You may expect morning sickness, stretch marks, and a backache, but pregnancy can cause some lesser-known symptoms, too. One of these is allergic rhinitis, also called allergies or hay fever. Many pregnant women suffer from sneezing, runny nose, and nasal congestion (stuffy nose) caused by this condition.

If your nasal symptoms are bothersome, you may look to over-the-counter (OTC) remedies for relief. Afrin is an OTC decongestant nasal spray. The active ingredient in Afrin is called oxymetazoline. It’s used to provide short-term relief of nasal congestion due to the common cold, hay fever, and upper respiratory allergies. It’s also used to treat sinus congestion and pressure. Oxymetazoline works by shrinking the blood vessels in your nasal passages, which helps you breathe more easily.

However, like many drugs, Afrin comes with unique considerations during pregnancy and breastfeeding. Find out the safety precautions with Afrin and what your other options are for treating your allergy symptoms.

Safety during pregnancy

Afrin would likely not be your doctor’s first choice to treat your allergies during pregnancy. Afrin is considered a second-line treatment during pregnancy. Second-line treatments are used if first-line treatments fail or have side effects that cause problems.

You can use Afrin during all three trimesters of pregnancy, but you should only use it if your doctor’s first-line choice doesn’t work for you. However, be sure to talk to your doctor before using Afrin or any other medication if your prescribed medication doesn’t work for you.

Effects of Afrin when breastfeeding

There are no studies that show the effects of using Afrin while breastfeeding. While it isn’t known for sure, a source in the U.S. National Library of Medicine suggests that little of this drug would pass to your child through breast milk. Even so, you should talk to your doctor about the benefits and risks before using this medication while breastfeeding.

Afrin side effects

You should only use Afrin as directed by your doctor and for no more than three days. Using Afrin more often than prescribed or for a longer amount of time may cause rebound congestion. Rebound congestion is when your nasal congestion comes back or gets worse.

Some other common side effects of Afrin include:

  • burning or stinging in your nose
  • increased nasal discharge
  • dryness inside your nose
  • sneezing
  • nervousness
  • dizziness
  • headache
  • nausea
  • trouble sleeping

These symptoms should go away on their own. Call your doctor if they get worse or don’t go away.

Afrin may also cause serious side effects. These can include a fast or slow heart rate. Call your doctor right away if you have any heart rate changes.

Alternative allergy solutions

First-line medication alternatives

A first-line medication for allergies during pregnancy would have the most research showing two things: that the drug is effective and that it does not cause birth defects when used during pregnancy. First-line medications used to treat nasal allergies in pregnant women include:

  • cromolyn (nasal spray)
  • corticosteroids such as budesonide and beclomethasone (nasal sprays)
  • antihistamines such as chlorpheniramine and diphenhydramine (oral tablets)

Your doctor will likely suggest you try one of these drugs before using Afrin.

Read more: Overview of nasal and oral corticosteroids for allergies »

Nondrug alternatives

Sinus and nasal problems are bothersome but not life-threatening, so your doctor may also suggest nondrug ways to relieve your discomfort. Your doctor may first suggest trying these tips to prevent or reduce allergy symptoms.

Reducing allergy symptoms

  • Avoid irritants or triggers for your allergy symptoms, such as pollen, dust, pets, or smoke.
  • Use OTC saline nasal spray as needed.
  • Rinse your nasal passages with a Neti pot once or twice a day.
  • Exercise. Physical activity can help decrease nasal swelling.
  • Use nasal strips at night to help open up your nasal passages while you sleep.
  • Use pillows or raise the head of your bed to elevate your head while you’re sleeping.
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Learn more: Neti pots for nasal congestion »

Talk with your doctor

If you have more questions about using Afrin during pregnancy or breastfeeding, talk to your doctor. They may suggest other options that can help ease your nasal and sinus problems. You may want to ask your doctor the following questions:

  • Do I need medication to treat my symptoms?
  • What non-drug treatments should I try first?
  • What are the risks to my pregnancy if I use Afrin while pregnant?

Your doctor can help you find relief from your allergy symptoms while keeping your pregnancy safe.