From the Research
Azelastine is generally considered safe to use during breastfeeding, but it should be used with caution, and the nasal spray form is preferred over oral formulations. The nasal spray form of azelastine is preferred because less medication enters the bloodstream and therefore less would transfer into breast milk 1. When using azelastine nasal spray, minimal amounts are expected to pass into breast milk, making it unlikely to cause significant effects in most breastfed infants. If oral antihistamines are needed, second-generation options like loratadine or cetirizine are typically preferred for nursing mothers. To minimize infant exposure, consider applying the nasal spray immediately after breastfeeding to allow time before the next feeding. Watch for potential side effects in the infant such as unusual drowsiness, irritability, or feeding difficulties. Azelastine works by blocking histamine receptors to reduce allergy symptoms, and its limited systemic absorption when used nasally contributes to its relatively favorable safety profile during lactation.
Some key points to consider when using azelastine during breastfeeding include:
- The nasal spray form is preferred due to its limited systemic absorption
- Minimal amounts of azelastine are expected to pass into breast milk
- Second-generation oral antihistamines like loratadine or cetirizine are preferred if oral medications are needed
- Monitoring for potential side effects in the infant is recommended
- Azelastine's mechanism of action and pharmacokinetics support its relatively safe use during lactation 1, 2.
It's also important to note that while azelastine is considered safe, it's always best to consult with a healthcare provider before using any medication during breastfeeding, especially if the infant has any pre-existing medical conditions or is premature 2.