Pyrilamine use while Breastfeeding
Drugs containing Pyrilamine: Midol PMS, Midol Maximum Strength Menstrual, Ninjacof, Poly Hist Forte (old formulation), Tannate 12D S, Triplex AD, Pamprin Maximum Pain, Pamprin Multi-Symptom Menstrual Relief, Premsyn PMS, Zotex-D, Show all 160 »Midol PMS Maximum Strength, Poly Hist DHC, Tussplex, Capron DM, Tanoral, Codituss DM, Resperal, Nalex A 12, ProHist, PMS Relief, Covangesic, Menstrual Complete, Dermagesic, PMS Formula Multi-Symptom, Hydrophene DH, Codituss DH, Codal-DH Syrup, Hyco-DH, Poly-D, Dicomal-DH, De-Chlor MR, Mintuss MR, Trimal DH, Poly Hist HC, Multihistamine-D, Hycomal DH, Multihistamine-D Ped, Delhist D, Vetuss HC Syrup, Pryil DM, Delhistine D, MyHist-DM, Tannate V DM, Viravan-PDM, Ru-Hist Plus, Reme Hist DM, Ryna-12X, Deconsal DM, Codimal DM, Ru-Tuss with Hydrocodone, Rolatuss with Hydrocodone, A-Tan 12X, PhendaCof Plus, Uni-Multihist D Ped, Viravan-S, V-Tann, Ry-T-12, Pyril Tann-12, R-Tannic-S A/D, K-Tan, Ryna-12, Pyril Mal Phenyl HCl, Deconsal CT Tannate, Aldex D, Pyril D, Viravan-P, Pyrlex, Ru-Hist D (old formulation), Ryna-12S, Rynesa 12S, Pyrlex PD, K-Tan 4, Viravan-T, Liqui-Histine-D, KG-Hist D, Iohist D, Trihist-D, Polytine D, Prohistine-D, Metahistine D, Histine-D, Triplex DM, Tri-Histine, Myci Spray, Deconsal CT, Poly-Histine, Quadra-Hist D, Liqui-Minic Infant, Quadra-Hist D Pediatric, Poly-Histine-D, Coryza-DM, Triotann-S Pediatric, Tanoral Pediatric, Equitan Pediatric, R-Tannamine Pediatric, Triotann-S, Gelhist Pediatric, R-Tannate, Triple Tannate Pediatric, Tri-Tannate, Url-Tannate Pediatric, Tritan, Tanamine, Rhinatate, Rhinatate Pediatric, Tanamine Pediatric, Tri-Tannate Pediatric, R-Tannate Pediatric, Rynatan-S Pediatric, Z-Xtra, Tussi-12D S, C-Tanna 12D, Syncol, Menstrual PMS, Menstrual Relief, Ninjacof-A, Tannihist-12D, Tussi-12D, Vanex Forte, Atrohist Pediatric, Histalet Forte, Pro-Chlo, Corzall Plus, Pyrlex CB, R-Tannamine, URL-Tannate, Pro-Clear AC, Poly Tan DM, Poly Tan D, Neo AC, Dicomal-PH, Codimal PH, Pro-Red AC (old formulation), Poly Tan, P-Hist, Zotex-12, Deconsal DM Tannate, Aldex DM, V-Tan DM, Viravan-DM, Nalfrx, Codal-DM Syrup, Zotex-C, MyHist-PD, Triotann Pediatric, Chlorex-A 12, Tri-Gestan S, Phena-S, Histatan, Triotann, Ru-Hist Forte, Tri-Hist Pediatric, Phena-Plus, Poly Hist PD (old formulation), Phena-S 12, Pyrichlor PE, Conal, Tri Tann Pediatric, AllerTan, 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.
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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