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Diphenhydramine use while Breastfeeding

Drugs containing Diphenhydramine: Benadryl, Ibuprofen PM, Banophen, Advil PM, Benadryl Allergy, Tylenol PM, ZzzQuil, Acetaminophen PM Extra Strength, Hydramine, Diphenhist, Show all 254 »Aleve PM, Sleep, CVS Allergy & Cold, Diphen, Diphenadryl, Benadryl Children's Allergy, Unisom SleepGels, Pain Relief PM Extra Strength, Diphendryl, Diphedryl, Bayer PM, Dicopanol, Nytol, Sominex, Q-Dryl, Aceta-Gesic, Buckley's Bedtime, Acetadryl, Legatrin PM, FIRST Mouthwash BLM, Percogesic Extra Strength, Nervine, Dormin, Sleepwell 2-nite, Coricidin Night Time Cold Relief, Theraflu Nighttime Severe Cold & Cough, Alahist LQ, Diphenyl, Itch Relief, Valu-Dryl, Quenalin, Diphentann-D, Vanamine PD, Doans PM, Sleep Tabs, DPH, Benadryl Severe Allergy & Sinus Headache, 40 Winks, Hydramine Cough Syrup, Hyrexin, Diphenydramine Quick Melt, Hydro-DP, Miles Nervine, Midol PM, Benylin Multi-Symptom, Headache Relief PM, CounterAct Night, Mucinex Fast-Max Night Time Cold & Flu, CVS Allergy & Sinus Headache, Excedrin 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Children's Allergy And Sinus, Benadryl Allergy Sinus, Respa SA, Tekral, Benaphen Plus, Di-Delamine, SM Anti-Itch, Anti-Itch Extra Strength, Benadryl Extra Strength Itch Stopping Cream, Benadryl Original Strength Itch Stopping Cream, Benadryl Extra Strength Itch Relief Stick, Benadryl Extra Strength Spray, Banophen Anti Itch, Triaminic Thin Strips Night Time Cold & Cough, Aldex-CT, Simply Sleep, Silphen Cough, Complete Allergy Relief, Dytuss, Scot-Tussin Allergy, Banophen M-S, Aller-Dryl, Valu-Dryl Topical, Dermarest Anti-Itch, Benadryl Extra Strength Itch Stopping Gel , Derma-Pax, Dermarest Plus, Dermamycin, Dermarest, Rindal HPD, Uni-Tann D, Endal HD, Tussinate, Gestuss-HC, Dytan-HC, D-Tann HC, HC-Derma-Pax, FIRST Duke's Mouthwash, FIRST Mary's Mouthwash, Motrin PM, FIRST BXN Mouthwash, Delsym Children's Night Time Cough & Cold, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, Sleep-ettes, Triaminic Thin Strips Allergy, Siladyl SA, Equate Allergy & Sinus Headache, Night Time Severe Cold and Cough, Suphedrine PE Severe Cold, Robitussin Multi-Symptom Cold Night Time, Mucinex Children's Night Time Multi-Symptom Cold, Mucinex Sinus-Max Day & Night (Night), Sudafed PE Nighttime Cold, Theraflu Warming Relief Flu & Sore Throat, Benadryl Severe Allergy Plus Sinus Headache, Severe Allergy and Sinus Headache, Tylenol Allergy Multi-Symptom Nighttime, Delsym Children’s Cough+ Cold Night Time, Children's Tylenol Plus Cold And Allergy, Robitussin Severe Multi-Symptom Cough Cold + Flu Nighttime, Theraflu Warming Relief Sinus & Cold, Theraflu ExpressMax Nighttime Severe Cold & Cough, Theraflu ExpressMax Flu, Cough & Sore Throat, Theraflu Nighttime Multi-Symptom Severe Cold With Lipton Flavors, Benadryl Allergy Plus Sinus Headache, Benadryl Cold, Contac Day and Night Allergy, Sudafed Sinus Nighttime Plus Pain, Mucinex Sinus-Max Night Time Congestion & Cough, Delsym Cough+ Cold Night Time, Actifed Sinus Day and Night, Wal-Nadol PM Extra Strength, Diabetic Tussin Night Time Formula, Respa C&C, Respa C&C IR, Contac Day and Night Cold and Flu, Bayer Select Max Strength Night Time Pain, ConRx PM, Night Time Pain, Genapap PM, Counteract PM Extra Strength, Headache Formula PM, Theraflu Warming Relief Nighttime Severe Cold & Cough, Sominex Pain Relief Formula, Pain Reliever PM, Tylenol Sore Throat Nighttime, Pharbetol PM, Non-Aspirin PM Extra Strength, Tylenol Severe Allergy, Anacin PM Aspirin Free, Dimetapp Children's Multi-Symptom Cold & Flu, Tylenol Plus Children's Cold & Allergy, Sudafed PE Severe Cold, Tylenol Allergy Complete NightTime, Allegra Cooling Relief Anti-Itch, Siladryl DAS, Sleep Tab II, Aler-Dryl, Allergia-C, Benahist-10, Benahist-50, Benoject-50, Calm-Aid, Genahist, Alka-Seltzer Plus Allergy, Aller-G-Time, Sleep-Eze-3, Diphen AF, Somnicaps, Nytol QuickCaps, Total Allergy, Trux-adryl, Altaryl, Triaminic Thin Strips Cough & Runny Nose, Beldin, Belix, Vicks QlearQuil Nighttime Allergy Relief, Siladryl, Diphen Cough, Bydramine, Allegra Intensive Relief Anti-Itch, D-Tann CT, Alka-Seltzer PM, Ala-Hist, Ala-Hist D, Calamine with Antihistamine, Invarest, Ivarest, Dytan-AT, D-Tann AT, Dytan-CS, D-Tann CD, ConRx Allergy, Uni-Tann CS, Dytan-CD, Airacof, Endal CD (old formulation), Dytan-DM, Duratuss AC 12, D-Tann DM, Snooze Fast, Sominex Maximum Strength Caplet, Diabetic Tussin Night Time Cold & Flu, Diphenhist Topical

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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