What allergy medicines can i take while breastfeeding

When you seek advice from your pharmacist, GP or health visitor they will take into account factors such as:

  1. how mild or severe your symptoms are – if your symptoms are mild, you may be capable to manage without treatment
  2. how effective the medicine is 
  3. how much of the medicine passes to your baby through your breast milk

If you take hay fever medicine while you’re breastfeeding, you should take the lowest possible dose for the shortest possible time, unless your healthcare professional gives you other advice.

Try topical treatments first.

These are medicines that you don’t need to swallow such as nasal sprays and eyedrops.

Corticosteroid nasal sprays assist to unblock your nose and sinuses. They’re unlikely to pass into your breast milk and only in low amounts.

Sodium cromoglicate eyedrops relieve the redness, itchiness and watering of your eyes. It’s unlikely that sodium cromoglicate passes into your breast milk.

Loratadine or cetirizine are the antihistamine tablets recommended if you’re breastfeeding.

They can own diverse brand names, so speak to your pharmacist for advice. These are non-drowsy antihistamines – you should avoid using antihistamines that make you drowsy (sedating) as they can affect your baby if used for more than a short time.

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.


Loratadine Levels and Effects while Breastfeeding

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. 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]

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 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]

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]

Alternate Drugs to Consider

Desloratadine, Fexofenadine

References

1.

What allergy medicines can i take 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. 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).

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


Loratadine Identification

Substance Name

Loratadine

CAS Registry Number

79794-75-5

Drug Class

Breast Feeding

Lactation

Antihistamines

Nonsedating Antihistamines


istrative Information

LactMed Record Number

163

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 Levels and Effects while Breastfeeding

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.

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 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.

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. 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. 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]

Alternate Drugs to Consider

Desloratadine, Fexofenadine, Loratadine

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. 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. 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.

What allergy medicines can i take while breastfeeding

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


Further information

Always consult your healthcare provider to ensure the information displayed on this sheet applies to your personal circumstances.

Medical Disclaimer

Yes, there are allergy medications that are safe to take while you’re breastfeeding.

Just be careful, because over-the-counter allergy medications are often combined with other drugs in one liquid or pill. To limit your baby’s exposure, it’s best to avoid products that tackle more than one symptom at once or that own more than one athletic ingredient listed.

Antihistamines, which alleviate allergies, are generally considered safe.

But hold in mind that so-called first-generation antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton) can potentially cause sedation in your baby (just as they can in you), while the second- and third-generation medications such as loratadine (Claritin) and fexofenadine (Allegra) are less likely to. Your pediatrician may own a preference as to which one you attempt first.

Learn more about the safety of commonly used medications during breastfeeding.

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Carl Weiner, M.D.

Carl Philip Weiner is chairman and a professor of obstetrics and gynecology at the University of Kansas School of Medicine.

My two oldest children were just bashful of their fourth and first birthdays when my husband and I moved to another city for work. Somewhere amid the chaos of securing a new put to live and a day care, I managed to discover a new ob-gyn. “I need dependable birth control,” I said to him, as we both eyed my son twirling the stirrups. He dashed off a prescription for oral contraceptives.

At the time, I was still nursing my youngest and wasn’t certain if the hormones would affect my baby or my milk supply. My doctor assured me they wouldn’t.

But I didn’t really know or believe him yet; and as a health journalist, I had read conflicting information. I filled the prescription but decided not to start on the contraceptives until after my baby was weaned. In the interim, my husband and I depended on a somewhat less dependable birth control method — which turned out to be not so dependable at every. Nine months later, we welcomed kid number three, a beautiful 9-pound baby boy, and leaned into the chaos just that much harder.

When you’re pregnant or breastfeeding for the better part of two or three years, the question of whether it’s O.K.

to take a given medication is bound to arise. Four in five new mothers in the United States breastfeed their infants, according to the Centers for Disease Control and Prevention. And half of mothers who breastfeed — an estimated 1.5 million women a year — will take a medication.

Yet despite the fact that the number of women who breastfeed each year is rising, we own shockingly little solid evidence on how numerous of those drugs may affect breast milk and nursing infants, according to Dr.

Catherine Spong, M.D., chief of the division of maternal-fetal medicine at the University of Texas Southwestern Medical Middle. Pregnant and nursing women are excluded from most clinical drug studies over fears of possible harms, said Dr. Spong.

This, in effect, has led to a paradox: The people who need answers the most are often left out of the studies that could supply them.

The result is that some women forgo breastfeeding completely when taking medications, or decide not to take needed meds at every, said Dr. Christina Chambers, Ph.D., a professor of pediatrics at the University of California, San Diego and president of the Organization of Teratology Information Specialists, a professional society that provides advice on medications during pregnancy and breastfeeding: “We hear these stories every the time.”

[How to feed a combination of breast milk and formula]

A dearth of information

After Jessica Kornberg-Wall of Austin, Tex., delivered her daughter prematurely at 31 weeks, none of her doctors could tell her with certainty whether any of the three drugs she was on — a serotonin-norepinephrine reuptake inhibitor antidepressant, a blood pressure drug and a thyroid medication — would render her breast milk unsafe for her daughter.

“She was 3 pounds and couldn’t even breathe on her own,” said Kornberg-Wall of her baby at birth. “I’m love, what am I putting in her body? Nobody had any answers for me. It was weird. It was frustrating.”

Jamie Erwin, a mom of two in Marietta, Ga., was similarly “frustrated” when her doctors told her that she’d need to stop nursing so that she could treat a stubborn urinary tract infection with a 60-day course of the antibiotic doxycycline. “There just wasn’t enough research done on it for them to tell it was O.K.,” she said. If she took the antibiotic, her doctors said she’d own to bottle-feed her 6-month-old with formula and “pump and dump” for two months to maintain her milk supply — every while keeping up with her older 2-year-old.

“I just didn’t know if I could do that,” said Erwin. “I was beautiful disheartened.”

In 2017, Dr. Spong chaired a task force which reviewed the available research on medication use during pregnancy and breastfeeding. Their results, published in 2018, found “limited information” for medications and pregnancy, said Dr. Spong, and “far, far less for breastfeeding.” Of the 575 prescription drug and biological products the Food and Drug istration approved for new labeling between 2015 and 2017, for instance, only 15 percent included information on breastfeeding. “It was fairly remarkable to every of us participating in the task force, the dearth of information for lactating women,” said Dr.

Spong.

Both Dr.

What allergy medicines can i take while breastfeeding

Chambers and Dr. Spong said that it’s neither hard nor expensive to study women who are already taking medication, but that helpful of research simply hasn’t been a priority. “The genuine travesty is that it’s a completely answerable question,” said Dr. Chambers.

In April 2019, Dr. Spong and a colleague published an editorial in The New England Journal of Medicine which pointed out that the problem, at least partially, stems from a lack of research funding. In 2017, for instance, the National Institutes of Health allocated $92 million — 0.3 percent of its budget — to research on breastfeeding.

For comparison, the agency spent almost $6 billion on cancer research and $1.1 billion on diabetes research that same year.

While there’s no doubt that research on cancer and diabetes is significant (they are the second and seventh leading causes of death and disability in the United States, respectively) — the more than 3 million American women who breastfeed every year need some research prioritization too, said Dr. Spong. “Pregnancy and lactation are setting up mothers and babies for a endless life of health,” she said. “That’s our future.”

What’s safe?

When studying drugs, researchers ponder of the human body as having diverse compartments: a brain compartment, a liver compartment and so on, according to Dr.

Thomas Hale, Ph.D., a professor of pediatrics at Texas Tech University Health Sciences Middle and co-director of the InfantRisk Middle, a leading research facility for medication safety during pregnancy and breastfeeding. “Nature really figured out how to make the breast milk compartment safe — isolated somewhat from the relax of the body — with the primary intent of safeguarding the baby,” said Dr. Hale.

While experts own evaluated fewer than 400 of the thousands of medications available on the market for safety for use during breastfeeding, experts know enough about how the human body processes them to postulate how much may get into breast milk and potentially affect the baby.

For most medications, according to available research, less than 3 percent of a mother’s dose of a drug can make it into her breast milk. “It’s likely that the vast majority of drugs are perfectly fine to use in breastfeeding if the dose is moderate,” said Dr. Hale.

But some drugs require more caution than others.

In most cases, medications that are already proven safe for babies — such as acetaminophen (Tylenol), ibuprofen (Advil) or certain antibiotics love amoxicillin — are safe to take while nursing. Same goes for topical medications, said Dr. Hale, such as benzoyl peroxide to treat acne or a steroid cream to quell a rash.

What allergy medicines can i take while breastfeeding

Little or none of those drugs absorb into the bloodstream and therefore can’t transfer into breast milk.

There are fewer drugs in the unsafe category. Some of the most concerning ones, according to Dr. Hale, are those that might cause serious side effects at their recommended dosages such as chemotherapy or certain radioactive drugs.

Some sedatives — including the anti-anxiety drugs alprazolam (Xanax) or diazepam (Valium); the anti-nausea drug promethazine (Phenergan); and prescription sleep aids — should be used with caution since they can cause excessive drowsiness and breathing problems in infants.

If your baby is prone to apnea (brief episodes where the baby stops breathing) avoid sedating medications altogether, said Dr. Hale.

While high-dose opioids are sedating and can pose risks to the baby, most women can safely take lower-dose opioids for up to three days if needed for pain after delivery, said Dr. Hale

It’s also a excellent thought to avoid over-the-counter allergy, freezing and sleep medications that contain antihistamines that can cause drowsiness — such as chlorpheniramine (Advil Allergy Sinus), diphenhydramine (Benadryl Allergy and Vick’s ZzzQuil) and doxylamine (Unisom).

If you need allergy relief, the non-sedating antihistamines cetirizine (Zyrtec), loratadine (Claritin) and fexofenadine (Allegra) are a better choice.

As for birth control, the American Academy of Pediatrics currently says that every hormonal contraceptives are safe for the baby. However, those containing estrogen — such as combination birth control pills (Loestrin, Seasonique or Yaz), vaginal rings (NuvaRing) or birth control patches (Xulane) — might reduce milk supply. Progestin-only birth control pills (or so-called “mini-pills,” love Camila or Micronor) are least likely to interfere with breastfeeding.

The A.A.P. advises nursing women who desire to use any type of hormonal contraceptive to wait until breastfeeding is firmly established at six weeks.

Finally, Dr. Spong advised against taking herbal products marketed to improve milk supply, such as fenugreek, milk thistle or others. “There’s not excellent evidence to show they work,” she said. And because they aren’t regulated by the F.D.A. as stringently as medications are, you can’t assume that a product actually contains what’s on the label.

Drug reactions are rare, but call your doctor if you notice signs that a medication is affecting your baby, such as excessive sleepiness, inconsolable crying, diarrhea or rashes.

Filling in the gaps

After Kornberg-Wall received conflicting advice from her health care providers, she wound up performing her own medical research in the library.

“We had to make these decisions — you know, me and my husband as first-time parents — having no thought what we’re doing,” she said.

Erwin, on the other hand, took to the online forum Reddit in desperation, hoping to at least discover support for transitioning her daughter to formula while treating her U.T.I. Surprisingly, she also got solid medical advice. A fellow Redditor suggested that a six-day course of the antibiotic azithromycin might be an acceptable alternative to the two months of doxycycline her doctor had originally recommended.

Erwin’s urologist agreed, though she still discouraged breastfeeding while taking it.

What allergy medicines can i take while breastfeeding

However, her pediatrician gave her the O.K., noting that the drug is prescribed to infants.

The whole experience was “shocking,” said Erwin. “I don’t own a medical degree or a pharmacology degree, and yet I had to do my own research.”

“Unfortunately, numerous physicians — even obstetricians and pediatricians — don’t get much education on the use of medications in breastfeeding,” said Dr. Hale.

However, several online resources can assist. MotherToBaby.org, sponsored by the nonprofit Organization of Teratology Information Specialists, and InfantRisk.com, maintained by the Texas Tech University Health Sciences Middle, both own toll-free hotlines that provide complimentary expert advice.

The Texas Tech research team has also created mobile apps that provide information on medication ingredients and safety during pregnancy and breastfeeding. And the N.I.H. maintains a website and free mobile app, which summarize the known effects of certain medications in pregnancy and breastfeeding.

As for filling in the research gaps, “I feel encouraged,” said Dr. Chambers. U.C.S.D., where she is director of the Human Milk Research Biorepository, is involved in a multi-center pilot study that is assessing how safe 10 older drugs — such as certain antibiotics, antidepressants and blood pressure medications — are for use during breastfeeding. “The hope is that if this demonstration goes well, the project can be expanded to more products and really move the field forward,” said Dr.

Chambers.

Meanwhile, both Dr.

What allergy medicines can i take while breastfeeding

Chambers and Dr. Hale are conducting studies that analyze breast milk from nursing mothers who are taking certain medications to see how much of those drugs pass into their milk.

What allergy medicines can i take while breastfeeding

(If you are a nursing mom who would love to contribute to research, check with Mommy’s Milk or the InfantRisk Middle for information on how to participate.)

In the finish, despite the uncertainty, both Erwin and Kornberg-Wall opted to continue breastfeeding while taking their meds. Kornberg-Wall said that she and her husband decided that the numerous benefits of nursing her daughter, now a thriving toddler, outweighed any potential risks of a little exposure to the drugs.

“I made the decision as best I could at the time with the information I could discover, and so far she’s doing great,” Kornberg-Wall said.

[How to breastfeed during the first two weeks of life]


Teresa Carr is an award-winning journalist based in Texas who specializes in science and health.

She is a previous Consumer Reports editor and author, a 2018 Knight Science Journalism Fellow at the Massachusetts Institute of Technology, and she pens the Matters of Fact column for Undark.

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.


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