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Diphenhydramine use while Breastfeeding

Drugs containing Diphenhydramine: Benadryl, Tylenol PM, Benadryl Allergy, Advil PM, ZzzQuil, Benadryl Children's Allergy, Diphen, Sleep, Aleve PM, Sominex, Show all 249 »Unisom SleepGels, Banophen, Diphenhist, CVS Allergy & Cold, Legatrin PM, Pain Relief PM Extra Strength, Dicopanol, Q-Dryl, Mucinex Fast-Max Night Time Cold & Flu, Percogesic Extra Strength, Calamine with Antihistamine, Diphenydramine Quick Melt, Nytol, FIRST Mouthwash BLM, Triaminic Night Time Cold & Cough, Ivarest, Airacof, Dermamycin, Unisom PM Pain, Ibuprofen PM, Excedrin PM, Sudafed PE Severe Cold, Tussinate, Quenalin, Vicks QlearQuil Nighttime Allergy Relief, Aler-Dryl, Calm-Aid, Headache Relief PM, Benadryl Cold, Dermarest, Motrin PM, Complete Allergy Relief, Sudafed Sinus Nighttime Plus Pain, Altaryl, Hydramine, Simply Sleep, Bayer PM, Aler-Tab, Delsym Children's Night Time Cough & Cold, Itch Relief, Triaminic Thin Strips Cough & Runny Nose, Help I Can't Sleep, Sleep Tabs, Delsym Cough+ Cold Night Time, Midol 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Children's Nighttime Cold & Congestion, Children's Triacting Night Time, Aldex-CT, Uni-Tann D, PediaCare Nighttime Multi-Symptom Cold, Sudafed PE Nighttime Nasal Decongestant, Diphentann-D, Dermarest Plus, Hydramine Cough Syrup, Theraflu Warming Relief Flu & Sore Throat, Benadryl Severe Allergy Plus Sinus Headache, Equate Allergy & Sinus Headache, Tylenol Allergy Multi-Symptom Nighttime, Sudafed PE Nighttime Cold, Mucinex Sinus-Max Day & Night (Night), Night Time Severe Cold and Cough, Suphedrine PE Severe Cold, Robitussin Multi-Symptom Cold Night Time, Mucinex Children's Night Time Multi-Symptom Cold, Robitussin Severe Multi-Symptom Cough Cold + Flu Nighttime, Theraflu Warming Relief Sinus & Cold, Ala-Hist, Ala-Hist D, Invarest, Dytan-AT, Alka-Seltzer PM, Actifed Sinus Day and Night, Benadryl Allergy Plus Sinus Headache, Contac Day and Night Allergy, Tylenol Allergy Complete NightTime, Benadryl Severe Allergy & Sinus Headache, Delsym Children’s Cough+ Cold Night Time, Theraflu Warming Relief Nighttime Severe Cold & Cough, Acetadryl, Percogesic Original Strength, Genapap PM, Mapap PM, ConRx PM, Bayer Select Max Strength Night Time Pain, Excedrin PM Headache, Diabetic Tussin Night Time Formula, Respa C&C, Contac Day and Night Cold and Flu, Counteract PM Extra Strength, Wal-Nadol PM Extra Strength, Tylenol Severe Allergy, Anacin PM Aspirin Free, Dimetapp Children's Multi-Symptom Cold & Flu, Tylenol Plus Children's Cold & Allergy, Non-Aspirin PM Extra Strength, Pharbetol PM, Headache Formula PM, Sominex Pain Relief Formula, Pain Reliever PM, D-Tann AT, Dytan-CS, Total Allergy, Trux-adryl, Valu-Dryl, Diphenyl, Nytol QuickCaps, Somnicaps, Genahist, Alka-Seltzer Plus Allergy, Aller-G-Time, Sleep-Eze-3, Beldin, Belix, Tusstat, Diphenylin, Hydramine Compound, Pardryl, Sleep-ettes, Silphen Cough, Siladryl, Siladryl DAS, Siladyl SA, Diphenadryl, Benoject-50, Duratuss AC 12, D-Tann DM, Snooze Fast, Triaminic Thin Strips Allergy, Dytan-DM, Endal CD (old formulation), D-Tann CT, D-Tann CD, Uni-Tann CS, Dytan-CD, ConRx Allergy, Hyrexin, DPH, Allergia-C, Benahist-10, Benahist-50, Diphen Cough, Diphen AF, Excedrin PM Triple Action, 40 Winks, Diphedryl, Nervine

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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