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