Is Carbinoxamine Maleate compatible with breastfeeding? Do we have alternatives for Carbinoxamine Maleate?

Carbinoxamine Maleate

August 30, 2018 (Low Risk)

First generation antihistamine (H1) of the ethanolamine type, with an anticholinergic activity and sedative effects, used in the treatment of allergic disorders.
It is a common component of medications for the symptomatic relief of the common cold (FDA 2013).
Its use is unauthorized in children under 2 years old.
Administered orally every 12 hours.

Since the last update we have not found published data on its excretion in breastmilk and the lack of available pharmacokinetic data makes it impossible to predict it.
There is very little literature in relation to this medication.

In the immediate postpartum, an inhibitory effect on the secretion of prolactin has been observed, which, however, does not influence the stimulation produced by the baby’s sucking (Messinis 1985).

There is a possibility of drowsiness with the use of high doses (Ito 1993, Chow 2015).
If used while breastfeeding, it is advisable to monitor drowsiness and the adequate feeding of the infant.
It is not recommended to share a bed with the baby if this medication is being taken (UNICEF 2013, Landa 2012, ABM 2008, UNICEF 2006).

Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Καρβινοξαμίνη μηλεϊνική (Greek)
  • Карбиноксамина Малеат (Cyrillic)
  • マレイン酸カルビノキサミン (Japanese)
  • C16 H19 ClN2 O, C4 H4 O4 (Molecular formula)
  • 2-[4-Chloro-α-(2-pyridyl)benzyloxy]-NN-dimethylethylamine hydrogen maleate (Chemical name)
  • R06AA08 (ATC Code/s)

Drug trade names

References

  1. Chow CK, Koren G. Sedating drugs and breastfeeding. Can Fam Physician. 2015Abstract Full text (link to original source) Full text (in our servers)
  2. FDA-Tris. Carbinoxamine Drug Summary. 2013 Full text (in our servers)
  3. UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. 2013 Full text (link to original source) Full text (in our servers)
  4. L.Landa Rivera, M.Díaz-Gómez, A.Gómez Papi, J.M.Paricio Talayero, C.Pallás Alonso, M.T.Hernández Aguilar, J.Aguayo Maldonado, J.M.Arena Ansotegui, S.Ares Segura, A.Jiménez Moya, J.J.Lasarte Velillas, J.Martín Calama, M.D.Romero Escós. El colecho favorece la práctica de la lactancia materna y no aumenta el riesgo de muerte súbita del lactante. Dormir con los padres. Rev Pediatr Aten Primaria. 14:53-60 2012 Full text (link to original source) Full text (in our servers)
  5. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008Abstract Full text (link to original source) Full text (in our servers)
  6. ABM - Comité de protocolos de la Academia médica de lactancia materna (Academy of Breastfeeding Medicine). Protocolo Clínico de la ABM #6: Lineamientos sobre la práctica de dormir al bebé junto con la madre y la lactancia materna Revisión, marzo de 2008. Breastfeeding Medicine 2008 Full text (link to original source) Full text (in our servers)
  7. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  8. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993Abstract
  9. Messinis IE, Souvatzoglou A, Fais N, Lolis D. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985Abstract