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Diphenhydramine use while Breastfeeding

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

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.

Drug Levels

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.[1] 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.[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.[3][4] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[3] 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

Desloratadine, Fexofenadine, Loratadine

References

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

Diphenhydramine Identification

Substance Name

Diphenhydramine

CAS Registry Number

58-73-1

Drug Class

Antihistamines

Administrative Information

LactMed Record Number

96

Last Revision Date

20130907

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 particular 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.

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