Are Nasal Decongestants Safe for Pregnant Women - November 2024

Nasal congestion is just one of those pregnancy symptoms that you least expect when you’re expecting. Often mistaken for the flu or the common cold, pregnancy congestion can seem like just a passing virus. Unfortunately, it may not be so simple. While totally harmless, nasal congestion can be bothersome. This is where nasal decongestants come in. But are they safe for pregnant mothers? Here’s what you need to know about nasal decongestants for pregnancy. Nasal Congestion and Pregnancy Nasal congestion during pregnancy is actually very common. It can happen whether or not you’ve had allergies or the flu. It often happens as a result of a condition known as pregnancy rhinitis. This is where you experience nasal congestion without any signs of respiratory disease or allergic reaction. It is more common among women in their third semester, particularly within the last 6 remaining weeks of pregnancy. However, it can happen way before that at any time. Studies show that the symptoms often disappear within two weeks of childbirth. That’s right, you may be struggling with the lingering aftermath of nasal congestion even after you've had your baby. Pregnancy rhinitis affects around one in five women and occurs primarily as a result of hormonal changes. Various hormones like placental growth hormone, oestrogen, and progesterone are often to blame for the condition. The nasal passages swell from the action of these hormones, causing symptoms that are fairly similar to textbook rhinitis. These include sneezing, runny nose, postnasal drip and of course, nasal congestion which happens when the mucous membranes become inflamed. This makes it difficult to breathe. However, it is also not uncommon as well for a pregnant mum to get the cold and the flu naturally from an upper respiratory tract infection which can cause nasal congestion as well. The common treatment is usually, of course, nasal decongestants. What Are Nasal Decongestants? Nasal decongestants are a classification of medicine that helps with nasal congestion. They work by constricting the blood vessels of the mucous membranes and opening up the nasal passages. The result is clear, unobstructed breathing. Doctors prescribe nasal decongestants to treat a variety of upper respiratory tract diseases and conditions including but not limited to: nasal and sinus congestion, seasonal rhinitis, common cold, allergic rhinitis, rhinosinusitis, nasal polyps, and hypertrophy. There are generally two common types of nasal decongestants: oral and topical (or intranasal). Oral decongestants come in pill forms while topical ones are typically available as nasal sprays. The most effective drugs used in decongestant medicine include phenylephrine, pseudoephedrine, oxymetazoline, naphazoline, and xylometazoline. Both oral and intranasal decongestants are available in drowsy and non-drowsy formulations but they both have different pros and cons. Oral decongestants work slowly, but are safer for long-term use. They typically come in the form of pills and syrups. On the other hand, topical decongestants (often sold as nasal sprays) have an instantaneous effect as they are administered straight into the nasal passages. However, topical or intranasal decongestants are not recommended for use any longer than three to five days. Doing so risks creating a condition known as rebound congestion. There are also other types of medication that help with nasal congestion that aren’t standard variety decongestants such as antihistamines and intranasal corticosteroids. Antihistamines are available both in oral and topical (intranasal) form. The intranasal version works better and faster than the oral version. On the other hand, intranasal corticosteroids only come as nasal sprays. Are Nasal Decongestants Safe for Pregnancy? Yes and no. Most over-the-counter decongestants are safe for pregnancy. The most common being pseudoephedrine. Some studies have found that use of decongestants during pregnancy has been associated with a small risk of certain birth defects. Particularly if taken during the first trimester. However, other studies have not found any adverse side effects to mother or baby from the use of decongestants. So the findings are inconclusive. Moreover, just like with the flu or the cold, medication only treats the symptoms not the cause. Unlike your garden variety respiratory viruses, pregnancy rhinitis doesn't just go away after a week or two. The condition may come and go, but tends to persist for weeks. As such, mums may feel prompted to rely on nasal decongestants for extended periods of time to relieve their stuffy noses (which can be dangerous). As a general rule, standard variety nasal decongestants (not antihistamines or corticosteroids) should not be used longer than 3 to 5 days. Therefore, it is important to note however, that while nasal decongestants are widely available over-the-counter, you should always seek proper medical advice. This ensures that you are making the safest healthcare decisions for you and your baby. Your doctor will most probably know the correct and safe dosage when prescribing decongestants for pregnancy. But in general, avoid taking any nasal decongestants (including over-the-counter antihistamines) during the first trimester of pregnancy. Just to be safe. Which Nasal Decongestants Are Safe for Pregnancy? There are a number of nasal decongestants that are considered safe for pregnancy. These include standard variety decongestants (like pseudoephedrine), antihistamines (like cetirizine) and intranasal corticosteroids (like fluticasone). Pseudoephedrine is often prescribed over phenylpropanolamine. However, pseudoephedrine has been associated with elevated blood pressure. This may increase your chances of developing gestational hypertension. Topical or inhaled decongestants typically contain either xylometazoline and oxymetazoline. These are safe for pregnancy as long as you don't overuse them, for reasons mentioned earlier (rebound congestion). That said, there are other medications that are safe such as your regular antihistamines, these include cetirizine (Zyrtec), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), fexofenadine (Allegra), and loratadine (Claritin). These offer minimal risk to baby and mother and fewer side effects. But it’s important to take them as instructed by your doctor or pharmacist. Experts recommend instant-release decongestants over extended-release ones. Mothers should take the smallest dose possible at the shortest duration. Intranasal corticosteroids such as fluticasone (Flonase), mometasone (Nasonex), and budesonide (Rhinocort) are all safe for pregnancy. You can use them a lot longer than topical decongestants (typically around 2 weeks). However, their effects are not instantaneous and you need to take them before the full effects of the symptoms kick in. Are There Side Effects to Using Nasal Decongestants? Yes, depending on the type of medication. Most of these risks and side effects are the same for everyone, regardless if they’re expecting or not. But others pose significant risks to both mother and baby if taken while pregnant. For nasal decongestants, the side effects (as mentioned earlier) are headache, nausea, insomnia and dizziness, nasal dryness, and nasal ulcers. As previously mentioned, overuse of nasal decongestants may also cause rebound congestion. This is where your nasal congestion gets worse the more you rely on the medication. Eventually prompting you to up the dose. Nasal injury can also occur as a result of overuse of topical decongestants as a result of the vasoconstrictive effects. There is also some small but inconclusive risk of birth defects when used in pregnancy. This risk is typically higher if you’re a habitual user of antihistamines. Other general side effects include: dry mouth, nose, or throat, gastrointestinal upset, stomach pain, or nausea, headache, constipation and diarrhoea. Intranasal or topical antihistamines on the other hand may cause vomiting, headache, dizziness, fatigue and drowsiness. For intranasal corticosteroids, side effects include burning, stinging, irritation, dryness and in extreme cases, nosebleeds. However, they are safer for pregnancy than antihistamines. How to Properly Use Nasal Decongestants The directions on how to use nasal decongestants are usually available on the package. But if you’re consulting a doctor, the clinic pharmacist will tell you how to use them. In general, healthcare professionals will prescribe nasal decongestants according to dosage and duration. And both vary depending on the type of drug. For example, the normal adult dosage of cetirizine is one 10mg tablet once a day as needed. On the other hand, topical decongestants require a different kind of administration. Typically available in spray form, topical decongestants make use of a nozzle to deliver the medicine straight into the nasal passages via the nostrils. The typical dosage for topical decongestants is usually two sprays a day, once in the evening and at night, or when needed. You will usually be instructed to tilt the head forward to avoid accidentally swallowing the medicine. It’s important to avoid using decongestants for an extended period of time as this may pose a significant risk to your baby. Alternatives to Nasal Decongestants During Pregnancy It’s normal to worry about the safety of your baby when using nasal decongestants. However, drugs aren’t the only way to go when you’re looking to relieve nasal congestion (or pregnancy rhinitis). One thing you can try is nasal rinses (also often called nasal irrigation or nasal wash). A typical nasal rinse kit includes specially designed bottles and salt sachets. You basically use the saline solution to flush out your nasal passages through the nostrils. The salt reduces the swelling in the mucous membranes thus relieving congestion. However, a study states alkaline solutions are better for irrigation as they provide a more effective and long-lasting relief from congestion. Another trick that you may like to try are mechanical alar dilators. These are small contraptions you put under your nose to widen the nasal passageways and improve airflow and breathing. They are often used when sleeping and may counteract snoring as well. You can also try humidifiers or steam to clear up congestion. These include any moist, warm air that can help clear up any mucus that is the cause of obstructed breathing. Some old wives remedies will have you drinking certain herbal teas. However, this is recommended for pregnancies as they may cause miscarriage or preterm birth. Breathing Right Again Nasal congestion can be an inconvenience. But it can also be more trouble than it's worth. Difficulty breathing, especially at night can cause sleep deprivation, which can be harmful for an expectant mother. When using nasal decongestants as a solution to the problem, it's better to be safe than sorry. So always consult a doctor before purchasing any over-the-counter medication to treat your symptoms. For both your safety and your baby’s. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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