Second generation antihistamine, drug derived from piperazine and metabolite of hydroxyzine, with a minimal sedative effect and low toxicity even at higher dose. No short or long-term side effects were found in an infant with a mother who was treated in the first month post delivery for pemphigus (Westermann 2012). Because of a high plasma protein binding capacity, excretion into breast milk seems to be unlikely. The British Society for Allergy and Clinical Immunology and other experts rates it as compatible with breastfeeding (Butler 2014, Powell 2007).