What allergy medicine is safe while breastfeeding

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Loratadine Levels and Effects while Breastfeeding

Alternate Drugs to Consider

Desloratadine, Fexofenadine

Effects on Lactation and Breastmilk

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[5][6] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[5] Whether lower oral doses of antihistamines own the same effect on serum prolactin or whether the effects on prolactin own any consequences on breastfeeding success own not been studied.

The prolactin level in a mom with established lactation may not affect her ability to breastfeed.

One mom out of 51 mothers who took loratadine while nursing reported that she had decreased milk production after taking loratadine 10 mg daily for less than one week at 4 months postpartum.[3]

Drug Levels

After a single oral dose of 40 mg of loratadine in 6 women, average peak milk levels of 29.2 (range 20.4 to 39) mcg/L occurred at two hours after the dose. In addition, average desloratadine peak milk levels of 16 (range 9 to 29.6) mcg/L occurred at 5.3 hours after the dose.

The entire quantity excreted in milk over 48 hours was 11.7 mcg of loratadine and its metabolite. However, the dose istered was four times greater than the usual dose of the drug, so a entire dose of about 3 mcg would be expected with a 10 mg dose. The calculated average and maximum expected doses of loratadine plus desloratadine in milk were 0.46 and 1.1% and of the maternal weight-adjusted dose, respectively, after the 40 mg dose.[2]

Effects in Breastfed Infants

A survey of 51 mothers who took loratadine during breastfeeding between 1999 and 2001 was conducted by a teratogen information service.

Most of the infants were over 2 months ancient and loratadine was generally taken for one week or less. Two mothers reported minor sedation in their infants, one at 3 days of age and one at 3 months of age. Both mothers were taking a dose of 10 mg daily. Weight acquire and psychomotor development were similar to infants in a control group of breastfed infants unexposed to medications.[3] An extension of the study that compared the results of this study (plus one additional patient) to that of a control group of 88 mothers who took a drug known to be safe while breastfeeding. No differences in sedation or any other side effects (p=0.606) in the baby were found between mothers who took loratadine during breastfeeding and those of the control group.[4]

Summary of Use during Lactation

Because of its lack of sedation and low milk levels, maternal use of loratadine would not be expected to cause any adverse effects in breastfed infants.

What allergy medicine is safe while breastfeeding

Loratadine might own a negative effect on lactation, especially in combination with a sympathomimetic agent such as pseudoephedrine. The British Society for Allergy and Clinical Immunology recommends loratadine at its lowest dose as a preferred choice if an antihistamine is required during breastfeeding.[1]

References

1. Powell RJ, Du Toit GL, Siddique N et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007;37:631-50. PMID: 17456211

2.

Hilbert J, Radwanski E, Affine MB et al. Excretion of loratadine in human breast milk. J Clin Pharmacol. 1988;28:234-9. PMID: 2966185

3. Messinis IE, Souvatzoglou A, Fais N et al. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985;8:143-6. PMID: 3928731

4. Merlob P, Stahl B. Prospective follow-up of adverse reactions in breast-fed infants exposed to loratadine treatment (1999-2001).

What allergy medicine is safe while breastfeeding

BELTIS Newsl. 2002;Number 10:43-51.

5. Merlob P. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal loratadine treatment (1999-2002). Unpublished manuscript.

6. Pontiroli AE, De Castro e Silva E, Mazzoleni F et al. The effect of histamine and H1 and H2 receptors on prolactin and luteinizing hormone release in humans: sex differences and the role of stress. J Clin Endocrinol Metab. 1981;52:924-8.

PMID: 7228996


Cetirizine Identification

CAS Registry Number

83881-51-0

Substance Name

Cetirizine

Drug Class

Breast Feeding

Lactation

Antihistamines


More about cetirizine ophthalmic

Related treatment guides

Loratadine use while Breastfeeding

Drugs containing Loratadine: Claritin, Claritin-D, Alavert, Claritin-D 24 Hour, Allergy Relief Tablets, Loratadine-D 24 Hour, Wal-itin, Claritin 24 Hour Allergy, Claritin-D 12 Hour, Alavert D-12 Hour Allergy and Sinus, Show every 31 »Claritin Reditabs, Tavist ND, AllerClear D-24 Hour, Allergy Relief D12, Allergy & Congestion Relief, Leader Allergy Relief D-24, Loratadine-D 12 Hour, Clear-Atadine-D, Loratadine Reditab, Children's Claritin Allergy, Bactimicina Allergy, Clear-Atadine Children's, Dimetapp Children's ND Non-Drowsy Allergy, Claritin Hives Relief, Clear-Atadine, ohm Allergy Relief, Assist I Own Allergies, Vicks QlearQuil Every Day & Every Night 24 Hour Allergy Relief, Children's Allergy Relief 24 Hour, Allergy Relief 24 Hour, Allergy Relief D 24 Hour

Medically reviewed by Drugs.com.

Final updated on Jul 13, 2019.


istrative Information

LactMed Record Number

62

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your specific situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.



Cetirizine use while Breastfeeding

Drugs containing Cetirizine: Zyrtec, Zyrtec-D, Aller-Tec, Wal-Zyr D, Every Day Allergy, Zyrtec-D 12 Hour, Zerviate, KS Aller-Tec D-12, Equate Allergy Relief, Zyrtec Hives, Show every 23 »Children's Zyrtec, Allergy Relief D, 12 Hour Allergy-D, Every Day Allergy-D, Up and Up Every Day Allergy Relief D, Allergy D-12, Alleroff, Aller-Tec Children's, Children's Allergy Relief, Every Day Allergy Children's, PediaCare Children's 24-Hour Allergy, Quzyttir, Cetiri D

Medically reviewed by Drugs.com.

Final updated on Apr 22, 2019.


Cetirizine Levels and Effects while Breastfeeding

Alternate Drugs to Consider

Desloratadine, Fexofenadine, Loratadine

Effects on Lactation and Breastmilk

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[6][7] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[6] Whether lower oral doses of cetirizine own the same effect on serum prolactin or whether the effects on prolactin own any consequences on breastfeeding success own not been studied.

The prolactin level in a mom with established lactation may not affect her ability to breastfeed.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

In one telephone follow-up study, mothers reported irritability and colicky symptoms 10% of infants exposed to various antihistamines and drowsiness was reported in 1.6% of infants.

None of the reactions required medical attention.[3]

A lady who was nursing (extent not stated) her newborn baby was treated for pemphigus with oral prednisolone 25 mg daily, with the dosage increased over 2 weeks to 60 mg daily. She was also taking cetirizine 10 mg daily and topical betamethasone 0.1% twice daily to the lesions.

What allergy medicine is safe while breastfeeding

Because of a poor response, the betamethasone was changed to clobetasol propionate ointment 0.05%. She continued breastfeeding throughout treatment and her baby was developing normally at 8 weeks of age and beyond.[4]

A lady with narcolepsy took sodium oxybate 4 grams each night at 10 pm and 2 am as well as fluoxetine 20 mg and cetirizine 5 mg daily throughout pregnancy and postpartum. She breastfed her baby except for 4 hours after the 10 pm oxybate dose and 4 hours after the 2 am dose.

What allergy medicine is safe while breastfeeding

She either pumped breastmilk or breastfed her baby just before each dose of oxybate. The baby was exclusively breastfed or breastmilk fed for 6 months when solids were introduced. The baby was evaluated at 2, 4 and 6 months with the Ages and Stages Questionnaires, which were withing the normal range as were the infant’s growth and pediatrician’s clinical impressions regarding the infant’s growth and development.[5]

Summary of Use during Lactation

Small occasional doses of cetirizine are probably acceptable during breastfeeding.

Larger doses or more prolonged use may cause drowsiness and other effects in the baby or decrease the milk supply, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. The British Society for Allergy and Clinical Immunology recommends cetirizine at its lowest dose as a preferred choice if an antihistamine is required during breastfeeding.[1] Cetirizine has been used successfully in cases of persistent pain of the breast during breastfeeding.[2]

Ophthalmic use of cetirizine by the mom should pose little risk to the breastfed baby. To substantially decrease the quantity of drug that reaches the breastmilk after using eye drops, put pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

References

1.

What allergy medicine is safe while breastfeeding

Powell RJ, Du Toit GL, Siddique N et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007;37:631-50. PMID: 17456211

2. Muddana A, Asbill DT, Jerath MR et al. Quantitative sensory testing, antihistamines, and beta-blockers for management of persistent breast pain: A case series. Breastfeed Med. 2018;13:275-80. PMID: 29630399

3. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol.

What allergy medicine is safe while breastfeeding

1993;168:1393-9. PMID: 8498418

4. Westermann L, Hugel R, Meier M et al. Glucocorticosteroid-resistant pemphigoid gestationis: successful treatment with adjuvant immunoadsorption. J Dermatol. 2012;39:168-71. PMID: 22379622

5. Gashlin LZ, Sullo D, Lawrence RA et al. Treatment of narcolepsy with sodium oxybate while breastfeeding: A case report. Breastfeed Med. 2016;11:261-3. PMID: 27057786

6. Messinis IE, Souvatzoglou A, Fais N et al. Histamine H1 receptor participation in the control of prolactin secretion in postpartum.

J Endocrinol Invest. 1985;8:143-6. PMID: 3928731

7. Pontiroli AE, De Castro e Silva E, Mazzoleni F et al. The effect of histamine and H1 and H2 receptors on prolactin and luteinizing hormone release in humans: sex differences and the role of stress. J Clin Endocrinol Metab. 1981;52:924-8. PMID: 7228996


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