THE BABY BEAT – June 22, 2011 D. Gary Benfield, M.D. Which of these seasonal allergy drugs is safe for pregnant women? DEAR DR. BENFIELD: I suffer from seasonal allergies, and I'm three
months pregnant. Can you tell me which of these three nonprescription drugs
is safe for my baby: Zyrtec, Allegra or Claritin? I can save some money if I
buy my drug store's brand (WalMart, in this case) instead of buying the name
brand. Would it be safe for my baby to do that? L.S. DEAR L.S.: Before we go any further, please be sure to check with your
doctor before taking any drug during your pregnancy. That said, the active
ingredient in Zyrtec is the antihistamine cetirizine, which has been assigned
by the FDA to pregnancy risk category B. The active ingredient in Claritin is
the antihistamine loratadine, which has also been assigned to pregnancy risk
category B. However, fexofenadine, the active ingredient in Allegra, belongs
to pregnancy risk category C. In general, drugs that belong to pregnancy risk
category B are considered somewhat safer in pregnancy than drugs in
category C. However, none of these drugs should be used in pregnancy
unless clearly indicated. That's where your doctor comes in. He or she is in a
better position to help you decide if the benefit of taking the medicine
outweighs any potential risk for you and your baby. Certainly, it doesn't do
your baby any good for you to suffer from seasonal allergies for days on end
when one of these medications might provide relief.
Which of these seasonal allergy drugs is safe for pregnant women?
One of the guiding principles pharmacists use when recommending a
nonprescription drug in pregnancy is to choose the one that has the been
approved the longest for over-the-counter (OTC) sale. Thus the drug will
have the longest track record of safety. In this case, loratadine, the active
ingredient in Claritin, was approved for OTC sale in 2002, whereas the other
two active ingredients, cetirizine and fexofenadine, were approved much
There is no reason, medically, for you to buy one of these name brands
when WalMart's in-house brand (Equate) has the same active ingredient and
will work just as well. And, you are correct: WalMart's Equate brand of
cetirizine, loratadine, or fexofenadine will be cheaper. For example, I went
on line to WalMart's pharmacy and found the following prices for Claritin and
the Equate brand of loratadine, the active ingredient in Claritin:
Thirty tablets of Claritin, containing 10 mg of loratadine per tablet (24-
hour relief), sells for $15.00, which comes to 50 cents per tablet.
Sixty, 10 mg tablets of loratadine (24-hour relief) under Walmart's
Equate brand sells for $7.42, which comes to 13 cents per tablet.
The bottom line? Check with your doctor concerning which of the three
drugs he or she might recommend for your seasonal allergies. Always buy
your drug store's in-house brand of the active ingredient unless your doctor
has a good medical reason for preferring the name brand.
Which of these seasonal allergy drugs is safe for pregnant women? A further thought: Unfortunately, the FDA does not require drug
manufacturers to place the pregnancy risk category (A, B, C, D or X) of each
active ingredient in drugs sold over-the-counter on the drug label. Thus,
pregnant women, as well as their doctors, cannot tell which active ingredients
are safer than others. That's why I've published my latest book,
"Nonprescription Drugs in Pregnancy: Your Guide to Fetal Risk for the Active Ingredients in 500 Over-The-Counter Drugs." The book is available at
www.Amazon.com, major book retailers, and at www.AtlasBooks.com. It
comes in two sizes: regular paperback and pocket size. It can also be
downloaded to any digital device, such as the Kindle, iPad, and Blackberry. I
To my knowledge, the information gathered in this unique book has not
been published, all in one place, before.