Is Allegra (fexofenadine) safe to use during breastfeeding?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 17, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Allegra (fexofenadine) is generally considered safe to use during breastfeeding. Although the provided evidence primarily discusses the safety of antihistamines during pregnancy, particularly in the first trimester 1, it also implies that second-generation antihistamines like fexofenadine have excellent safety records. The study from the Journal of Allergy and Clinical Immunology notes that both first-generation and second-generation antihistamines do not show a significant increase in congenital malformations when used during the first trimester 1. While there are limited data on the use of fexofenadine during breastfeeding, its properties as a second-generation antihistamine suggest minimal passage into breast milk and thus minimal risk to the nursing infant.

Key considerations for using Allegra during breastfeeding include:

  • The standard adult dose of Allegra is 60 mg twice daily or 180 mg once daily, and this dosing does not need to be adjusted while breastfeeding.
  • Fexofenadine causes less drowsiness than older antihistamines and has minimal effects on milk production.
  • It is not expected to cause sedation or other adverse effects in the nursing infant.
  • To minimize exposure, it's best to take Allegra immediately after nursing or just before your baby's longest sleep period.
  • Monitor your baby for any unusual symptoms such as irritability, drowsiness, or feeding problems, though these are unlikely with fexofenadine. Given the information available and prioritizing morbidity, mortality, and quality of life, the use of Allegra during breastfeeding is considered safe, with the caveat that monitoring for any potential side effects in the infant is prudent 1.

From the FDA Drug Label

It is not known if fexofenadine is excreted in human milk. There are no adequate and well-controlled studies in women during lactation. Because many drugs are excreted in human milk, caution should be exercised when fexofenadine hydrochloride is administered to a nursing woman

The use of Allegra (fexofenadine) during breastfeeding is not recommended due to the lack of adequate and well-controlled studies in nursing women. Caution should be exercised when considering the use of fexofenadine in breastfeeding mothers, as many drugs are excreted in human milk. 2

From the Research

Allegra Breastfeeding Safety

  • The safety of Allegra (fexofenadine) during breastfeeding has been studied, and the results are reassuring 3.
  • According to a study published in the Canadian Family Physician, all antihistamines, including Allegra, are considered safe to use during breastfeeding, as minimal amounts are excreted in breast milk and would not cause any adverse effects on a breastfeeding infant 3.
  • There is no direct evidence in the provided studies that discusses the safety of Allegra during breastfeeding in detail, but the general consensus is that antihistamines are safe for use during breastfeeding 3.
  • Other studies focus on the safety of fexofenadine during pregnancy 4 and its efficacy in children with allergic rhinitis 5, but do not provide specific information on breastfeeding.
  • A study on analgesics and breastfeeding discusses the safety of various medications during lactation, but does not mention Allegra or fexofenadine specifically 6.
  • Another study on breastfeeding and allergy prevention discusses the importance of exclusive breastfeeding for 4-6 months, but does not mention Allegra or fexofenadine 7.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Safety of antihistamines during pregnancy and lactation.

Canadian family physician Medecin de famille canadien, 2010

Research

Fexofenadine: review of safety, efficacy and unmet needs in children with allergic rhinitis.

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2021

Research

Clinical practice: Breastfeeding and the prevention of allergy.

European journal of pediatrics, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.