Nasal Sprays in Pregnancy: What’s Safe and What to Avoid

Pregnancy changes your nose. Stuffiness, runny nose, and sinus pressure are common. You don’t need to suffer, but some sprays are better than others. This guide gives clear, practical choices so you feel better without unnecessary risk.

Which sprays are considered safe?

Saline nasal sprays and rinses are the safest first step. They use salt water, relieve congestion, and have no drug absorption—use them as often as you need. If allergies or prolonged congestion need more help, nasal steroid sprays (also called intranasal corticosteroids) are commonly recommended. Budesonide has the most pregnancy-specific data showing low systemic absorption and a solid safety record for pregnant people; fluticasone and mometasone are also widely used and considered low risk. These sprays reduce inflammation and often work well for pregnancy-related rhinitis and allergic symptoms.

Topical decongestant sprays like oxymetazoline or phenylephrine can give fast relief, but only for short bursts. Use them for no more than 3 days in a row to avoid rebound congestion (rhinitis medicamentosa). Long-term use can make stuffiness worse, so keep these as a short-term fix and only after checking with your prenatal provider.

How to use nasal sprays safely during pregnancy

Start simple: try saline first. If you need more, use a nasal steroid at the lowest effective dose. If you choose a decongestant spray for urgent relief, limit it to 48–72 hours. Always follow the product directions. Tilt your head slightly forward, aim the spray away from the center of the nose, and breathe gently to get the medicine to the right spot.

A few practical tips: tell your obstetrician what you’re using, especially during the first trimester. Avoid oral decongestants (like pseudoephedrine) unless your doctor says it’s okay—some providers prefer to avoid them early in pregnancy. Don’t share spray bottles to reduce infection risk. If you have persistent fever, bad facial pain, bloody discharge, or symptoms lasting more than two weeks, contact your healthcare provider—these signs could mean an infection that needs different treatment.

Allergic rhinitis vs. pregnancy rhinitis: pregnancy can cause nonallergic swelling of nasal tissues, which responds best to saline and steroid sprays. If you have a long allergy history, your doctor might suggest an antihistamine nasal spray (azelastine) or another approach—talk it over so you know the pros and cons.

Bottom line: saline is safe anytime. Nasal steroids (especially budesonide) are a low-risk option for ongoing symptoms. Decongestant sprays work fast but only for a few days. When in doubt, check with your prenatal care team. They’ll help you pick the simplest, safest option so you breathe easier without unnecessary worry.