Safety of intranasal corticosteroid sprays during pregnancy: an updated review

Eur Arch Otorhinolaryngol. 2018 Feb;275(2):325-333. doi: 10.1007/s00405-017-4785-3. Epub 2017 Nov 21.


Introduction: Rhinitis and rhinosinusitis are commonly encountered in pregnant women. Intranasal corticosteroid (INCS) sprays are generally safe and effective in the treatment of these conditions in the general population. However, the use of some of these INCS sprays during pregnancy is still controversial.

Objective: To review the current literature about the safety of intranasal corticosteroid sprays during pregnancy.

Methodology: Using different search engines, each type of INCS was reviewed separately (triamcinolone, beclomethasone, budesonide, fluticasone propionate, fluticasone furoate, mometasone, and ciclesonide). A total of 51 full-length articles were examined for eligibility. After applying inclusion and exclusion criteria, a total of three articles were reviewed.

Results: No significant association with congenital organ malformations has been linked to intranasal use of beclomethasone, budesonide, fluticasone propionate, fluticasone furoate, or mometasone. Intranasal triamcinolone, however, has been found to have a significant association with respiratory tract defects. Data about the safety of intranasal ciclesonide during pregnancy are not available.

Conclusion: Lacking sufficient clinical trials on the use of intranasal corticosteroid sprays in pregnancy, we suggest that the intranasal use of fluticasone furoate, mometasone, and budesonide is safe if they are used at the recommended therapeutic dose after a proper medical evaluation. Intranasal fluticasone propionate might be a safe option in the absence of other INCS options due to its questionable efficacy during pregnancy. Risk-benefit ratio should always be considered before prescribing any intranasal corticosteroid sprays during pregnancy.

Keywords: Corticosteroids; Intranasal; Pregnancy; Rhinitis; Safety; Sinusitis.

Publication types

  • Review

MeSH terms

  • Abnormalities, Drug-Induced / etiology*
  • Administration, Intranasal
  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Inflammatory Agents / adverse effects*
  • Anti-Inflammatory Agents / therapeutic use
  • Female
  • Humans
  • Infant, Newborn
  • Nasal Sprays
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Rhinitis / drug therapy*
  • Sinusitis / drug therapy*


  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Nasal Sprays