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Diphenhydramine use while Breastfeeding

Drugs containing Diphenhydramine: Benadryl, Ibuprofen PM, Banophen, Tylenol PM, Benadryl Allergy, ZzzQuil, Advil PM, Sleep, Benadryl Children's Allergy, Hydramine, Show all 256 »Diphenadryl, Acetaminophen PM Extra Strength, FIRST Mouthwash BLM, Legatrin PM, Pain Relief PM Extra Strength, Sominex, Diphen, Unisom SleepGels, Dicopanol, Bayer PM, 40 Winks, Q-Dryl, Motrin PM, Dormin, Quenalin, Percogesic Extra Strength, Midol PM, Mapap PM, Nytol, Aleve PM, Valu-Dryl, Calm-Aid, Tranquil Nighttime Sleep Aid, Ala-Hist, Nightime Sleepaid, Diphenydramine Quick Melt, Banaril, Diphendryl, Siladryl DAS, Triaminic Night Time Cold & Cough, DPH, Benadryl Allergy Sinus, Diphenhist, Benadryl Severe Allergy & Sinus Headache, Benadryl Allergy Plus Cold, Equate Allergy & Sinus Headache, CVS Allergy & Cold, Theraflu Nighttime Severe Cold & Cough, Delsym Cough+ Cold Night Time, Sleep Tabs, Headache Relief PM, Headache Formula PM, Wal-Nadol PM Extra Strength, Acetadryl, Derma-Pax, Siladryl, PediaCare 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Allergy And 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, Diphenmax D, Uni-Tann D, Dytuss, Hydro-DP, Miles Nervine, Scot-Tussin Allergy, Sleepwell 2-nite, Banophen M-S, Itch Relief, Aller-Dryl, Valu-Dryl Topical, Dermarest Anti-Itch, Benadryl Extra Strength Itch Stopping Gel , Dermarest Plus, Belix, Dermamycin, Dermarest, Rindal HPD, Diphentann-D, Endal HD, Tussinate, Gestuss-HC, Dytan-HC, D-Tann HC, HC-Derma-Pax, FIRST Duke's Mouthwash, FIRST Mary's Mouthwash, FIRST BXN Mouthwash, Doans PM, Delsym Children's Night Time Cough & Cold, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, Vicks QlearQuil Nighttime Allergy Relief, Buckley's Bedtime, Beldin, Benadryl Severe Allergy Plus Sinus Headache, Mucinex Sinus-Max Night Time Congestion & Cough, Night Time Severe Cold and Cough, Suphedrine PE Severe Cold, CounterAct Night, Robitussin Multi-Symptom Cold Night Time, Mucinex Children's Night Time Multi-Symptom Cold, Mucinex Fast-Max Night Time Cold & Flu, Mucinex Sinus-Max Day & Night (Night), Sudafed PE Nighttime Cold, Theraflu Warming Relief Flu & Sore Throat, Severe Allergy and Sinus Headache, Theraflu Warming Relief Nighttime Severe Cold & Cough, Tylenol Allergy Multi-Symptom Nighttime, CVS Allergy & Sinus Headache, 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, Delsym Children’s Cough+ Cold Night Time, Sudafed PE Severe Cold, Sudafed Sinus Nighttime Plus Pain, Counteract 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, Percogesic Original Strength, Unisom PM Pain, Genapap PM, Excedrin PM, Tylenol Plus Children's Cold & Allergy, Sominex Pain Relief Formula, Pain Reliever PM, Coricidin Night Time Cold Relief, Tylenol Sore Throat Nighttime, Pharbetol PM, Non-Aspirin PM Extra Strength, Aceta-Gesic, Tylenol Severe Allergy, Anacin PM Aspirin Free, Dimetapp Children's Multi-Symptom Cold & Flu, Contac Day and Night Allergy, Tylenol Allergy Complete NightTime, Triaminic Thin Strips Cough & Runny Nose, Benoject-50, Hyrexin, Hydramine Cough Syrup, Bydramine, Diphedryl, Diphen AF, Diphen Cough, Aler-Dryl, Allergia-C, Benahist-10, Benahist-50, Genahist, ConRx Allergy, Alka-Seltzer Plus Allergy, Aller-G-Time, Sleep Tab II, Sleep-Eze-3, Somnicaps, Nytol QuickCaps, Total Allergy, Trux-adryl, Diphenyl, Altaryl, Diabetic Tussin Night Time Cold & Flu, Triaminic Thin Strips Allergy, Actifed Sinus Day and Night, D-Tann CT, Allegra Cooling Relief Anti-Itch, Allegra Intensive Relief Anti-Itch, Alka-Seltzer PM, Ala-Hist D, Calamine with Antihistamine, Invarest, Ivarest, Dytan-AT, D-Tann AT, Dytan-CS, D-Tann CD, Unisom Liquid, Uni-Tann CS, Dytan-CD, Airacof, Endal CD (old formulation), Dytan-DM, Duratuss AC 12, D-Tann DM, Snooze Fast, Sominex Maximum Strength Caplet, Unisom SleepMinis, Diphenhist Topical

Medically reviewed on June 4, 2018

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 diphenhydramine 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.

One woman became dependent on dimenhydrinate (which is 55% diphenhydramine) during her first pregnancy and continued to take it in a dose of 150 mg (83 mg diphenhydramine) daily while she breastfed her infant for 3 months. The infant did well except for a febrile seizure at 2 years of age, which was probably unrelated to dimenhydrinate. During her second pregnancy, she took dimenhydrinate 300 mg (165 mg diphenhydramine) daily during the pregnancy and while breastfeeding her infant for 2 years.[5]

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

5. Kaya FD. A patient with dimenhydrinate dependence: A case report. Klinik Psikofarmakoloji Bulteni. 2014;24:184-7. DOI: doi:10.5455/bcp.20140131023347

Diphenhydramine Identification

Substance Name

Diphenhydramine

CAS Registry Number

58-73-1

Drug Class

Antihistamines

Administrative Information

LactMed Record Number

96

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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