The American College of Obstetricians and Gynecologists (ACOG) and The
American College of Allergy, Asthma and Immunology (ACAAI) have recommended chlorpheniramine and tripelennamine as the
antihistamines of choice for pregnant women. Cetirizine and loratadine
may be considered (preferably after the first trimester) in patients who
cannot tolerate or do not respond to maximal doses of chlorpheniramine or tripelennamine [3]
BREAST FEEDING: Fexofenadine appears to be excreted into breast milk.
In a study of four healthy lactating mothers subjects received 60 mg
terfenadine every 12 hours over a period of 48 hours. Terfenadine was not
detected in milk or plasma. However, fexofenadine was found in milk and
plasma.
The AUCmilk/AUCplasma (0-12) ratio for
fexofenadine was 0.21 (range 0.12 to 0.28)
Newborn dosage estimates based on the highest measured concentration of fexofenadine
in milk suggest the maximum level of newborn exposure would not exceed 0.45%
of the recommended maternal weight-corrected dose [4].
SEARCH LITERATURE
1. Physicians Desk Reference 57th ed. Montvale, NJ: Thomson PDR;
2004: 713-714
2.Honig PK, et al. The effect of fluconazole on the steady-state pharmacokinetics
and electrocardiographic pharmacodynamics of terfenadine in humans.Clin Pharmacol Ther. 1993 Jun;53(6):630-6.
MEDLINE
3. The use of newer asthma and
allergy medications during pregnancy. Position Statement. The American
College of Obstetricians and Gynecologists (ACOG) and The American College
of Allergy, Asthma and Immunology (ACAAI). Ann Allergy Asthma Immunol.
2000;84:475-480.
MEDLINE
4. Lucas BD, et al. Terfenadine pharmacokinetics in breast milk in lactating
women.Clin Pharmacol Ther. 1995 Apr;57(4):398-402.
MEDLINE
Created: 11/17/2000
Updated: 11/30/2002
Updated: 4/17/2004
