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Conjunctivitis - allergic - Management
Which oral antihistamine can I use during pregnancy and breastfeeding?
- Where possible, oral antihistamines should be avoided during pregnancy, especially during the first trimester.
- During pregnancy — a topical ocular antihistamine is probably safe as minimal systemic exposure can be expected, or alternatively an 'older sedating' antihistamine such as oral chlorphenamine is recommended.
- During breastfeeding — oral loratadine or oral cetirizine can be recommended.
[Lee et al, 2000; DTB, 2002; NTIS, 2002; UKMiCentral, 2004]
Basis for recommendation
- Chlorphenamine is not licensed during pregnancy, but there have been several thousand known exposures to this during pregnancy, with no evidence of an increased risk of fetal toxicity.
- The safety of other oral antihistamines in pregnancy has not been established. The available evidence does not suggest that other antihistamines (sedating or non-sedating) are associated with a high risk of teratogenic effects, but not enough exposures have been documented to be confident that there is no or minimal risk of fetal malformations.
- Loratadine and cetirizine are preferred during breastfeeding because only small amounts are secreted in breast milk and both drugs are non-sedating.
[Lee et al, 2000; DTB, 2002; NTIS, 2002; UKMiCentral, 2004]
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