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Urticaria - Management
Which antihistamine can I use during pregnancy and breastfeeding?
- Where possible, oral antihistamines should be avoided during pregnancy, especially during the first trimester.
- If an oral antihistamine is required to control urticaria or pruritus during pregnancy, chlorphenamine is the antihistamine of choice.
- Loratadine and cetirizine are recommended for use during breastfeeding.
Basis for recommendation
- Chlorphenamine is not licensed during pregnancy, but there have been several thousand known exposures 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 there are not enough documented exposures to be confident that there is no risk or only a very low risk of fetal malformations.
- Loratadine and cetirizine are preferred during breastfeeding as only small amounts are secreted in breast milk and both drugs are non-sedating.
[Lee et al, 2000; DTB, 2002a; NTIS, 2002; UKMiCentral, 2004]
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