Fexofenadine Use During Breastfeeding
Fexofenadine (Allegra) can be used during breastfeeding with caution, as it is unknown whether it is excreted in human milk, but all antihistamines are generally considered safe with minimal infant exposure expected.
Safety Profile
- The FDA label states that it is not known if fexofenadine is excreted in human milk, and caution should be exercised when administering to nursing women 1
- However, all antihistamines are considered safe to use during breastfeeding, as minimal amounts are excreted in breast milk and would not cause adverse effects on a breastfeeding infant 2
- Most commonly used drugs are relatively safe for breastfed babies, with the dose received via milk generally small and much less than known safe doses given directly to infants 3
Clinical Recommendations
- Fexofenadine can be used during breastfeeding based on the general safety profile of antihistamines in this population 2
- Second-generation antihistamines like fexofenadine have fewer published studies compared to first-generation agents, but available data are reassuring 2
- The infant should be monitored for any unusual symptoms, though adverse effects are not expected given the class safety profile 2, 3
Practical Considerations
- Take fexofenadine with water only, not fruit juices, to maximize bioavailability and therapeutic effect 1
- Breastfeeding should not be interrupted when fexofenadine is needed for allergic conditions, as the benefits of continued breastfeeding outweigh theoretical minimal risks 2, 3
- Most medications appear in only small amounts in breast milk, and with appropriate resources, medications can be identified as compatible with breastfeeding 4