Treatment of allergic rhinitis during pregnancy


  • Conflicts of interest: The author has received travel assistance and an honorarium for a talk from Nippon Boehringer Ingelheim, Co., Ltd.


Kodo Sato

Department of Gynecology, Meirikai Chuo General Hospital,

3-2-11 Higashi Jyujo, Kita-ku,

Tokyo 114-0001, Japan.


Many women suffer from allergic rhinitis (AR). The disease is often pre-existing and sometimes coincidental during pregnancy, and can worsen, improve, or stay the same during pregnancy. Besides ameliorating the detrimental effects of AR on the patient's quality of life, correct treatment is important for controlling concomitant asthma. If possible, it is important to highlight the risks of not taking such medications at a pre-conception visit. Although most medications for AR readily cross the placenta, there are several choices of treatment for controlling the symptoms during pregnancy. The choices may be varied depending on the disease course and symptoms, and inhaled corticosteroids are considered to be the first-line medical treatment. In addition, either a first-generation antihistamine, such as chlorpheniramine, or a second-generation antihistamine, such as cetirizine or loratadine, can be prescribed as the second-line medical treatment. As an alternative, intranasal cromolyn can be prescribed safely. Some of the leukotriene receptor antagonists and nasal decongestant sprays can only be prescribed when other methods are no longer valid and strict benefits can be expected. It is considered safe to continue immunotherapy during pregnancy.