Pregnant individuals often question the safety of common over-the-counter medications like diphenhydramine. Making informed decisions about medication use during pregnancy is important for the well-being of both the pregnant person and the developing fetus.
Understanding Diphenhydramine
Diphenhydramine is a first-generation antihistamine that blocks H1 histamine receptors, counteracting allergic reactions. Its influence on central H1 receptors also causes sedative effects, making it a common sleep aid. Additionally, it has anticholinergic effects, contributing to its use for motion sickness and certain movement disorders.
Safety Considerations During Pregnancy
Diphenhydramine is generally considered low risk for occasional, short-term use during pregnancy. The U.S. Food and Drug Administration (FDA) has classified diphenhydramine as a Category B medication, which indicates that animal studies have not demonstrated a risk to the fetus, though comprehensive studies in pregnant individuals are limited.
While early research suggested a possible link to malformations like cleft palate, more recent and extensive studies, including a large 2020 study involving over 41,000 pregnancies, have not found a consistent pattern of birth defects. The available human data for first-trimester use of antihistamines, including diphenhydramine, are largely reassuring, showing no significant increase in congenital malformations.
However, some experts suggest exercising caution during the third trimester. Research indicates that excessive or prolonged use in the later stages of pregnancy could lead to side effects such as uterine contractions. There have also been isolated reports of temporary withdrawal symptoms, like tremors or diarrhea, in newborns whose mothers used diphenhydramine daily throughout pregnancy. Occasional use at recommended doses is not anticipated to increase the likelihood of other pregnancy-related issues, such as low birth weight.
Recommended Usage and Precautions
When considering diphenhydramine during pregnancy, it is advised to use it infrequently and only as needed, always under the guidance of a healthcare provider. The typical adult dosage for diphenhydramine ranges from 25 to 50 mg every four to six hours, with a maximum daily intake not exceeding 300 mg. It is recommended to limit use to short periods, ideally not longer than two weeks at a time, rather than continuous administration throughout pregnancy.
Pregnant individuals may experience common side effects such as drowsiness, dizziness, dry mouth, or headache. These effects might be more pronounced during pregnancy. Diphenhydramine should not be used by individuals with known hypersensitivity to the medication. Alcohol consumption should be avoided while taking diphenhydramine, as it can heighten the risk of side effects. Concomitant use with certain benzodiazepines, like temazepam, has been associated with adverse outcomes and is generally not recommended during pregnancy.
Alternative Approaches and Medical Advice
For managing common symptoms like allergies or mild insomnia during pregnancy, non-pharmacological methods can often provide relief and should be considered first. For allergy symptoms, strategies such as avoiding known allergens, using saline nasal sprays or neti pots to clear nasal passages, and maintaining a clean indoor environment with air purifiers can be effective. Simple measures like taking a relaxing shower or using a humidifier can also help soothe irritated airways.
To improve sleep, practicing good sleep hygiene is beneficial. This involves establishing a consistent sleep schedule, ensuring the bedroom is dark, cool, and quiet, and reserving the bed primarily for sleep. Avoiding strenuous exercise close to bedtime and limiting screen time before sleep can also promote better rest. Sleeping on the left side with supportive pillows can enhance comfort and circulation during pregnancy.
Before taking any medication, including over-the-counter options like diphenhydramine, pregnant individuals should consult with their healthcare provider. A medical professional can assess individual circumstances, discuss the potential benefits and risks, and help determine the most suitable approach for managing symptoms while prioritizing the health of both the pregnant person and the baby.