Pyrilamine use while Breastfeeding

Drugs containing Pyrilamine: Pamprin Maximum Pain, Triplex AD, Poly Hist Forte (old formulation), Pamprin Multi-Symptom Menstrual Relief, Codituss DM, Midol PMS, Midol PMS Maximum Strength, Midol Maximum Strength Menstrual, Pyril D, Ru-Hist D, Show all 159 »Neo AC, Dermagesic, Resperal, Codimal PH, Hydrophene DH, Rhinatate, Tritan, K-Tan, Phena-S, Aldex D, PMS Relief, Syncol, Aldex DM, Viravan-P, Menstrual Relief, Premsyn PMS, PhendaCof Plus, Hyco-DH, Hycomal DH, Dicomal-DH, Codal-DH Syrup, Tussplex, Poly Hist HC, Delhist D, Trimal DH, Mintuss MR, Codituss DH, De-Chlor MR, Codimal DM, Rolatuss with Hydrocodone, Multihistamine-D, Ru-Hist Plus, Ryna-12X, Poly Hist DHC, Viravan-PDM, Capron DM, Tannate V DM, Pyril DM, Deconsal DM, Ru-Tuss with Hydrocodone, A-Tan 12X, Reme Hist DM, MyHist-DM, Vetuss HC Syrup, KG-Hist D, Ryna-12, Pyril Mal Phenyl HCl, R-Tannic-S A/D, K-Tan 4, Viravan-T, Myci Spray, Deconsal CT, Pyril Tann-12, Viravan-S, Pyrlex PD, Ryna-12S, Pyrlex, Rynesa 12S, Deconsal CT Tannate, V-Tann, Ry-T-12, Tri-Histine, Poly-Histine, Metahistine D, Polytine D, Trihist-D, Prohistine-D, Poly-Histine-D, Poly-D, Delhistine D, Liqui-Histine-D, Triplex DM, Quadra-Hist D Pediatric, Quadra-Hist D, Liqui-Minic Infant, Uni-Multihist D Ped, Iohist D, Histine-D, Multihistamine-D Ped, P-Hist, 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, Url-Tannate Pediatric, Tanamine Pediatric, Tri-Tannate, Equitan Pediatric, Triple Tannate Pediatric, Vanex Forte, Histalet Forte, PMS Formula Multi-Symptom, Z-Xtra, Tussi-12D S, Menstrual PMS, Covangesic, Menstrual Complete, Ninjacof-A, C-Tanna 12D, Tannihist-12D, Pyrlex CB, Pro-Chlo, Corzall Plus, Zotex-D, Tannate 12D S, Tussi-12D, Tanamine, R-Tannamine, Pro-Clear AC, Poly Tan DM, Poly Tan D, Dicomal-PH, Pro-Red AC, MyHist-PD, Zotex-C, Poly Tan, Coryza-DM, V-Tan DM, Zotex-12, Deconsal DM Tannate, Viravan-DM, Codal-DM Syrup, ProHist, Nalfrx, Phena-S 12, Poly Hist PD (old formulation), Histatan, Triotann Pediatric, Chlorex-A 12, Ru-Hist Forte, Triotann, Tanoral, URL-Tannate, Tri-Gestan S, Tri-Hist Pediatric, Conal, Pyrichlor PE, AllerTan, Nalex A 12, Phena-Plus, Tri Tann Pediatric, Viratan-DM

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.

Drug Levels

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.[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

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.[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.

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

Pyrilamine Identification

Substance Name

Pyrilamine

CAS Registry Number

91-84-9

Drug Class

Antihistamines

Administrative Information

LactMed Record Number

232

Last Revision Date

20140116

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