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The use of hydroxyzine is contraindicated during pregnancy because its effects on the fetus are not fully understood. 

Does Hydroxyzine Cause Birth Defects?

Studies on pregnant mice and rats have shown that hydroxyzine can induce fetal abnormalities in the rat and mouse at doses substantially higher than the human therapeutic range. However, clinical studies on humans have not established whether hydroxyzine is safe for the foetus, therefore, this drug is contraindicated in pregnancy. 

What Pregnancy Category is Hydroxyzine?

Hydroxyzine is pregnancy category C.

Which Antihistamines are Safe in Pregnancy?

During pregnancy, other oral antihistamines can be taken alternatively to hydroxyzine. For example, antihistamines such as cetirizine (Zyrtec), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), fexofenadine (Allegra Allergy), and loratadine (Claritin) appear to be safe. Always ask a physician before taking any medications while you are pregnant.

Other alternatives for pregnant individuals may be the nasal spray cromolyn sodium (NasalCrom) and the steroid nasal spray Rhinocort Aqua (budesonide). Their advantage is that they are released exclusively in the nose; they do not travel throughout the body. However, since there is little evidence for their safety, patients should always consult a doctor before using these drugs during pregnancy. 

If allergy symptoms aren’t bad, patients could try drug-free alternatives first. For example, they can allergy-proof their home or rely on saline nasal sprays. But, if allergy symptoms are severe and cause problems sleeping or allergic asthma, patients should speak to their doctor about possible medications. Allergic asthma, in particular, can have serious consequences during pregnancy, and taking medications may provide a better outcome for the parent’s health and the health of their fetus. 

Hydroxyzine and Lactation

There is not enough evidence for the safety of hydroxyzine on the nursing baby; it is still unknown whether the drug passes into breast milk. It is therefore not recommended to take this medication while breastfeeding. It is therefore best to consult a doctor to manage allergy symptoms.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.

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