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

Clemastine lactation summary

Clemastine usage has low risk in breastfeeding
  • DrLact safety Score for Clemastine is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Clemastine may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Clemastine may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Clemastine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Clemastine We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Clemastine usage in lactation

1st generation antihistamine, ethanolamine, with moderate sedative and marked antimuscarinic effects. The latter could decrease prolactin production, which is important for milk production especially in the first few weeks. Their pharmacokinetic data (high volume of distribution and high percentage of plasma protein binding) explain the negligible excretion observed in milk (Kok 1982). However, there is a published case of a 10-week-old infant who showed signs of lethargy, irritability and rejection of feeding, although the mother took phenytoin and carbamazepine in addition to clemastine. No levels of clemastine were detected in the girl's plasma, who recovered well and continued to breastfeed (Kok 1982). Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity. Lethargy and adequate feeding of the infant should be monitored. Co-sleeping with the baby is not recommended if this drug is being taken (UNICEF 2013, Landa 2012, ABM 2008, UNICEF 2006).

Answer by DrLact: About Clemastine usage in lactation

Small occasional doses of clemastine are acceptable during breastfeeding. Larger doses or more prolonged use 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. Single bedtime doses after the last feeding of the day may be adequate for many women and will minimize any effects of the drug. The nonsedating antihistamines are preferred alternatives.

Clemastine Side Effects in Breastfeeding

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 and none of the infants were exposed to clemastine.[2] A 10-week-old breastfed infant whose mother was taking clemastine, phenytoin and carbamazepine was drowsy, refused to feed, was irritable, and had high-pitched crying.[1] These side effects were possibly caused by clemastine in breastmilk, but the other drugs could also have contributed.

Clemastine Possible Effects in Breastfeeding

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[3][4] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[3] 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.
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.