This sheet is about exposure to cetirizine in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is cetirizine?

Cetirizine is an antihistamine. Antihistamines are medications that have been used to treat symptoms of allergies. such as sneezing, itching, runny nose, and watery eyes. Cetirizine is sold over the counter under brand names including Zyrtec® and Reactine®.

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I take cetirizine. Can it make it harder for me to get pregnant?

It is not known if cetirizine can make it harder to get pregnant.

Does taking cetirizine increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Several small studies done on the use of cetirizine during pregnancy didnot find a higher chance for miscarriage.

Does taking cetirizine increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Studies involving over 1,300 babies exposed to cetirizine in the first trimester of pregnancy did not show an increased chance of birth defects.

Does taking cetirizine in pregnancy increase the chance of other pregnancy-related problems?

Studies on a small number of pregnancies did not find a higher chance for pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking cetirizine in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if cetirizine can cause behavior or learning issues for the child.

Breastfeeding while taking cetirizine:

Although it has been suggested that antihistamines might lower the amount of breast milk made by the body, this has not been proven. Compared to some other antihistamines, cetirizine has less chance of causing drowsiness for the mother or the nursing baby. For this reason, cetirizine may be preferred for breastfeeding over antihistamines that cause sleepiness. With repeated use, babies should be checked for signs of being too drowsy. If you suspect the baby has any symptoms (like drowsiness), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a male takes cetirizine, could it affect his fertility (ability to get partner pregnant) or increase the chance of birth defects?

One report suggests the long-term use of antihistamines such as cetirizine may lower sperm count. However, this has not been proven. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Selected References:

• Ahmed E, Abdel-Emam R. 2019. The potential impact of 1st and 2nd generation antihistamines on male fertility. Comp Clin Pathol, 28, 1465–1470.
• Einarson A, et al. 1997. Prospective controlled study of hydroxyzine and cetirizine in pregnancy. Annals of Allergy, Asthma & Immunology, 78, 183-186. [PubMed: 9048526]
• Etwel F, et al. 2014. The fetal safety of cetirizine: an observational cohort study and meta-analysis. Journal of Obstetrics and Gynaecology. 34(5):392-9. [PubMed: 24678814]
• Gilbert C, et al. 2005. Fetal safety of drugs used in the treatment of allergic rhinitis. Drug Safety, 28(8), 707-719. [PubMed: 16048356]
• Andersson N, et al. 2020. Association Between Fexofenadine Use During Pregnancy and Fetal Outcomes. JAMA Pediatr. 174(8):e201316. [PMC free article: PMC7265125] [PubMed: 32478810]
• Gilboa S, et al. & The National Birth Defects Prevention Study. 2009. Use of antihistamine medications during early pregnancy and isolated major malformations. Birth Defects Research Part A: Clinical and Molecular Teratology, 85, 137-150. [PMC free article: PMC3619228] [PubMed: 19161158]
• Golembesky A, et al. 2018. Safety of cetirizine in pregnancy. Journal of Obstetrics and Gynaecology,22,1-6. [PubMed: 29565188]
• Hayashi T, et al. 2006. Asthenospermia in hay fever patients improved by stopping treatment with histamine H1 receptor antagonists. International Journal of Urology.13(7):1028-30. [PubMed: 16882083]
• Powell R, et al. 2007. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clinical and Experimental Allergy, 37, 631-650. [PubMed: 17456211]
• So M, et al. 2010. Safety of antihistamines during pregnancy and lactation. Canadian Family Physician, 56, 427-429. [PMC free article: PMC2868610] [PubMed: 20463270]
• Weber-Schoendorfer C & Schaefer C. 2008. The safety of cetirizine during pregnancy: A prospective observational cohort study. Reproductive Toxicology, 26(1), 19-23. [PubMed: 18571373]
• Wilton L, et al. 1998. The outcomes of pregnancy in women exposed to newly marketed drugs in general practice in England. British Journal of Obstetrics and Gynecology, 105, 882-889. [PubMed: 9746382]
• Wolfgang P, et al. 2004. Pregnancy outcome after exposure to cetirizine/levocetirizine in the first trimester--a prospective controlled study. Reproductive Toxicology 19(2):258.

“OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.