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

Terfenadine

June 10, 2018 (Low Risk)

A 2nd generation antihistamine, derived from piperidine, with minimal sedative effects.
It is completely metabolized to fexofenadine.
Administered orally once a day.

Its high percentage of protein binding explains the negligible transfer to milk observed from fexofenadine (Lucas 1995).

In a telephone follow-up, 10% of infants whose mothers were taking terfenadine exhibited colic and irritability, which did not require treatment (Ito 1993).

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

It has been withdrawn from sale in most countries due to serious cardiac arrhythmias when taken with many other medications and with grapefruit juice (Benton 1996, Smith 1994, Monahan 1990). Its metabolite, fexofenadine, does not cause arrhythmias.


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.

Writings

  • Τερφαιναδίνη (Greek)
  • تيرفينادين (Arabic)
  • Терфенадин (Cyrillic)
  • 特非那定 (Chinese)
  • テルフェナジン (Japanese)
  • C32 H41 NO2 (Molecular formula)
  • 1-(4-tert-Butylphenyl)-4-[4-(α-hydroxybenzhydryl)piperidino]butan-1-ol (Chemical name)
  • R06AX12 (ATC Code/s)

Drug trade names

References

  1. 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)
  2. Benton RE, Honig PK, Zamani K, Cantilena LR, Woosley RL. Grapefruit juice alters terfenadine pharmacokinetics, resulting in prolongation of repolarization on the electrocardiogram. Clin Pharmacol Ther. 1996Abstract
  3. Lucas BD Jr, Purdy CY, Scarim SK, Benjamin S, Abel SR, Hilleman DE. Terfenadine pharmacokinetics in breast milk in lactating women. Clin Pharmacol Ther. 1995Abstract
  4. Smith SJ. Cardiovascular toxicity of antihistamines. Otolaryngol Head Neck Surg. 1994Abstract
  5. Ghaeli P, Kaufman MB. Oral antihistamines/decongestants and breastfeeding. J Hum Lact. 1993Abstract
  6. 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
  7. Monahan BP, Ferguson CL, Killeavy ES, Lloyd BK, Troy J, Cantilena LR Jr. Torsades de pointes occurring in association with terfenadine use. JAMA. 1990Abstract