The Basics

What is Acrivastine?

Acrivastine and pseudoephedrine combination is used to treat an itchy or runny nose, sneezing, or other symptoms caused by seasonal hay fever

Brand names for Acrivastine

Semprex-D

How Acrivastine is classified

Antihistamines

Acrivastine During Pregnancy

Acrivastine pregnancy category

Category Not AssignedNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Acrivastine while pregnant

Teratogenic Effects No evidence of teratogenicity was seen in rats and rabbits given acrivastine 1000 and 400 mg/kg/day, respectively (5900 and 4720 mg/m2 /day or 249 and 200 times the recommended human daily dose). No evidence of teratogenicity was seen in rats given a combination of acrivastine 30 mg/kg/day and pseudoephedrine 150 mg/kg/day (177 and 885 mg/m2 /day or 8 and 5 times the recommended human daily dose, respectively). Similarly, no evidence of teratogenicity was observed in rabbits given acrivastine 20 mg/kg/day and pseudoephedrine 100 mg/kg/day (236 and 1180 mg/m2 /day or 10 and 7 times the recommended human daily doses, respectively). There are, however, no adequate and well-controlled studies in pregnant women. Because animal teratology studies are not always predictive of human responses, SEMPREX-D Capsules should be used during pregnancy only if the potential benefit justifies the potential risks to the fetus. Nonteratogenic Effects In a perinatal-postnatal study in rats, acrivastine given alone at levels up to 500 mg/kg/day (2950 mg/m2 /day or 124 times the recommended human daily dose) was associated with maternal and neonatal mortality at the maximum dose level. Neonatal survival was decreased in rats given a combination of acrivastine 20 mg/kg/day and pseudoephedrine 100 mg/kg/day (118 and 590 mg/m2 /day or 5 and 3 times the human dose, respectively).

Taking Acrivastine While Breastfeeding

What are recommendations for lactation if you're taking Acrivastine?

Small, occasional doses of acrivastine wouldn’t be expected to cause any adverse effects in breastfed infants. If you take larger doses or used it in a more prolonged way, it may cause drowsiness and other effects in the infant or it could decrease your milk supply, especially if you also a sympathomimetic like pseudoephedrine or before lactation is well established. The nonsedating antihistamines are preferred alternatives.

Maternal / infant drug levels

Small, occasional doses of acrivastine wouldn’t be expected to cause any adverse effects in breastfed infants. If you take larger doses or used it in a more prolonged way, it may cause drowsiness and other effects in the infant or it could decrease your milk supply, especially if you also a sympathomimetic like pseudoephedrine or before lactation is well established. The nonsedating antihistamines are preferred alternatives.

Possible effects of Acrivastine on milk supply

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 acrivastine 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.

Possible alternatives to Acrivastine

Desloratadine, Fexofenadine, Loratadine.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
2. Messinis IE, Souvatzoglou A, Fais N et al. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985;8:143-6. PMID: 3928731
3. Pontiroli AE, De Castro e Silva E, Mazzoleni F et al. The effect of histamine and H1 and H2 receptors on prolactin and luteinizing hormone release in humans: sex differences and the role of stress. J Clin Endocrinol Metab. 1981;52:924-8. PMID: 7228996

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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