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Comparison · Pregnancy Smart

Zyrtec vs Claritin during pregnancy

Assigned clinical reviewerMatt Stahl· PharmDDraft · pending clinical reviewUpdated

How do the options compare?

This comparison weighs pregnancy safety data, dosing, and drowsiness side effects to help decide between the two most common options.

OptionStudied pregnancy doseGuideline supportNotes
Cetirizine (Zyrtec)10 mg once dailyNamed a second-generation antihistamine of choice in pregnancy. Studies covering more than 1,300 exposed pregnancies did not show an increased chance of birth defects.More likely to cause drowsiness than loratadine, though still less sedating than first-generation antihistamines.
Loratadine (Claritin)10 mg once dailyAlso named a second-generation antihistamine of choice in pregnancy. Not expected to increase the chance of birth defects, and a study of 163 first-trimester exposures found no increased chance of miscarriage.Less likely to cause drowsiness than cetirizine, which is often the deciding factor rather than safety.
Zyrtec-D / Claritin-D (with pseudoephedrine)Adds pseudoephedrine to the same antihistamine base. ACOG does not recommend pseudoephedrine during the first three months of pregnancyMost studies of pseudoephedrine have not found an increased chance of birth defects, though some found a small increased chance of specific defects, thought to be small overall.The plain, non-D versions keep the exposure to the antihistamine alone.
  • Studies covering more than 1,300 pregnancies exposed to cetirizine did not show an increased chance of birth defects. 1
  • Loratadine is not expected to increase the chance of birth defects, and studies have found no increase in any kind of defect including hypospadias, the concern raised by one earlier report. 2
  • A study of 163 loratadine exposures during the first trimester did not show an increased chance of miscarriage, and separate small studies of cetirizine found no higher miscarriage rate either. 2
  • Loratadine is described as less likely to cause drowsiness than some other antihistamines, while cetirizine is described as lower-drowsiness only relative to the older generation, which is the practical gap between the two. 1
  • Loratadine at 10 mg once daily and cetirizine at 10 mg once daily are named the second-generation antihistamines of choice in pregnancy in a World Allergy Organization review. 3
  • Most studies of pseudoephedrine have not found an increased chance of birth defects, though some have found a small increased chance of specific defects such as gastroschisis, small intestinal atresia, and hemifacial microsomia, thought to be small overall. ACOG does not recommend pseudoephedrine during the first three months of pregnancy. 4

Which option makes sense?

The safety data alone won't pick a winner here. How each one affects your alertness usually will.

Disclosure: Pregnancy Smart offers a supplement that overlaps with one or more options above. This page describes the pregnancy evidence for each option on its own merits.

Frequently asked questions

Is Zyrtec or Claritin better during pregnancy?

Neither wins on safety. Both are named the second-generation antihistamines of choice in pregnancy and both have studies behind them showing no increase in birth defects. Loratadine is the less sedating of the two, so it tends to win on daytime function rather than on risk.

Which one causes less drowsiness?

Loratadine. It is specifically described as less likely to cause drowsiness than other antihistamines, while cetirizine is only lower-drowsiness compared with the older generation like diphenhydramine. In pregnancy, when fatigue is already high, that difference is worth something.

Can I switch from one to the other while pregnant?

That is a common adjustment and a reasonable one to raise with your provider. They are different molecules in the same class, so people genuinely respond better to one than the other. Give a switch several days before deciding it has not worked.

Are the '-D' versions safe too?

Those are a different question entirely. Zyrtec-D and Claritin-D add pseudoephedrine, a decongestant that carries its own early-pregnancy caution and is commonly advised against in the first trimester. The plain versions keep the exposure to the antihistamine alone.

Related in the library

References

  1. Cetirizine (Zyrtec): MotherToBaby Fact Sheet

    MotherToBaby · https://mothertobaby.org/fact-sheets/cetirizine/

  2. Loratadine (Claritin): MotherToBaby Fact Sheet

    MotherToBaby · https://mothertobaby.org/fact-sheets/loratadine-pregnancy/

  4. Pseudoephedrine: MotherToBaby Fact Sheet

    MotherToBaby · https://mothertobaby.org/fact-sheets/pseudoephedrine/

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.