Can you use nasal spray while pregnant

This sheet is about exposure to oxymetazoline in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is oxymetazoline?

Oxymetazoline is a medication in nasal sprays (sprayed into nostrils) and topical preparations (applied to skin). Oxymetazoline is used treat nasal congestion, eye inflammation, and skin redness. It works by constricting blood vessels (making the blood vessels smaller). Oxymetazoline can be found in prescription products and in many over the counter products. Some examples are: Afrin®, Dristan®, Nostrilla®, Rhofade®, and Vicks®.

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I take oxymetazoline. Can it make it harder for me to get pregnant?

It is not known if oxymetazoline can make it harder to get pregnant.

Does taking oxymetazoline increase the chance for miscarriage? 

Miscarriage can occur in any pregnancy. Studies have not been done to see if oxymetazoline increases the chance for miscarriage.

Does taking oxymetazoline increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the studies reviewed, oxymetazoline is not expected to increase the chance for birth defects above the background risk.

Does taking oxymetazoline in pregnancy increase the chance of other pregnancy-related problems?

A report of 12 pregnancies in healthy people exposed to a one-time nasal spray dose of oxymetazoline showed no effect on uterine blood flow. Studies have not been done to see if oxymetazoline increases the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking oxymetazoline in pregnancy affect future behavior or learning for the child? 

Studies have not been done to see if oxymetazoline can cause behavior or learning issues for the child.

Breastfeeding while taking oxymetazoline:

Oxymetazoline has not been well-studied for use while breastfeeding. Since oxymetazoline is sprayed into nose or rubbed onto skin, it is thought that very little of the medication could reach breastmilk. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a male takes oxymetazoline, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Studies have not been done to see if oxymetazoline could affect male fertility or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here to view references.

OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.

These five tips for treating sinus congestion while pregnant can help you get over your stuffy nose without using medication that might pose a risk to baby.

1. Avoid Allergens and Pollutants

2. Keep Yourself Hydrated

Drinking even more water than usual each day is very effective in treating sinus congestion while pregnant.

Related Articles

• Sinus Infection in Pregnancy

• Natural Ways to Reduce Nasal Congestion During Pregnancy

• Preventing Sinus Congestion

3. Keep Your Nasal Passages Clear

Flush your nasal passages with saltwater nose drops several times a day. These are available without a prescription, or you can make your own. To make your own saltwater drops, use a quarter teaspoon of salt to a cup of water.

4. Use a Facial Steamer for Treating Sinus Congestion

Clear sinus congestion while pregnant with a simple facial steamer. A facial steamer is a hot mist vaporizer. A facial steamer “steam cleans” your nasal passageways.

5. Consider Nasal Sprays (Decongestants, Antihistamines)

Medicines that constrict the nose’s blood vessels may enter the bloodstream and constrict the uterus or placenta blood vessels. Therefore, decongestants should be used only under a doctor’s supervision and only in the dosage and frequency your doctor recommends. (Women with decreased placental circulation should be cautious about taking any form of inhaled or oral decongestants.)

Some nasal sprays are safer than others. Except for saltwater (or saline) nasal spray, consult your doctor before taking nasal sprays.

Afrin

• Afrin (oxymetazoline), when used only twice a day and for a couple of days, hasn’t been shown to cause harmful effects on the developing baby.

Inhaled Nasal Steroids

• Inhaled nasal steroids (e.g., Vancenase and Beconase) are in the “probably safe” category for treating sinus congestion while pregnant. However, only when taken a couple of times a day and for a short period of time. Best to stick with the lower potency inhaled steroids unless advised by your doctor.

Cromolyn

• Cromolyn (Intal) is safe to take during pregnancy. It’s not a decongestant, a steroid, or antihistamine. Cromolyn is a medication that lessens nasal congestion due to allergies when taken over a long period of time. It is beneficial during seasonal allergic rhinitis or hayfever. It’s not helpful during an acute attack of a stuffy nose.

Nasal or Oral Decongestants

• Nasal or oral decongestants that contain the following compounds are possibly harmful to the developing baby. They shouldn’t be taken to clear sinus congestion while pregnant. Consult with your doctor. These decongestants include ephedrine, phenylpropanolamine, Neo-synephrine, phenylephrine. These decongestants constrict the vessels in the airway passages. Therefore, they may also constrict the blood vessels delivering blood to the baby.

Antihistamines

• Antihistamines. Chlorpheniramine and tripelennamine are categorized as safe to use for sinus congestion while pregnant. (green light). Others are recommended only with reservation (yellow light). Yellow light antihistamines include those containing brompheniramine, diphenhydramine, terfenadine, and clemastine. These have been implicated in causing eye damage in premature infants if taken in the last two weeks of pregnancy. However, this is a rare finding.

Injections

• If you have been taking allergy shots before becoming pregnant, your doctor may advise continuing these shots during pregnancy. However, reactivity to these injections may change during pregnancy. Your doctor may elect to change the dosage. It is unlikely that your doctor would advise starting allergy shots during pregnancy.

Cough Syrup

• While pregnant, cough syrups should be taken with caution. It’s best to limit to nighttime-use or severe coughs. Available studies have shown no link between guaifenesin and fetal defects.

For more information on medication safe during pregnancy, see The Healthy Pregnancy Book: Month by Month, Everything You Need to Know from America’s Baby Experts

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