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Diphenhydramine use while Breastfeeding

Drugs containing Diphenhydramine: Benadryl, Ibuprofen PM, Banophen, Benadryl Allergy, Tylenol PM, Advil PM, ZzzQuil, Sleep, Acetaminophen PM Extra Strength, Diphenydramine Quick Melt, Show all 256 »Diphenhist, Benadryl Children's Allergy, Aleve PM, Hydramine, Pain Relief PM Extra Strength, Sominex, Diphenadryl, Nytol, Benadryl Extra Strength Itch Stopping Gel , Unisom SleepGels, Diphendryl, Unisom SleepMelts, Theraflu Nighttime Severe Cold & Cough, Allergia-C, CVS Allergy & Cold, Acetadryl, Mapap PM, DPH, Benadryl Allergy Sinus, Midol PM, Diphen, Diphen Cough, Motrin PM, Quenalin, Valu-Dryl, Nervine, Trux-adryl, Aler-Dryl, Bayer PM, 40 Winks, Benadryl Severe Allergy & Sinus Headache, Bydramine, Hydramine Cough Syrup, Hyrexin, Dicopanol, Gestuss-HC, FIRST Mouthwash BLM, Uni-Tann D, Ala-Hist, Airacof, Delsym Children's Night Time Cough & Cold, Pharbedryl, Aldex-CT, Excedrin PM, Benylin Multi-Symptom, Twilite, Percogesic Extra Strength, Tylenol Severe Allergy, Delsym Cough+ Cold Night Time, Benadryl Allergy Plus Cold, Headache Formula PM, Benadryl Allergy Plus Sinus Headache, Nightime Sleepaid, Diabetic Tussin Night Time Cold & Flu, Diphenmax, Banaril, Tusstat, Sleep-ettes, Compoz Nighttime Sleep Aid, Silphen Cough, Siladyl SA, Diphenylin, Hydramine Compound, Pardryl, Nu-Med, Nytol Caplet, Siladryl Allergy, Sleepinal, Help I Can't Sleep, Allermax, Aler-Tab, Theraflu Thin Strips Multi Symptom, Sleep-ettes D, Uni-Tann, Q-Dryl A/F, Ben-Tann, Dytan, Vanamine PD, Histaprin, Z-Sleep, Tranquil Nighttime Sleep Aid, PediaCare Children's Allergy, Excedrin PM Headache, Derma-Pax, Truxadryl, PediaCare Children's Allergy & Cold, Dimetapp Children's Nighttime Cold & Congestion, Children's Triacting Night Time, Triaminic Night Time Cold & Cough, Theraflu Thin Strips Nighttime Cold and Cough, Benadryl Children's Allergy Plus Congestion, Robitussin Night Time Cough & Cold, Alahist LQ, Dytan-D, Pediatex-CT, D-Tann, Benadryl-D Allergy Plus Sinus, Benadryl-D Children's Allergy & Sinus, Actifed Allergy Day/Night, Diphenmax D, Tavist NightTime Allergy, Benadryl Children's 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, Triaminic Thin Strips Night Time Cold & Cough, Diphentann-D, Simply Sleep, Dermarest Plus, Complete Allergy Relief, Dytuss, Dormin, Miles Nervine, Scot-Tussin Allergy, Sleepwell 2-nite, Banophen M-S, Itch Relief, Aller-Dryl, Valu-Dryl Topical, Dermarest Anti-Itch, Siladryl, Dermamycin, Sudafed PE Nighttime Nasal Decongestant, Dermarest, Hydro-DP, Rindal HPD, Endal HD, Tussinate, 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, Siladryl DAS, Sominex Maximum Strength Caplet, Vicks QlearQuil Nighttime Allergy Relief, Mucinex Sinus-Max Day & Night (Night), Theraflu Warming Relief Nighttime Severe Cold & Cough, 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 Fast-Max Night Time Cold & Flu, Sudafed PE Nighttime Cold, Tylenol Plus Children's Cold & Allergy, 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, Theraflu ExpressMax Nighttime Severe Cold & Cough, Sudafed PE Severe Cold, Dimetapp Children's Multi-Symptom Cold & Flu, Theraflu Nighttime Multi-Symptom Severe Cold With Lipton Flavors, Genapap PM, 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, Counteract PM Extra Strength, Anacin PM Aspirin Free, Wal-Nadol PM Extra Strength, Sominex Pain Relief Formula, Pain Reliever PM, Legatrin PM, Coricidin Night Time Cold Relief, Tylenol Sore Throat Nighttime, Headache Relief PM, Pharbetol PM, Non-Aspirin PM Extra Strength, Aceta-Gesic, Theraflu ExpressMax Flu, Cough & Sore Throat, Benadryl Cold, Belix, Q-Dryl, Buckley's Bedtime, Diphedryl, Diphen AF, Benahist-10, Benahist-50, Benoject-50, Calm-Aid, Genahist, Alka-Seltzer Plus Allergy, Aller-G-Time, Triaminic Thin Strips Allergy, Sleep Tab II, Sleep Tabs, Sleep-Eze-3, Somnicaps, Nytol QuickCaps, Total Allergy, Diphenyl, Altaryl, Triaminic Thin Strips Cough & Runny Nose, Beldin, ConRx Allergy, Unisom Liquid, Contac Day and Night Allergy, Dytan-AT, Sudafed Sinus Nighttime Plus Pain, Tylenol Allergy Complete NightTime, Actifed Sinus Day and Night, Allegra Cooling Relief Anti-Itch, Allegra Intensive Relief Anti-Itch, Alka-Seltzer PM, Ala-Hist D, Calamine with Antihistamine, Invarest, Ivarest, D-Tann AT, Unisom SleepMinis, Dytan-CS, D-Tann CT, D-Tann CD, Uni-Tann CS, Dytan-CD, Endal CD (old formulation), Dytan-DM, Duratuss AC 12, D-Tann DM, Snooze Fast, 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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