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