Diphenhydramine use while Breastfeeding
Drugs containing Diphenhydramine: Benadryl, Tylenol PM, Benadryl Allergy, Advil PM, ZzzQuil, Sleep, Percogesic Original Strength, Banophen, Q-Dryl, Unisom SleepGels, Show all 247 »Benadryl Children's Allergy, Diphen, Nervine, Nytol, Simply Sleep, Sominex, Dicopanol, Pain Relief PM Extra Strength, Diphenhist, Aleve PM, FIRST Mouthwash BLM, Percogesic Extra Strength, Dormin, Ala-Hist, Banophen Anti Itch, Mucinex Fast-Max Night Time Cold & Flu, Unisom PM Pain, Ibuprofen PM, Itch Relief, Theraflu Nighttime Severe Cold & Cough, Acetadryl, Equate Allergy & Sinus Headache, Midol PM, Diphendryl, FIRST Mary's Mouthwash, Sleep-ettes D, Suphedrine PE Severe Cold, Theraflu Warming Relief Flu & Sore Throat, Sleep-ettes, Benadryl-D Children's Allergy & Sinus, Ivarest, Nytol Caplet, Benadryl Severe Allergy & Sinus Headache, FIRST BXN Mouthwash, Sleep-Eze-3, Excedrin PM, Unisom SleepMelts, Quenalin, Trux-adryl, Benadryl Extra Strength Itch Stopping Cream, Nytol QuickCaps, Hydramine, Doans PM, Diphenydramine Quick Melt, Help I Can't Sleep, Dytan, Tylenol Severe Allergy, Robitussin Multi-Symptom Cold Night Time, Benadryl Allergy Plus Cold, Dermarest, Calamine with Antihistamine, Anti-Itch Extra Strength, Tekral, Benaphen Plus, Hyrexin, Diphedryl, Benadryl Children's Allergy And Sinus, Theraflu Thin Strips Nighttime Cold and Cough, Dimetapp Children's Nighttime Cold & Congestion, Sleep Tabs, Calm-Aid, DPH, Aler-Dryl, Headache Relief PM, Dytuss, Sleepinal, Compoz Nighttime Sleep Aid, Allermax, Twilite, Aler-Tab, Banaril, Nu-Med, Pardryl, Silphen Cough, Siladyl SA, Tusstat, Diphenylin, Hydramine Compound, Siladryl Allergy, Theraflu Thin Strips Multi Symptom, Tranquil Nighttime Sleep Aid, Z-Sleep, PediaCare Children's Allergy, Truxadryl, Complete Allergy Relief, Histaprin, Pharbedryl, Q-Dryl A/F, Uni-Tann, Diphenmax, Nightime Sleepaid, Ben-Tann, Miles Nervine, Hydro-DP, Dytan-D, Alahist LQ, Pediatex-CT, D-Tann, Benadryl-D Allergy Plus Sinus, Robitussin Night Time Cough & Cold, Triaminic Night Time Cold & Cough, Aldex-CT, Diphenmax D, Triaminic Thin Strips Night Time Cold & Cough, Children's Triacting Night Time, PediaCare Children's Allergy & Cold, Benylin Multi-Symptom, Benadryl Original Strength Itch Stopping Cream, Benadryl Extra Strength Itch Relief Stick, Benadryl Extra Strength Spray, Diphenhist Topical, SM Anti-Itch, Di-Delamine, Actifed Allergy Day/Night, Tavist NightTime Allergy, Benadryl Allergy Sinus, Respa SA, Uni-Tann D, Diphentann-D, Derma-Pax, Dermarest Plus, Dermamycin, Siladryl DAS, Benadryl Extra Strength Itch Stopping Gel , Dermarest Anti-Itch, Sleepwell 2-nite, Banophen M-S, Aller-Dryl, Valu-Dryl Topical, Rindal HPD, Endal HD, Motrin PM, Delsym Children's Night Time Cough & Cold, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, FIRST Duke's Mouthwash, HC-Derma-Pax, Tussinate, Gestuss-HC, Dytan-HC, D-Tann HC, Scot-Tussin Allergy, Snooze Fast, CounterAct Night, Mucinex Children's Night Time Multi-Symptom Cold, Mucinex Sinus-Max Day & Night (Night), Sudafed PE Nighttime Cold, Mucinex Sinus-Max Night Time Congestion & Cough, Delsym Children’s Cough+ Cold Night Time, Tylenol Plus Children's Cold & Allergy, Sudafed PE Severe Cold, Theraflu Warming Relief Nighttime Severe Cold & Cough, Delsym Cough+ Cold Night Time, Robitussin Night Time Cough, Cold & Flu, Robitussin Peak Cold Nighttime Multi-Symptom Cold, Theraflu Warming Relief Sinus & Cold, Benadryl Allergy Plus Sinus Headache, Benadryl Cold, Contac Day and Night Allergy, Children's Tylenol Plus Cold And Allergy, CVS Allergy & Sinus Headache, Benadryl Severe Allergy Plus Sinus Headache, Severe Allergy and Sinus Headache, CVS Allergy & Cold, Tylenol Allergy Multi-Symptom Nighttime, Anacin PM Aspirin Free, Aceta-Gesic, Bayer Select Max Strength Night Time Pain, ConRx PM, Night Time Pain, Genapap PM, Contac Day and Night Cold and Flu, Respa C&C IR, Excedrin PM Headache, Diabetic Tussin Night Time Cold & Flu, Diabetic Tussin Night Time Formula, Respa C&C, Mapap PM, Counteract PM Extra Strength, Tylenol Sore Throat Nighttime, Pharbetol PM, Non-Aspirin PM Extra Strength, Acetaminophen PM Extra Strength, Coricidin Night Time Cold Relief, Legatrin PM, Wal-Nadol PM Extra Strength, Headache Formula PM, Sominex Pain Relief Formula, Pain Reliever PM, Sudafed Sinus Nighttime Plus Pain, Tylenol Allergy Complete NightTime, Benahist-50, Benoject-50, Diphenadryl, Genahist, Benahist-10, Allergia-C, Bydramine, 40 Winks, Diphen AF, Diphen Cough, Alka-Seltzer Plus Allergy, Aller-G-Time, Triaminic Thin Strips Cough & Runny Nose, Beldin, Belix, Vicks QlearQuil Nighttime Allergy Relief, Altaryl, Diphenyl, Sleep Tab II, Somnicaps, Total Allergy, Valu-Dryl, Hydramine Cough Syrup, Buckley's Bedtime, D-Tann AT, Dytan-CS, D-Tann CT, D-Tann CD, Dytan-AT, Invarest, Actifed Sinus Day and Night, Alka-Seltzer PM, Bayer PM, Ala-Hist D, Uni-Tann CS, Dytan-CD, Excedrin PM Triple Action, Sominex Maximum Strength Caplet, Triaminic Thin Strips Allergy, ConRx Allergy, D-Tann DM, Duratuss AC 12, Airacof, Endal CD (old formulation), Dytan-DM, Siladryl
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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