as a preferred antihistamine option for allergy relief during pregnancy, with a typical adult dose of 5-10 mg once daily.

Key Points to Consider

  • Cetirizine works by blocking histamine receptors, reducing allergy symptoms like sneezing, itching, watery eyes, and runny nose without crossing the blood-brain barrier significantly, which means it causes less drowsiness than older antihistamines.
  • While cetirizine appears safe, it's always best to use the lowest effective dose for the shortest duration needed to control symptoms.
  • As with any medication during pregnancy, you should consult with your healthcare provider before starting cetirizine, especially if you have other medical conditions or are taking additional medications.
  • A study from 2008 1 also confirms the safety of second-generation antihistamines, including cetirizine, during the first trimester of pregnancy, with no significant increase in congenital malformations.

Recommendations

  • If you need allergy relief during pregnancy, cetirizine is often recommended as a preferred antihistamine option.
  • Consult with your healthcare provider before starting cetirizine, especially if you have other medical conditions or are taking additional medications.
  • Use the lowest effective dose for the shortest duration needed to control symptoms.

From the FDA Drug Label

If pregnant or breast-feeding: if breast-feeding: not recommended if pregnant: ask a health professional before use. The FDA drug label does not answer the question.

From the Research

Cetirizine Use During Pregnancy

  • Cetirizine, also known as Zyrtec, is a second-generation antihistamine used to treat allergic symptoms.
  • The safety of cetirizine during pregnancy has been evaluated in several studies, with most suggesting that it is safe to use 2, 3, 4, 5, 6.

Studies on Cetirizine and Pregnancy

  • A 2016 study published in The American Journal of the Medical Sciences found that second-generation antihistamines, including cetirizine, are considered safe to use during pregnancy 2.
  • A 2004 study published in the American Journal of Rhinology found that cetirizine can be used to treat allergic rhinitis during pregnancy, especially when first-line therapies are ineffective or poorly tolerated 3.
  • A 1997 prospective controlled study published in the Annals of Allergy, Asthma & Immunology found no significant differences in pregnancy outcomes between women who took cetirizine or hydroxyzine during pregnancy and those who did not 4.
  • A 1999 review published in Drug Safety found that first-generation and second-generation antihistamines, including cetirizine, have not been incriminated as human teratogens 5.
  • A 2018 study published in the Journal of Obstetrics and Gynaecology found that cetirizine exposure during pregnancy was not associated with adverse pregnancy outcomes above background rates 6.

Key Findings

  • Cetirizine is considered a safe option for treating allergic symptoms during pregnancy.
  • Most studies found no increased risk of congenital malformations or adverse pregnancy outcomes associated with cetirizine use.
  • Cetirizine can be used during pregnancy, especially when first-line therapies are ineffective or poorly tolerated.
  • Further studies are needed to confirm the safety of cetirizine during pregnancy, but current evidence suggests that it is a safe option for managing allergic symptoms.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Allergy Medications During Pregnancy.

The American journal of the medical sciences, 2016

Research

Treatment of allergic rhinitis during pregnancy.

American journal of rhinology, 2004

Research

Prospective controlled study of hydroxyzine and cetirizine in pregnancy.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 1997

Research

Safety of cetirizine in pregnancy.

Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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