What’s Safe, What’s Not, and When to Call Us

Fenom Team
May 6th, 2026

If you’re pregnant in Fort Worth right now, your nose probably already knows it’s spring. Oak, pecan, and hickory pollen peak in our area from February through April (and our city has some of the heaviest tree pollen in the DFW Metroplex). On top of that, Bermuda grass is just getting started.

Pregnancy can also stuff up your nose all on its own. Hormonal changes increase blood flow to the nasal passages, which is why so many of our patients say, “I never had allergies before, but this year I can’t breathe.” That’s a real thing. It’s called pregnancy rhinitis, and when you stack it on top of true seasonal allergies, the result is misery.

The good news? You don’t have to suffer through it, and you don’t have to guess about what’s safe. Here’s what we recommend.

Start With Non-Medication Strategies

Before you reach for anything from the pharmacy aisle, try the basics. They work better than most people expect, and they’re risk-free for you and baby.

Saline nasal spray or rinse.

Use as often as you like. A simple saline rinse flushes pollen out of your nasal passages and thins mucus, no medication required.

Shower and change clothes when you come inside.

Pollen sticks to hair, skin, and fabric. Rinsing it off (especially before bed) keeps it out of your pillowcase and your airway overnight.

Keep windows closed on high-pollen days.

Run your A/C with a clean filter. Check Fort Worth’s daily pollen count and plan outdoor time for early morning or after rain, when counts tend to be lower.

Wear sunglasses outdoors.

They’re a surprisingly effective barrier for itchy, watery eyes.

Stay hydrated.

Water thins mucus and helps your body manage congestion. Aim for the same hydration goals you should be hitting for pregnancy anyway.

Medications That Are Generally Safe in Pregnancy

If non-medication strategies aren’t cutting it, several allergy medications have a long track record of safety in pregnancy. Always confirm with us before you start anything new, but here’s what’s typically on the “yes” list.

Second-generation oral antihistamines.

Loratadine (Claritin) and cetirizine (Zyrtec) are considered generally safe throughout pregnancy. They cause less drowsiness than older options and are usually our first recommendation. Fexofenadine (Allegra) is also reasonable.

Older antihistamines (when needed).

Chlorpheniramine and diphenhydramine (Benadryl) are well-studied and considered safe. They can cause drowsiness, which can actually be a plus at bedtime if congestion is keeping you up.

Nasal corticosteroid sprays.

Budesonide (Rhinocort) has the most pregnancy safety data and is typically the preferred option. These sprays target nasal symptoms directly with minimal absorption into the rest of your body.

Saline products and nasal strips.

No restrictions, use as needed.

Medications to Avoid (or Limit)

Not everything in the allergy aisle is created equal. A few to be cautious with:

Pseudoephedrine (Sudafed) in the first trimester. It has been linked to a small increase in certain abdominal wall birth defects and should be avoided in the first 12 weeks. After that, talk with us before using it.
Phenylephrine. Limited safety data and limited effectiveness anyway. We usually recommend skipping it.
Combination “cold and allergy” products. These often contain pseudoephedrine, decongestants, or pain relievers you don’t actually need. Single-ingredient products are almost always the better choice in pregnancy.
Oral decongestants in general during the first trimester. Stick with nasal sprays and antihistamines until you’re past 12 weeks.

When to Call Us

Most spring allergy symptoms can be managed at home. But pregnancy changes the calculus on a few things, so call our office if you experience:

Wheezing, chest tightness, or shortness of breath. This can signal asthma flare, which is more common in pregnancy and needs prompt evaluation.
A fever, facial pain, or thick discolored nasal discharge lasting more than a few days. That can point to a sinus infection, which sometimes needs treatment.
Symptoms that aren’t responding to safe over-the-counter options after a week or two. There are prescription options we can discuss.
Any reaction to a medication. Hives, swelling, or trouble breathing always warrant a call.

A Few Things to Remember

Pregnancy already asks a lot of your body, and adding spring in North Texas on top of it is a lot. You don’t have to white-knuckle your way through allergy season. Most of our patients get significant relief with a combination of saline rinses, a daily second-generation antihistamine, and a nasal steroid spray, all of which are safe options we use regularly.

If you’re not sure what’s right for you, or you’re not sure whether what you’re feeling is allergies, pregnancy rhinitis, or something else, that’s exactly what we’re here for. Bring it up at your next visit, or give us a call.