Therapy for allergic conjunctivitis in pregnancy
Question:
8/14/2024
For pregnant ladies with allergic conjunctivitis, I've always used cromolyn eye drops as they were designated category B whereas most other allergy eye drops are designated category C for pregnancy. Since cromolyn eye drops are no longer available at pharmacies in our area due to manufacturing issues, would you advise what eye drops you feel are safest in pregnancy for allergic conjunctivitis?
Answer:
Over the counter oral cetirizine or loratadine, with or without artificial tears, may be the safest option available at this time for the treatment of allergic conjunctivitis in pregnancy.
Data on the use of ophthalmic antihistamines in pregnancy is very limited. No epidemiological studies have been conducted on the effect of ophthalmic antihistamines in human pregnancy.
Epinastine, ketorolac ophthalmic have been given pregnancy category C ratings.
Eye drops containing containing travoprost, latanoprost, bimatoprost, dorzolamide, latanoprost/timolol, and brinzolamide are typically contraindicated in pregnancy because their potential for adverse fetal effects.
First-line tear substitutes are in general safe during pregnancy. The use of hyaluronate 0.1% alone, hyaluronate 0.3% alone, and diquafosol alone for dry eye disease in pregnant women was not associated with adverse neonatal outcomes.
Demarinis G, Tatti F, Taloni A, Giugliano AV, Panthagani J, Myerscough J, Peiretti E, Giannaccare G. Treatments for Ocular Diseases in Pregnancy and Breastfeeding: A Narrative Review. Pharmaceuticals (Basel). 2023 Oct 9;16(10):1433.
Eric Macy, MD, MS, FAAAAI