1-(4-Chlorobenzhydryl)-4-(3-methylbenzyl)piperazine dihydrochloride

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)} and Ménière's disease. 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, Briggs 2015).}

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. ^{(ABM 2020 y 2008, UNICEF 2018, 2017, 2014 y 2013, Landa 2012, UNICEF 2006)}