Diphenhydramine use while Breastfeeding
Drugs containing Diphenhydramine: Benadryl, Tylenol PM, Benadryl Allergy, ZzzQuil, Severe Allergy and Sinus Headache, Advil PM, Diphen, Benadryl Children's Allergy, Sleep, Q-Dryl, Show all 247 »Banophen, Unisom SleepGels, Motrin PM, Nytol, Sominex, Aleve PM, Pain Relief PM Extra Strength, Simply Sleep, Dormin, Benadryl Allergy Plus Cold, Calamine with Antihistamine, Legatrin PM, Sleep Tabs, Benadryl Children's Allergy And Sinus, Sleepinal, Dicopanol, Dermarest, Quenalin, Diphenhist, Diphedryl, DPH, Ibuprofen PM, Valu-Dryl, Beldin, Hydramine Compound, Benoject-50, Gestuss-HC, Excedrin PM, Itch Relief, Diabetic Tussin Night Time Formula, Nervine, FIRST Mouthwash BLM, Benadryl-D Children's Allergy & Sinus, Allermax, Headache Relief PM, Pharbedryl, Mucinex Fast-Max Night Time Cold & Flu, Invarest, D-Tann CT, Airacof, Triaminic Thin Strips Allergy, Triaminic Night Time Cold & Cough, FIRST Mary's Mouthwash, Tussinate, Benylin Multi-Symptom, Actifed Allergy Day/Night, Benadryl Extra Strength Itch Stopping Cream, Anti-Itch Extra Strength, Tekral, Sleepwell 2-nite, Dytuss, Genahist, Aler-Dryl, Buckley's Bedtime, Triaminic Thin Strips Cough & Runny Nose, Belix, Tranquil Nighttime Sleep Aid, Twilite, Pardryl, Ala-Hist, Sleep-ettes D, Unisom PM Pain, Percogesic Original Strength, Night Time Pain, Acetadryl, Wal-Nadol PM Extra Strength, Equate Allergy & Sinus Headache, Percogesic Extra Strength, Aceta-Gesic, CVS Allergy & Cold, Respa C&C, Headache Formula PM, Banophen M-S, Aller-Dryl, Valu-Dryl Topical, Genapap PM, Mapap PM, Complete Allergy Relief, Miles Nervine, Scot-Tussin Allergy, Dermarest Anti-Itch, Benadryl Extra Strength Itch Stopping Gel , Hydro-DP, Rindal HPD, Endal HD, Bayer Select Max Strength Night Time Pain, ConRx PM, Derma-Pax, Dermarest Plus, Dermamycin, Truxadryl, PediaCare Children's Allergy, Aler-Tab, Siladryl Allergy, Theraflu Thin Strips Multi Symptom, Banaril, Diphendryl, Nytol Caplet, Compoz Nighttime Sleep Aid, Help I Can't Sleep, Diphenydramine Quick Melt, Uni-Tann, Histaprin, Z-Sleep, Unisom SleepMelts, Dytan, Ben-Tann, Q-Dryl A/F, Diphenmax, Nightime Sleepaid, Dytan-HC, D-Tann HC, Robitussin Night Time Cough & Cold, Alahist LQ, Dytan-D, Theraflu Thin Strips Nighttime Cold and Cough, Children's Triacting Night Time, Diphenmax D, Triaminic Thin Strips Night Time Cold & Cough, Dimetapp Children's Nighttime Cold & Congestion, Pediatex-CT, D-Tann, Benaphen Plus, Tavist NightTime Allergy, Benadryl Allergy Sinus, Respa C&C IR, Contac Day and Night Cold and Flu, Benadryl-D Allergy Plus Sinus, PediaCare Children's Allergy & Cold, Di-Delamine, Aldex-CT, Uni-Tann D, Benadryl Extra Strength Spray, Benadryl Extra Strength Itch Relief Stick, Benadryl Original Strength Itch Stopping Cream, Nu-Med, Banophen Anti Itch, HC-Derma-Pax, FIRST Duke's Mouthwash, Diphenhist Topical, FIRST BXN Mouthwash, Doans PM, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, Diphentann-D, Delsym Children's Night Time Cough & Cold, Diabetic Tussin Night Time Cold & Flu, SM Anti-Itch, Excedrin PM Headache, Respa SA, Tusstat, Robitussin Peak Cold Nighttime Multi-Symptom Cold, Robitussin Night Time Cough, Cold & Flu, Sudafed PE Nighttime Cold, Mucinex Sinus-Max Day & Night (Night), Theraflu Nighttime Severe Cold & Cough, Theraflu Warming Relief Flu & Sore Throat, CVS Allergy & Sinus Headache, Tylenol Allergy Multi-Symptom Nighttime, Benadryl Severe Allergy Plus Sinus Headache, Mucinex Children's Night Time Multi-Symptom Cold, Robitussin Multi-Symptom Cold Night Time, Theraflu Warming Relief Nighttime Severe Cold & Cough, Sudafed PE Severe Cold, Tylenol Plus Children's Cold & Allergy, Anacin PM Aspirin Free, Delsym Cough+ Cold Night Time, Delsym Children’s Cough+ Cold Night Time, CounterAct Night, Suphedrine PE Severe Cold, Mucinex Sinus-Max Night Time Congestion & Cough, Children's Tylenol Plus Cold And Allergy, Theraflu Warming Relief Sinus & Cold, D-Tann AT, Benadryl Severe Allergy & Sinus Headache, Dytan-CS, D-Tann CD, Dytan-AT, Ivarest, Ala-Hist D, Alka-Seltzer PM, Actifed Sinus Day and Night, Uni-Tann CS, Dytan-CD, Sudafed Sinus Nighttime Plus Pain, Contac Day and Night Allergy, Benadryl Cold, Benadryl Allergy Plus Sinus Headache, D-Tann DM, Duratuss AC 12, Tylenol Allergy Complete NightTime, Endal CD (old formulation), Dytan-DM, Tylenol Severe Allergy, Acetaminophen PM Extra Strength, Sleep-Eze-3, Somnicaps, Nytol QuickCaps, Total Allergy, Sleep Tab II, Aller-G-Time, Calm-Aid, Diphenadryl, Alka-Seltzer Plus Allergy, Trux-adryl, Diphenyl, Siladyl SA, Silphen Cough, Sleep-ettes, Bayer PM, Siladryl DAS, Siladryl, Altaryl, Vicks QlearQuil Nighttime Allergy Relief, Hydramine, Benahist-50, Benahist-10, Excedrin PM Triple Action, Sominex Pain Relief Formula, Midol PM, Counteract PM Extra Strength, Pain Reliever PM, Coricidin Night Time Cold Relief, Non-Aspirin PM Extra Strength, Pharbetol PM, Tylenol Sore Throat Nighttime, Snooze Fast, Sominex Maximum Strength Caplet, Diphen AF, Diphen Cough, Allergia-C, 40 Winks, Bydramine, ConRx Allergy, Hyrexin, Hydramine Cough Syrup, Diphenylin
Diphenhydramine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Small, occasional doses of diphenhydramine would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use may cause effects in the infant or decrease the milk supply, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. Single bedtime doses after the last feeding of the day may be adequate for many women and will minimize any effects of the drug. The nonsedating antihistamines are preferred alternatives.
Maternal Levels. One old study that used a biologic assay system reported that after a 100 mg intramuscular dose of diphenhydramine in four women, drug levels in milk were undetectable in two and 42 and 100 mcg/L in two others at one hour after the dose. Five hours after the dose, milk levels were undetectable in two women and 20 and 100 mcg/L in two others. No studies using modern assay methods have been reported.
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. In this study, drowsiness was reported in 1 infant of 12 exposed to diphenhydramine in breastmilk.
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. However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers. Whether lower oral doses of antihistamines have the same effect on serum prolactin or whether the effects on prolactin have any consequences on breastfeeding success have not been studied. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs to Consider
1. Rindi V. La eliminazione degli antistaminici di sintesi con il latte e l'azione latto-goga de questi. Riv Ital Ginecol. 1951;34:147-57.
2. 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
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. 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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