Is Ebastine safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Ebastine. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Ebastine is a nonsedating antihistamine that is not available in the United States, but is available in other countries. Preliminary evidence indicates that the amounts in milk are unlikely to affect a breastfed infant.
Effects on the breastfed infant
A woman with chronic urticaria was taking ebastine 10 mg daily during pregnancy and postpartum. Her infant was exclusively breastfed until the age of 6 months. He showed normal development at 1 and 3 months of age.[1]
Effects on milk supply
Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[2,3] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[2] Whether lower oral doses of antihistamines or ebastine 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.
Levels in milk
Ebastine is a pro-drug that is metabolized to the active metabolite, carebastine, which has a much longer half-life than ebastine.
Maternal Levels. A woman with chronic urticaria was taking ebastine 10 mg daily during pregnancy and postpartum. On day 5 postpartum, the highest measured ebastine concentration in breastmilk was 6.3 mcg/L at 3.9 hours after the dose. The highest measured breastmilk carebastine concentration of 5.4 mcg/L occurred at 11.3 hours after administration. At 24.3 hours after the dose, the ebastine concentration was 1.1 mcg/L and the carebastine concentration was 4.4 mcg/L. Based on milk samples obtained at 11.3 hours after the dose, the authors estimated that a fully breastfed infant would receive daily dosages of 0.3 mcg/kg of ebastine and 0.2 mcg/kg of carebastine.[1]
Infant Levels. A woman with chronic urticaria was taking ebastine 10 mg daily during pregnancy and postpartum. At 24 hours after birth, her breastfed infant had an undetectable serum (<0.2 mcg/L) ebastine concentration and a carebastine concentration of 46.8 mcg/L, probably obtained via placental transfer. At 2 days postpartum, both ebastine and carebastine were undetectable in the infant’s serum.[1]
Alternatives LactMed lists
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Ebastine” (ebastine). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.