Diphenhydramine use while Breastfeeding
Drugs containing Diphenhydramine: Benadryl, Ibuprofen PM, Benadryl Allergy, Banophen, ZzzQuil, Tylenol PM, Advil PM, Diphen, Hydramine, Diphenhist, Show all 248 »Sominex, Diphenadryl, Dicopanol, Diphenydramine Quick Melt, Q-Dryl, Acetadryl, Theraflu Nighttime Severe Cold & Cough, Sleep, Acetaminophen PM Extra Strength, CVS Allergy & Cold, Pain Relief PM Extra Strength, Aleve PM, Nytol, Diphendryl, Theraflu Warming Relief Flu & Sore Throat, Calamine with Antihistamine, FIRST Mouthwash BLM, Aldex-CT, Benadryl Children's Allergy, Airacof, Benadryl Allergy Plus Sinus Headache, Diphedryl, Diabetic Tussin Night Time Formula, Unisom SleepGels, Itch Relief, Dermarest, Mapap PM, Motrin PM, Triaminic Night Time Cold & Cough, PediaCare Children's Allergy & Cold, Pediatex-CT, Dytan-D, Excedrin PM, Unisom SleepMelts, Ala-Hist D, Allermax, Nervine, Siladryl Allergy, Diphenmax, Tranquil Nighttime Sleep Aid, Diabetic Tussin Night Time Cold & Flu, Ben-Tann, Tussinate, Rindal HPD, Theraflu Warming Relief Nighttime Severe Cold & Cough, Delsym Cough+ Cold Night Time, Mucinex Fast-Max Night Time Cold & Flu, Severe Allergy and Sinus Headache, Siladryl, Legatrin PM, Benadryl Children's Allergy And Sinus, Benadryl Allergy Sinus, SM Anti-Itch, Non-Aspirin PM Extra Strength, Robitussin Severe Multi-Symptom Cough Cold + Flu Nighttime, Hyrexin, Benoject-50, Somnicaps, Diphenyl, Headache Formula PM, Aler-Dryl, Pain Reliever PM, Hydramine Cough Syrup, 40 Winks, DPH, Benylin Multi-Symptom, Miles Nervine, Twilite, Help I Can't Sleep, Banaril, Aler-Tab, Sleep-ettes D, Theraflu Thin Strips Multi Symptom, Sleepinal, Compoz Nighttime Sleep Aid, Pardryl, Hydramine Compound, Quenalin, Nu-Med, Nytol Caplet, Uni-Tann, Q-Dryl A/F, Complete Allergy Relief, Simply Sleep, Dytuss, Dormin, Scot-Tussin Allergy, Truxadryl, PediaCare Children's Allergy, Dytan, Nightime Sleepaid, Pharbedryl, Histaprin, Z-Sleep, Sleepwell 2-nite, Hydro-DP, D-Tann, Benadryl-D Allergy Plus Sinus, Benadryl-D Children's Allergy & Sinus, Actifed Allergy Day/Night, Alahist LQ, Robitussin Night Time Cough & Cold, Dimetapp Children's Nighttime Cold & Congestion, Children's Triacting Night Time, Theraflu Thin Strips Nighttime Cold and Cough, Benadryl Children's Allergy Plus Congestion, Tavist NightTime Allergy, Respa SA, Benadryl Extra Strength Itch Relief Stick, Benadryl Extra Strength Spray, Banophen Anti Itch, Diphenhist Topical, Benadryl Original Strength Itch Stopping Cream, Benadryl Extra Strength Itch Stopping Cream, Tekral, Benaphen Plus, Di-Delamine, Anti-Itch Extra Strength, Triaminic Thin Strips Night Time Cold & Cough, Diphenmax D, Dermamycin, Diphenylin, Endal HD, Gestuss-HC, Dermarest Plus, Derma-Pax, Aller-Dryl, Valu-Dryl Topical, Dermarest Anti-Itch, Benadryl Extra Strength Itch Stopping Gel , Dytan-HC, D-Tann HC, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, Diphentann-D, Uni-Tann D, Delsym Children's Night Time Cough & Cold, Doans PM, HC-Derma-Pax, FIRST Duke's Mouthwash, FIRST Mary's Mouthwash, FIRST BXN Mouthwash, Banophen M-S, Sominex Maximum Strength Caplet, Mucinex Children's Night Time Multi-Symptom Cold, Mucinex Sinus-Max Day & Night (Night), Sudafed PE Nighttime Cold, Benadryl Severe Allergy Plus Sinus Headache, Robitussin Multi-Symptom Cold Night Time, CounterAct Night, Delsym Children’s Cough+ Cold Night Time, Mucinex Sinus-Max Night Time Congestion & Cough, Night Time Severe Cold and Cough, Suphedrine PE Severe Cold, Equate Allergy & Sinus Headache, Tylenol Allergy Multi-Symptom Nighttime, Sudafed Sinus Nighttime Plus Pain, Tylenol Allergy Complete NightTime, Benadryl Severe Allergy & Sinus Headache, Actifed Sinus Day and Night, Contac Day and Night Allergy, Benadryl Cold, CVS Allergy & Sinus Headache, Children's Tylenol Plus Cold And Allergy, Theraflu Warming Relief Sinus & Cold, Benadryl Allergy Plus Cold, Sudafed PE Severe Cold, Tylenol Plus Children's Cold & Allergy, Percogesic Original Strength, Unisom PM Pain, Genapap PM, Counteract PM Extra Strength, Night Time Pain, ConRx PM, Respa C&C, Respa C&C IR, Contac Day and Night Cold and Flu, Bayer Select Max Strength Night Time Pain, Midol PM, Wal-Nadol PM Extra Strength, Tylenol Severe Allergy, Percogesic Extra Strength, Anacin PM Aspirin Free, Dimetapp Children's Multi-Symptom Cold & Flu, Aceta-Gesic, Pharbetol PM, Sominex Pain Relief Formula, Coricidin Night Time Cold Relief, Tylenol Sore Throat Nighttime, Headache Relief PM, Alka-Seltzer PM, Bayer PM, Sleep Tab II, Sleep Tabs, Sleep-Eze-3, Nytol QuickCaps, Aller-G-Time, Alka-Seltzer Plus Allergy, Benahist-10, Benahist-50, Calm-Aid, Genahist, Total Allergy, Trux-adryl, Siladryl DAS, Siladyl SA, Silphen Cough, Sleep-ettes, Vicks QlearQuil Nighttime Allergy Relief, Belix, Valu-Dryl, Altaryl, Triaminic Thin Strips Cough & Runny Nose, Beldin, Allergia-C, Diphen Cough, D-Tann CT, D-Tann CD, Uni-Tann CS, Dytan-CD, Dytan-CS, D-Tann AT, Ala-Hist, Invarest, Ivarest, Dytan-AT, Endal CD (old formulation), Dytan-DM, ConRx Allergy, Buckley's Bedtime, Bydramine, Diphen AF, Triaminic Thin Strips Allergy, Excedrin PM Headache, Duratuss AC 12, D-Tann DM, Snooze Fast, Tusstat
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.
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. 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.
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. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
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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