Is Desloratadine compatible with breastfeeding? Do we have alternatives for Desloratadine?

Desloratadine

February 27, 2018 (Very Low Risk)

Second generation anti-histaminic drug with low sedative effect.

Desloratadine es the active metabolite of loratadine. Its characteristics might be extrapolated to those of loratadine (So 2010).

Loratadine is excreted in non-significant amount into breast milk (Hilbert 1988). No side effects were observed in breastfed infants of treated mothers (Merlob 2002).

Various medical societies and expert consensus consider the use of loratadine safe during breastfeeding (So 2010, National Asthma Ed. 2004, Solhaug 2004, Ghaeli 1993).

The British Society of Immunology and Allergy rates loratadine compatible with breastfeeding (Powell 2007).

American Academy of Pediatrics: loratadine is a medication usually compatible with breastfeeding (AAP 2001).

The pharmacokinetic data of loratadine (higher percentage of protein binding, pKa acid and shorter half-life) would favor a lower excretion in breast milk.

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.

Synonyms

  • Descarboethoxyloratadine

Writings

  • Δεσλοραταδίνη (Greek)
  • ديسلوراتادين (Arabic)
  • Дезлоратадин (Cyrillic)
  • 地氯雷他定 (Chinese)
  • デスロラタジン (Japanese)
  • C19 H19 ClN2 (Molecular formula)
  • 8-Chloro-6,11-dihydro-11-(4-piperidylidene)-5H-benzo[5,6]cyclohepta[1,2-b]pyridine (Chemical name)
  • R06AX27 (ATC Code/s)

References

  1. So M, Bozzo P, Inoue M, Einarson A. Safety of antihistamines during pregnancy and lactation. Can Fam Physician. 2010Abstract Full text (link to original source) Full text (in our servers)
  2. Powell RJ, Du Toit GL, Siddique N, Leech SC, Dixon TA, Clark AT, Mirakian R, Walker SM, Huber PA, Nasser SM; British Society for Allergy and Clinical Immunology (BSACI). BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007Abstract Full text (link to original source) Full text (in our servers)
  3. Solhaug V, Roland PD. Bruk av antihistaminer under graviditet og amming \ [Use of antihistaminics during pregnancy and breast feeding]. Tidsskr Nor Laegeforen. 2004Abstract Full text (link to original source) Full text (in our servers)
  4. Merlob P, Stahl B. Prospective follow-up of adverse reactions in breast-fed infants exposed to loratadine treatment (1999-2001). BELTIS Newsl. 2002;Number 10:43-51 (in Lactmed) 2002 Full text (in our servers)
  5. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  6. Ghaeli P, Kaufman MB. Oral antihistamines/decongestants and breastfeeding. J Hum Lact. 1993Abstract
  7. Hilbert J, Radwanski E, Affrime MB, Perentesis G, Symchowicz S, Zampaglione N. Excretion of loratadine in human breast milk. J Clin Pharmacol. 1988Abstract