Is Azelastinum Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Azelastinum? Is Azelastinum safe for nursing mother and child? Does Azelastinum extracts into breast milk? Does Azelastinum has any long term or short term side effects on infants? Can Azelastinum influence milk supply or can Azelastinum decrease milk supply in lactating mothers?

Second generation anti-histaminic drug with low sedative effect. Used for ophthalmic and nasal topical administration. On last update no relevant published data related to breastfeeding were found. A small dose together with a low plama level of most nasal and ophthalmologic compounds make that a significant excretion into breast milk would be unlikely.

Small occasional doses of Azelastinum nasal spray would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use of the nasal spray may cause drowsiness and other effects in the infant or decrease the milk supply, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. Infant rejection of the breast might occur because of the bitter taste of the drug. The oral, nonsedating antihistamines are preferred alternatives. Because absorption from the eye is limited, Azelastinum would not be expected to cause any adverse effects in breastfed infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

Relevant published information on Azelastinum was not found as of the revision date. In one telephone follow-up study, mothers reported irritability and colicky symptoms 10% of infants exposed to various antihistamines and drowsiness was reported in 1.6% of infants. None of the reactions required medical attention.[1]

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[2][3] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[2] Whether lower oral doses of antihistamines have the same effect on serum prolactin or whether the effects on prolactin have any consequences on breastfeeding success have not been studied. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.