Some decongestants can be used in pregnancy, but safety depends on which medicine you take, how far along you are, and your own health (like high blood pressure). Always check with your OB, midwife, or pharmacist before starting anything new.

Quick Scoop

  • Safest first-line options are non‑drug methods and saline nasal sprays or rinses.
  • Certain nasal sprays with steroids (like fluticasone/“Flonase”) are generally considered acceptable in pregnancy when used as directed.
  • Short‑term use of nasal decongestant sprays with oxymetazoline (Afrin) or phenylephrine can sometimes be used, but only for a few days because of rebound congestion.
  • Oral decongestants like pseudoephedrine (Sudafed) are usually avoided in the first trimester and used only sparingly later in pregnancy, and not if you have high blood pressure.
  • Multi‑symptom “cold & flu” powders or combo products (for example some Lemsip, Beechams, Sudafed mixes) may contain decongestants and sometimes aspirin, so many sources advise avoiding these in pregnancy unless a clinician specifically okays them.

If a product doesn’t clearly list each active ingredient, treat it as “not safe” until a professional checks it for you.

Usually preferred options

When asking “what decongestant can I take while pregnant,” most up‑to‑date guidance leans toward local treatments and gentle measures first.

  • Non‑medicine relief :
    • Saline nasal sprays or rinses (neti pot, squeeze bottle, saline mists).
* Cool‑mist humidifier, warm showers, extra fluids, sleeping with head elevated.
  • Nasal sprays often considered acceptable (check with your clinician):
    • Saline sprays: drug‑free, safe in all trimesters.
* Nasal corticosteroid sprays (e.g., fluticasone/Flonase, budesonide/Nasacort) for allergy‑type congestion.
  • Short‑term nasal decongestant sprays :
    • Oxymetazoline (Afrin) or phenylephrine sprays may be allowed for very short periods (commonly up to 3 days) because longer use can worsen congestion.

Oral decongestants in pregnancy

Oral decongestants reach the whole body and baby, so advice is stricter.

  • Pseudoephedrine (Sudafed and generics) :
    • Some expert sources say it may be used in the second and third trimesters in people without high blood pressure, but only at the lowest dose for the shortest time, and only after your clinician okays it.
* Use in the **first trimester** may be linked with a small increased risk of certain birth defects, so many clinicians avoid it early in pregnancy.
  • Phenylephrine by mouth :
    • Often discouraged in pregnancy due to limited safety data and concerns about reduced uterine blood flow; many “cold & flu” mixes use this, so labels need very careful reading.
  • Combo cold/flu powders and syrups (Lemsip, some Beechams, Night Nurse, certain Sudafed or Benylin products):
    • These may include decongestants plus caffeine, aspirin, or other drugs, and several maternity‑medicine resources advise avoiding any products that contain decongestants or aspirin in pregnancy unless a professional specifically recommends them.

Other meds often used with decongestant strategies

You might see these recommended alongside or instead of a decongestant to manage overall cold or allergy symptoms.

  • Acetaminophen (paracetamol) : commonly used for fever or pain and considered the first‑line analgesic in pregnancy when needed, at the lowest effective dose.
  • Guaifenesin (Mucinex) : an expectorant used to thin mucus; some sources note it appears reasonably safe in later pregnancy, but often recommend avoiding it in the first trimester unless necessary.
  • Antihistamines : certain second‑generation antihistamines (like loratadine/Claritin) and some first‑generation ones are often considered options for allergy‑driven congestion; specific product choice and timing should be guided by your clinician.

Practical steps before you take anything

  • Check how many weeks pregnant you are (advice changes after the first trimester).
  • Read the label for each active ingredient; don’t rely on brand names.
  • Avoid long‑term daily use of any decongestant spray without medical supervision because of rebound congestion.
  • If you have high blood pressure, heart disease, or are on other medications, avoid oral decongestants unless a clinician says otherwise.

If your congestion is severe, lasts more than 10–14 days, comes with high fever, facial pain, or trouble breathing, contact your prenatal care team or an urgent‑care provider promptly.

Information gathered from public forums or data available on the internet and portrayed here.