Is Fexofenadine 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 Fexofenadine. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Because of its lack of sedation and low milk levels, maternal use of fexofenadine would not be expected to cause any adverse effects in breastfed infants. Fexofenadine might have a negative effect on lactation, especially in combination with a sympathomimetic agent such as pseudoephedrine.
Effects on the breastfed infant
In one telephone follow-up study of 25 infants exposed to the fexofenadine's parent drug terfenadine, 3 mothers reported irritability in their infants. None of the reactions required medical attention.[2]
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.[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.
Levels in milk
Fexofenadine is an active metabolite of terfenadine.
Maternal Levels. Milk levels have not been measured after fexofenadine administration. However, after 60 mg every 12 hours orally of its parent compound, terfenadine, peak steady-state fexofenadine milk levels averaged 41 mcg/L (range 23 to 60 mcg/L). Based on the data on drug passage into breastmilk in this study and the typical serum levels found after fexofenadine administration, an exclusively breastfed infant would receive less than 0.1% of the weight-adjusted maternal dosage of fexofenadine.[1]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Fexofenadine in pregnancy
LactMed covers breastfeeding only. For what the NHS and the US prescribing label say about pregnancy, see:
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Fexofenadine” (LM111). 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.