Diphenhydramine use while Breastfeeding
Drugs containing Diphenhydramine: Benadryl, Ibuprofen PM, Banophen, Tylenol PM, Benadryl Allergy, ZzzQuil, Advil PM, Diphenhist, Diphen, Acetaminophen PM Extra Strength, Show all 256 »Sleep, Unisom SleepGels, Hydramine, Diphen Cough, Aleve PM, Benadryl Children's Allergy, Sominex, FIRST Mouthwash BLM, Motrin PM, Pain Relief PM Extra Strength, Diphenadryl, Theraflu Nighttime Severe Cold & Cough, Diphedryl, Excedrin PM, Dicopanol, CVS Allergy & Cold, Nytol, Diphenydramine Quick Melt, Triaminic Night Time Cold & Cough, Legatrin PM, Headache Relief PM, Aceta-Gesic, Itch Relief, Delsym Children's Night Time Cough & Cold, Valu-Dryl, Vicks QlearQuil Nighttime Allergy Relief, Beldin, Diphenyl, Sleep-Eze-3, Actifed Sinus Day and Night, Q-Dryl, DPH, Banophen M-S, Ivarest, 40 Winks, Buckley's Bedtime, Bayer PM, Duratuss AC 12, Histaprin, Sleep-ettes, Diabetic Tussin Night Time Formula, Wal-Nadol PM Extra Strength, Pain Reliever PM, Allermax, Theraflu ExpressMax Nighttime Severe Cold & Cough, 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Children's Allergy And Sinus, Benadryl Allergy Sinus, Respa SA, 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, Unisom SleepMelts, Dermamycin, PediaCare Children's Allergy, Truxadryl, Simply Sleep, Complete Allergy Relief, Dytuss, Miles Nervine, Scot-Tussin Allergy, Siladryl, Valu-Dryl Topical, Dermarest Anti-Itch, Benadryl Extra Strength Itch Stopping Gel , Derma-Pax, Dermarest Plus, Dermarest, Diphentann-D, Hydro-DP, Rindal HPD, 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, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, Siladryl DAS, Sominex Maximum Strength Caplet, Belix, Mucinex Fast-Max Night Time Cold & Flu, Theraflu Warming Relief Nighttime Severe Cold & Cough, Delsym Cough+ Cold Night Time, Delsym Children’s Cough+ Cold Night Time, 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 Sinus-Max Day & Night (Night), Tylenol Plus Children's Cold & Allergy, Sudafed PE Nighttime Cold, Theraflu Warming Relief Flu & Sore Throat, Benadryl Severe Allergy Plus Sinus Headache, Severe Allergy and Sinus Headache, Equate Allergy & Sinus Headache, 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, Sudafed PE Severe Cold, Dimetapp Children's Multi-Symptom Cold & Flu, Benadryl Allergy Plus Cold, Genapap PM, Diabetic Tussin Night Time Cold & Flu, Respa C&C, Respa C&C IR, Contac Day and Night Cold and Flu, Bayer Select Max Strength Night Time Pain, ConRx PM, Acetadryl, Night Time Pain, Percogesic Original Strength, Unisom PM Pain, Mapap PM, Anacin PM Aspirin Free, Counteract PM Extra Strength, Midol PM, Headache Formula PM, Sominex Pain Relief Formula, Coricidin Night Time Cold Relief, Tylenol Sore Throat Nighttime, Pharbetol PM, Non-Aspirin PM Extra Strength, Tylenol Severe Allergy, Percogesic Extra Strength, Theraflu ExpressMax Flu, Cough & Sore Throat, Theraflu Nighttime Multi-Symptom Severe Cold With Lipton Flavors, Triaminic Thin Strips Cough & Runny Nose, Benoject-50, ConRx Allergy, Hyrexin, Hydramine Cough Syrup, Bydramine, Diphen AF, Aler-Dryl, Allergia-C, Benahist-10, Benahist-50, Calm-Aid, Unisom Liquid, Genahist, Alka-Seltzer Plus Allergy, Aller-G-Time, Sleep Tab II, Sleep Tabs, Somnicaps, Nytol QuickCaps, Total Allergy, Trux-adryl, Altaryl, Triaminic Thin Strips Allergy, Unisom SleepMinis, Benadryl Allergy Plus Sinus Headache, Calamine with Antihistamine, Benadryl Cold, Contac Day and Night Allergy, Sudafed Sinus Nighttime Plus Pain, Tylenol Allergy Complete NightTime, Benadryl Severe Allergy & Sinus Headache, Allegra Cooling Relief Anti-Itch, Allegra Intensive Relief Anti-Itch, Alka-Seltzer PM, Ala-Hist, Ala-Hist D, Invarest, Snooze Fast, Dytan-AT, D-Tann AT, Dytan-CS, D-Tann CT, D-Tann CD, Uni-Tann CS, Dytan-CD, Airacof, Endal CD (old formulation), D-Tann DM, Diphenhist Topical
Medically reviewed on Jun 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.
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 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.
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
5. Kaya FD. A patient with dimenhydrinate dependence: A case report. Klinik Psikofarmakoloji Bulteni. 2014;24:184-7. DOI: doi:10.5455/bcp.20140131023347
CAS Registry Number
LactMed Record Number
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