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

Hydroxyzine

June 11, 2018 (Very Low Risk)

First-generation antihistamine, piperazine derived drug with mild sedative effect. It is used as anxiolytic.
Oral or intramuscular administration up to 4 times a day.
It is metabolized into Cetirizine which is compatible with breastfeeding.

At last update no relevant information concerning breastfeeding were found.

Its pharmacokinetic characteristics (high plasma protein binding and large volume of distribution), make it very unlikely its excretion into breast milk in significant amounts.

Since it has been shown to be well tolerated by young infants for itching relief and because it is metabolized into Cetirizine, we would assume that there is a low risk for breastfeeding in short-term treatments.

Lethargy and adequate feeding of the infant should be monitored.
Co-sleeping with the baby is not recommended if this drug is being taken (UNICEF 2013, Landa 2012, ABM 2008, UNICEF 2006).

Its dopaminergic effect is anti-prolactin (dopamine inhibits prolactin secretion) and may decrease milk production during the first weeks after delivery. When breastfeeding is well established, prolactin levels are not correlated with milk production (Messinis 1985).


See below the information of this related product:

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

  • Hydroxyzine Embonate
  • Hydroxyzine Hydrochloride

Writings

  • Υδροξυζίνη (Greek)
  • هيدروكسيزين (Arabic)
  • Гидроксизин (Cyrillic)
  • 羟嗪 (Chinese)
  • ヒドロキシジン (Japanese)
  • C21 H27 ClN2 O2 (Molecular formula)
  • (RS)-2-{2-[4-(p-Chloro-α-phenylbenzyl)piperazin-1-yl]ethoxy}ethanol (Chemical name)
  • N05BB01 (ATC Code/s)

References

  1. AEMPS. Hidroxizina. Ficha técnica. 2017 Full text (in our servers)
  2. 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)
  3. Glaxo-S-K. Hydroxyzine. Drug Summary. 2013 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 - 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)
  6. 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)
  7. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  8. 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)
  9. 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
  10. Paton DM, Webster DR. Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines). Clin Pharmacokinet. 1985Abstract