Last update: May 31, 2019

Meclizine Hydrochloride

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

A first generation antihistamine, derivative of piperazine with sedative and antocholinergic effects. Antivertiginous and antiemetic properties.
Indicated in the treatment and prevention of travel sickness (AEMPS 2014, Chen 2010).
Oral administration once a day. Occasional use while travelling.

Since the last update we have not found any published data on its excretion in breast milk.

The lack of known pharmacokinetic data (Wang 2012) makes it difficult to accurately predict possible excretion in breastmilk, although its moderately high molecular weight and its high volume of distribution would hinder significant excretion.

First-generation antihistamines, at high doses, inhibit the secretion of prolactin (Messinis 1985, Board 1981, Golstein 1979, Wortsman 1979), but the stimulation from infant suckling is usually sufficient to ensure the production of breastmilk (Messinis 1985 ).
No decrease in breastmilk production has been reported with usual doses of antihistamines.

The occasional use or minimum doses of antihistamines, even first generation, is considered safe during breastfeeding (So 2010), with low frequency of side effects being observed, which are also mild (Ito 1993).

The occasional use of meclizine to avoid travel sickness during a trip is considered compatible with breastfeeding (Hale 2017 p595, Briggs 2017).

Somnolence and adequate feeding of the infant should be monitored.
Because it can cause sedation and drowsiness, it is not recommended to share a bed (co-sleeping, bed-sharing) with the baby if this medication is being taken, due to increased risk of asphyxia or sudden infant death (UNICEF 2018, 2017, 2014 and 2013, Landa 2012, ABM 2008, UNICEF 2006).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Meclizine Hydrochloride is also known as Meclozine Hydrochloride. Here it is a list of alternative known names::


Meclizine Hydrochloride in other languages or writings:

Group

Meclizine Hydrochloride belongs to this group or family:

Tradenames

Main tradenames from several countries containing Meclizine Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 464 daltons
VD 6,7 l/Kg
Tmax 1,3 - 3,1 hours
T1/2 5,2 - 6 hours

References

  1. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  2. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  3. Ball H, Blair PS. (For UNICEF UK). Caring for your baby at night. Health professional´s guide. 2017 Full text (link to original source) Full text (in our servers)
  4. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. 11th edition (acces on line) 2017
  5. AEMPS - Dr. Torrents. Meclozina (Chiclida). Ficha técnica. 2014 Full text (in our servers)
  6. UNICEF UK. Statement on co-sleeping following publication of new NICE postnatal guidance. Infosheet. 2014 Full text (link to original source) Full text (in our servers)
  7. UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. 2013 Full text (link to original source) Full text (in our servers)
  8. Wang Z, Lee B, Pearce D, Qian S, Wang Y, Zhang Q, Chow MS. Meclizine metabolism and pharmacokinetics: formulation on its absorption. J Clin Pharmacol. 2012 Sep;52(9):1343-9. Abstract
  9. L.Landa Rivera, M.Díaz-Gómez, A.Gómez Papi, J.M.Paricio Talayero, C.Pallás Alonso, M.T.Hernández Aguilar, J.Aguayo Maldonado, J.M.Arena Ansotegui, S.Ares Segura, A.Jiménez Moya, J.J.Lasarte Velillas, J.Martín Calama, M.D.Romero Escós. El colecho favorece la práctica de la lactancia materna y no aumenta el riesgo de muerte súbita del lactante. Dormir con los padres. Rev Pediatr Aten Primaria. 14:53-60 2012 Full text (link to original source) Full text (in our servers)
  10. So M, Bozzo P, Inoue M, Einarson A. Safety of antihistamines during pregnancy and lactation. Can Fam Physician. 2010 May;56(5):427-9. Abstract Full text (link to original source) Full text (in our servers)
  11. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  12. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008 Abstract Full text (link to original source) Full text (in our servers)
  13. ABM - Comité de protocolos de la Academia médica de lactancia materna (Academy of Breastfeeding Medicine). Protocolo Clínico de la ABM #6: Lineamientos sobre la práctica de dormir al bebé junto con la madre y la lactancia materna Revisión, marzo de 2008. Breastfeeding Medicine 2008 Full text (link to original source) Full text (in our servers)
  14. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  15. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  16. Messinis IE, Souvatzoglou A, Fais N, Lolis D. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985 Apr;8(2):143-6. Abstract
  17. Board JA, Fierro RJ. Effect of cyproheptadine on chlorpromazine stimulation of prolactin in women. Am J Obstet Gynecol. 1981 Jan 15;139(2):160-3. Abstract
  18. Wortsman J, Soler NG, Hirschowitz J. Cyproheptadine in the management of the galactorrhea-amenorrhea syndrome. Ann Intern Med. 1979 Jun;90(6):923-5. Abstract
  19. Golstein J, Vanhaelst L, Bruno OD, L'Hermite M. Effect of cyproheptadine on thyrotrophin and prolactin secretion in normal man. Acta Endocrinol (Copenh). 1979 Oct;92(2):205-13. Abstract

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