Pyrilamine use while Breastfeeding
Drugs containing Pyrilamine: Midol PMS, Triplex AD, Pamprin Maximum Pain, Pamprin Multi-Symptom Menstrual Relief, Midol Maximum Strength Menstrual, Tanoral, Ru-Hist D, C-Tanna 12D, Aldex DM, Phena-S, Show all 160 »Capron DM, Histalet Forte, V-Tann, Codituss DM, Poly Hist Forte (old formulation), A-Tan 12X, Menstrual Relief, Nalex A 12, K-Tan 4, K-Tan, Tanamine, Codituss DH, Hydrophene DH, Deconsal CT Tannate, Vanex Forte, MyHist-DM, Premsyn PMS, Syncol, Rynesa 12S, Resperal, Menstrual Complete, Hycomal DH, Hyco-DH, Dicomal-DH, PhendaCof Plus, De-Chlor MR, Poly Hist HC, Delhist D, Tussplex, Trimal DH, Triplex DM, Mintuss MR, Codal-DH Syrup, Rolatuss with Hydrocodone, Ru-Hist Plus, Tannate V DM, Deconsal DM, Viravan-PDM, Multihistamine-D, Pyril DM, Reme Hist DM, Ru-Tuss with Hydrocodone, Ryna-12X, Codimal DM, Poly Hist DHC, Vetuss HC Syrup, Histine-D, Pyril Mal Phenyl HCl, R-Tannic-S A/D, Pyril Tann-12, Ryna-12, Viravan-T, Myci Spray, Deconsal CT, Viravan-S, Ry-T-12, Viravan-P, Pyrlex, Pyril D, Ryna-12S, Aldex D, Pyrlex PD, Tri-Histine, Poly-Histine, Metahistine D, Polytine D, Trihist-D, Prohistine-D, Poly-Histine-D, Poly-D, Delhistine D, Liqui-Histine-D, KG-Hist D, Quadra-Hist D Pediatric, Quadra-Hist D, Liqui-Minic Infant, Uni-Multihist D Ped, Iohist D, Viratan-DM, Multihistamine-D Ped, ProHist, R-Tannate, Triotann-S, R-Tannamine Pediatric, Gelhist Pediatric, R-Tannate Pediatric, Atrohist Pediatric, Rynatan-S Pediatric, Triotann-S Pediatric, Tanoral Pediatric, Tri-Tannate Pediatric, Rhinatate Pediatric, Rhinatate, Tanamine Pediatric, Tri-Tannate, Equitan Pediatric, Triple Tannate Pediatric, Ninjacof, Pro-Chlo, PMS Formula Multi-Symptom, PMS Relief, Dermagesic, Menstrual PMS, Midol PMS Maximum Strength, Ninjacof-A, Covangesic, Z-Xtra, Tussi-12D S, Corzall Plus, Pyrlex CB, Zotex-D, Tussi-12D, Tannihist-12D, Tannate 12D S, Url-Tannate Pediatric, Tritan, Neo AC, Pro-Clear AC, Poly Tan DM, Dicomal-PH, Pro-Red AC, Zotex-C, Codimal PH, Poly Tan D, Poly Tan, Viravan-DM, V-Tan DM, Zotex-12, Codal-DM Syrup, Nalfrx, Coryza-DM, P-Hist, MyHist-PD, Phena-S 12, Histatan, Triotann Pediatric, Chlorex-A 12, Ru-Hist Forte, Triotann, R-Tannamine, URL-Tannate, Tri-Gestan S, Tri-Hist Pediatric, Pyrichlor PE, Poly Hist PD (old formulation), Conal, AllerTan, Phena-Plus, Tri Tann Pediatric, Deconsal DM Tannate
Pyrilamine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Small, occasional doses of pyrilamine are probably acceptable during breast feeding. 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. The nonsedating antihistamines are preferred alternatives.
Maternal Levels. One early study that used a biologic assay system reported that after a 100 mg intramuscular dose of diphenhydramine in 3 women, drug levels in milk ranged from 50 to 2.3 mg/L at 1 to 2 hours after the dose and 220 mcg/L to 4 mg/L 5 hours after the dose. Eight hours after the dose, levels were 200 mcg/L and 1.16 mg/L in two mothers, respectively, and not measured in the third. 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
Relevant published information on pyrilamine was not found as of the revision date. 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 and none of the infants were exposed to pyrilamine.
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.
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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