The Basics
What is Cetirizine?
A second-generation antihistamine used to treat allergic rhinitis, dermatitis, and urticaria.
Brand names for Cetirizine
Zyrtec
How Cetirizine is classified
Antihistamines
Cetirizine During Pregnancy
Cetirizine pregnancy category
Category N/A
Note 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 Cetirizine while pregnant
Is Cetirizine safe in pregnancy? Yes, it is generally safe.
Taking Cetirizine While Breastfeeding
What are recommendations for lactation if you're taking Cetirizine?
It is probably acceptable to take small occasional doses of cetirizine while 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. The British Society for Allergy and Clinical Immunology recommends cetirizine at its lowest dose as a preferred choice if an antihistamine is required during breastfeeding.[1] Cetirizine has been used successfully in cases of persistent pain of the breast during breastfeeding.[2] Ophthalmic use of cetirizine by the mother should pose little risk to the breastfed infant. 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.
Maternal / infant drug levels
It is probably acceptable to take small occasional doses of cetirizine while 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. The British Society for Allergy and Clinical Immunology recommends cetirizine at its lowest dose as a preferred choice if an antihistamine is required during breastfeeding.[1] Cetirizine has been used successfully in cases of persistent pain of the breast during breastfeeding.[2] Ophthalmic use of cetirizine by the mother should pose little risk to the breastfed infant. 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.
Possible effects of Cetirizine on milk supply
Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[6][7] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[6] Whether lower oral doses of cetirizine 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 Cetirizine
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. Powell RJ, Du Toit GL, Siddique N et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007;37:631-50. PMID: 17456211
2. Muddana A, Asbill DT, Jerath MR et al. Quantitative sensory testing, antihistamines, and beta-blockers for management of persistent breast pain: A case series. Breastfeed Med. 2018;13:275-80. PMID: 29630399
3. 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
4. Westermann L, Hugel R, Meier M et al. Glucocorticosteroid-resistant pemphigoid gestationis: successful treatment with adjuvant immunoadsorption. J Dermatol. 2012;39:168-71. PMID: 22379622
5. Gashlin LZ, Sullo D, Lawrence RA et al. Treatment of narcolepsy with sodium oxybate while breastfeeding: A case report. Breastfeed Med. 2016;11:261-3. PMID: 27057786
6. 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
7. 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.
