Is Allegra (Fexofenadine) Safe During Breastfeeding?
Yes, Allegra (fexofenadine) is considered safe to use while breastfeeding, as all antihistamines are compatible with lactation due to minimal excretion into breast milk.
FDA Drug Label Information
The FDA label for fexofenadine states that "it is not known if fexofenadine is excreted in human milk" and recommends that "caution should be exercised when fexofenadine hydrochloride is administered to a nursing woman" 1. However, this conservative language reflects the lack of specific human lactation studies rather than evidence of harm.
Clinical Evidence Supporting Safety
Second-generation antihistamines like fexofenadine are safe for breastfeeding mothers based on the following:
All antihistamines, including both first-generation sedating and second-generation nonsedating medications, are considered safe during breastfeeding because minimal amounts are excreted in breast milk and would not cause adverse effects on the breastfed infant 2
Inhaled and nasal treatments for asthma and allergic rhinitis (the conditions fexofenadine treats) are unlikely to affect breastfed infants 3
Most commonly used drugs are relatively safe for breastfed babies, as the dose received via milk is generally small and much less than known safe doses given directly to infants 4
Why Fexofenadine Is Preferred
Fexofenadine has specific advantages for breastfeeding mothers:
As a second-generation antihistamine, it is nonsedating, which means it poses no risk of infant sedation (unlike first-generation antihistamines that can cause drowsiness) 2
Published studies on second-generation antihistamines are reassuring regarding their safety profile during lactation 2
The medication is well-tolerated with an established safety profile in both adults and children as young as 6 years 1
Practical Recommendations
When prescribing fexofenadine to breastfeeding mothers:
Use the standard adult dosing (typically 60 mg twice daily or 180 mg once daily for seasonal allergic rhinitis) 1
Time the dose before the infant's longest sleep interval to minimize any theoretical exposure 3
No need to interrupt breastfeeding or pump and discard milk when taking fexofenadine at recommended doses 3
Monitor the infant for any unusual symptoms, though adverse effects are not expected 2
Common Pitfalls to Avoid
Do not unnecessarily discontinue breastfeeding due to unfounded concerns about antihistamine safety, as this is a common reason for premature cessation of breastfeeding 5
Avoid relying solely on conservative product labeling that may not reflect current clinical evidence 4
Do not switch to first-generation sedating antihistamines thinking they are "safer"—while they have more historical data, second-generation agents like fexofenadine offer the advantage of no sedation risk 2