Can You Use Flonase While Pregnant?

If your allergies are in full swing, you may be tempted to reach for your Flonase nasal spray. Here's why you should talk to a doctor first.

Medically reviewed by Alyssa Dweck, MS, MD, FACOG

A familiar tickle in your nose and watery eyes tell you that allergy season has arrived. Normally, you would pull out your tried-and-true allergy products to fight runny noses and itchy eyes over the next few months. But if you're pregnant or trying to get pregnant, you may be unsure what medication is safe to take and what isn't.

Will you just have to suffer through your allergy symptoms this time around? Not enough research has been done to say for sure whether Flonase (fluticasone) is completely safe to take during pregnancy. However, studies indicate that the nasal spray may be OK if you stick to the recommended dose and get your health care provider's approval.

Read on to learn more about Flonase and pregnancy, including safety, precautions, and safe alternatives for treating your allergy symptoms.

What Is Flonase?

Flonase (fluticasone) is a nasal spray used to treat allergy symptoms. It belongs to a group of drugs called corticosteroids. Corticosteroids resemble cortisol, a naturally occurring stress hormone.

If you experience allergies, airborne particles set off your body’s defense system, resulting in symptoms like a runny or stuffy nose, sore throat, and itchy, watery eyes. Flonase blocks this immune response in your body so that your symptoms clear up.

Is It Safe to Take Flonase During Pregnancy?

Taking Flonase during pregnancy may be OK if your allergy symptoms are extreme and your health care provider gives the green light, but you should understand the safety precautions.

"Flonase is currently category C per the FDA for use in pregnancy," says Neeta Ogden, MD, an allergist and immunologist and a medical advisor for Curex. "This means the drug can be taken if there is a clinical need for it where the benefits outweigh the risks."

The Food and Drug Administration's (FDA) Category C label means animal studies have found some adverse effects on a fetus. Animal studies on Flonase during pregnancy found decreased body weight and skeletal variations in fetuses.

Your health care provider may recommend Category C drugs like Flonase when the benefits outweigh the risks. "If allergic rhinitis interferes with your daily life, Flonase is likely acceptable for the treatment during pregnancy," notes Chet Tharpe, MD, an allergist, immunologist, and medical director at Curex.

According to the FDA, there's "insufficient data" to determine whether Flonase poses a "drug-associated risk" to pregnant or breastfeeding parents. Because of this, many people avoid Flonase unless they find it absolutely necessary for their everyday lives. Always consult with your health care provider to make an informed decision about using Flonase.

What If I Took Flonase Before Realizing I Was Pregnant?

Animal studies suggest that there may be some risks associated with taking Flonase during pregnancy, so you'd prefer to avoid it. But what if you find out that you are pregnant after or while you're already using Flonase? If this is the case, don't worry. Just check in with your health care provider.

"Since Flonase has been shown to have low bioavailability, [which means] low systemic absorption, it is unlikely to be dangerous if you took it before you realized you are pregnant," notes Dr. Ogden. "We simply don't have enough studies in pregnancy, but a recent review of intranasal steroids showed no significant association with congenital organ malformations linked to Flonase." That is to say that while there may be some risk, the risk is likely low.

You and a health care provider will need to weigh the risks and benefits of continuing to take Flonase during your pregnancy. Together you can decide whether you should continue taking it, stop taking it, or switch to another allergy medication.

Safety Precautions for Using Flonase in Pregnancy

If you and a health care provider decide that taking Flonase during pregnancy is the right choice for you, it is important to stick to the recommended daily dose and follow your health care provider's guidance on how and when to take it.

Adults should use no more than 200 micrograms of Flonase per day, which is equivalent to two sprays per nostril. To minimize any possible risk to your baby, stick strictly to this limit. Your health care provider may even advise taking a smaller dose during your pregnancy.

When You Can Resume Taking Flonase After Pregnancy

If you chose to stop using Flonase during pregnancy, you can start taking Flonase again after you give birth. Just take extra caution if you are breastfeeding or chestfeeding.

Because corticosteroids have been detected in human milk and there is no data from controlled trials on the use of Flonase by lactating people, Dr. Ogden explains that you should be cautious about using Flonase while breastfeeding. Always get a health care provider's advice on which medications are safe to take while breastfeeding.

Pregnancy-Safe Alternatives to Flonase

Since we don't know enough about Flonase to say for sure whether it's completely safe during pregnancy, you may want to try other remedies for your allergies while pregnant. If they work for you, stick with them throughout pregnancy.

Avoid allergens

If you are concerned about the risks of taking Flonase while pregnant, you may want to abstain from it completely. Instead, try staying away from anything that might set off your allergies.

If you can avoid or reduce contact with your allergy triggers, you may be able to get through allergy season without having to take any type of medicine. This won't necessarily be feasible for everyone, however.

Try lower-risk allergy medications

Flonase may not be the safest choice for a nasal corticosteroid during pregnancy, but you have other options to try. You may be able to switch to another allergy medicine.

While Flonase is category C, Rhinocort (budesonide) is category B. Category B drugs have been tested on animals and have shown no adverse effects on a fetus. Talk with a health care provider about what other allergy medications might be safer for you to use during your pregnancy.

Try saline spray

If congestion is your most frustrating allergy symptom, try a saline solution. Spraying a mixture of salt and warm water into your nose may be just as effective for congestion relief as over-the-counter sprays. "A saline spray can rinse out allergens and inflammatory mucous, bringing relief," explains Dr. Tharpe.

Saline is completely safe during pregnancy and is available over-the-counter in nasal sprays and neti pot and sinus rinse kits. Just be sure to use clean, filtered water and follow all product instructions for safe use.

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