THIS MEDICATION MAY CAUSE HARM TO YOUR BABY:
Claritin is not recommended during pregnancy unless it is clearly indicated. There is limited safety information from human studies that have looked at the use of Claritin during pregnancy, but available studies indicate that the risk of harm in the developing baby is low. Claritin is considered safe during breastfeeding, but nursing infants should be monitored for drowsiness and irritability.
What is Claritin?
Claritin is a second generation antihistamine medication currently available as both generic and brand name products. The active ingredient in Claritin is loratadine. Claritin is available in capsule, solution, syrup, tablet, chewable tablet, and orally disintegrating tablet and is taken once daily (twice daily for orally disintegrating tablets). It is available as an over-the-counter and prescription medication.
What is Claritin used to treat?
Claritin is used to treat hives, allergic conjunctivitis (eye inflammation), and symptoms of upper respiratory allergies including sneezing, runny nose, itchy nose or throat, itchy skin, and watery eyes in children over 2 years of age, adolescents, and adults.
How does Claritin work?
Claritin works by preventing histamine from binding to receptors on cells in the respiratory tract, gastrointestinal tract, or blood vessels. Interruption of histamine binding prevents the inflammation and activation of the immune system that causes allergy symptoms. Second generation antihistamines such as Claritin do not cause as much drowsiness as first generation antihistamines.
If I am taking Claritin, can it harm my baby?
Claritin should only be administered to a pregnant woman when clearly needed. There are limited human studies that have looked at the safety of this medication in pregnancy so the exact risk of taking this medication during pregnancy is unknown. Claritin has not been associated with a significant increase in risk of birth defects during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) and the American College of Allergy, Asthma, and Immunology (ACAAI) have stated that Claritin is recommended in pregnant women who cannot tolerate chlorpheniramine or tripelennamine or who fail topical antihistamine therapy. Limited use of small doses of Claritin during the second and third trimesters of pregnancy are expected to be safe. Second generation antihistamines such as Claritin are considered second line treatment for allergy symptoms during the second or third trimester of pregnancy. First generation antihistamines such as chlorpheniramine or tripelennamine are considered first line treatment for allergy symptoms during pregnancy, particularly during the first trimester of pregnancy. Available studies have not proven a direct association between Claritin use during pregnancy and an increased risk of birth defects. Some studies suggest there may be benefits associated with antihistamine use during pregnancy. A recent review of 50 scientific articles found most types of antihistamines used during pregnancy do not increase the risk of birth defects in newborns.
Evidence from animal studies with Claritin:
When given to pregnant rats and rabbits at doses much larger doses than the maximum recommended human dose, Claritin was not associated with an increased risk of birth defects.
Evidence for the risks of Claritin in human babies:
Claritin use during pregnancy was reported in several groups of women without an increase in birth defects or negative effects on gestational age, live birth, or birth weight. In 161 pregnancies, loratadine exposure during the first trimester did not significantly increase the risk of birth defects in newborns. A large review of 10 studies found loratadine use during pregnancy is not associated with an increased risk of hypospadia (a condition where the opening of the penis is not on the tip of the penis). Data from the National Danish Birth Cohort from 1998 to 2002 found no increase in the risk of hypospadia in babies born to women who took Claritin during pregnancy. The National Birth Defects Prevention Study evaluated first trimester Claritin use during pregnancies with 563 male infants, finding no increased risk of hypospadia with Claritin exposure. A CDC analysis of these results confirmed no increased risk of hypospadia with first trimester Claritin use. Data from the Swedish Medical Birth Registry suggest antihistamine exposure during pregnancy may slightly decrease the risk of heart defects, premature birth, and low birth weight. A study in Israel found Claritin use during the first trimester was not associated with an increased risk of birth defects.
Bottom line: Claritin has not been associated with an increased risk of birth defects or hypospadia in available human studies. Claritin may be an alternative antihistamine to use in the second or third trimesters of pregnancy in women who do not respond to recommended first generation antihistamines, chlorpheniramine or tripelennamine. It is important to weigh the risks versus benefits before using this medication during pregnancy.
If I am taking Claritin and become pregnant, what should I do?
If you are taking Claritin and become pregnant, you should contact your doctor immediately. Your doctor will determine if your medication is medically necessary, or if it should be discontinued until after the birth of your baby.
If I am taking Claritin, can I safely breastfeed my baby?
It is important to weigh the risks to the infant versus the benefits for the mother before taking this medication while nursing a baby. Women who are breastfeeding infants and require an antihistamine are generally advised to take a second generation antihistamine like Claritin. The American Academy of Pediatrics considers Claritin compatible with breastfeeding. Claritin is excreted into breast milk. Nursing infants exposed to Claritin should be monitored for signs of drowsiness, jitteriness, or irritability. Claritin may decrease milk production particularly if taken before lactation is established in new mothers or if high doses are administered.
Bottom line: Women with newborn babies should weigh the risks versus benefits of breastfeeding while on Claritin. In breastfeeding moms taking this medication, babies should be monitored for signs of drowsiness, jitteriness, and irritability.
If I am taking Claritin, will it be more difficult to get pregnant?
Studies in rats given Claritin found no evidence of impaired fertility in males at doses of 64 mg/kg/day.
If I am taking Claritin, what should I know?
Claritin may be a second line treatment option in the second or third trimesters of pregnancy if first generation antihistamines, chlorpheniramine or tripelennamine, are not effective. Human studies suggest there is no increased risk of birth defects with exposure to this medication during pregnancy.
If women with babies decide to continue breastfeeding their babies while on Claritin, nursing babies should be monitored for signs of drowsiness, jitteriness, and irritability.
If I am taking any medication, what should I know?
This report provides a summary of available information about the use of Claritin during pregnancy and breastfeeding. Content is from the product label unless otherwise indicated.
You may find Pregistry's expert report about allergic rhinitis here, reports about various other health conditions as well as the individual medications used to treat allergies and other conditions here. Additional information can also be found in the resources below.
For more information about Claritin during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following link:
Centers for Disease Co
ntrol and Prevention (2018). Key Findings: Antihistamines and Birth Defects
U.S. Food and Drug Administration: loratidine prescribing information
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.