Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.
Is it allowed to take Promethazine Hydrochloride during lactation? |
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1st-generation-antihistamine and phenothiazine-type drug with a strong sedative effect. At latest update relevant published data on excretion into breast milk were not found. It may decrease prolactin levels and interfere with milk production during the first few weeks after birth (Pontiroli 1981, Messinis 1985).Pharmacokinetic data (high volume of distribution and high plasma protein-binding capacity) would render it unlikely a significant passage into the breastmilk.In addition, a low oral bioavailability would hinder a further passage to infant’s plasma through the ingested breastmilk, except on premature infants and immediate neonatal period when there may be an increased intestinal permeability.There are doubts about any association with Sudden Infant Death Syndrome (SIDS) (Kahn 1982, Stanton 1983). It may be considered compatible with breastfeeding on isolated doses such as those used for pre-surgical medication or traveler's dizziness (WHO 2002). Avoid a repeated use as it may cause drowsiness in the infant.Avoid using it in the immediate neonatal period (first 4 to 6 weeks after birth) and in case of prematurity. If used, follow-up the infant for drowsiness and feeding issues. It is not recommended bed-sharing when taking this medication (UNICEF 2006, ABM 2008, Landa 2012, UNICEF 2013). |
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Types of risk
VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...
LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...
HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...
VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...
Scientific literature
The level of risk for breastfeeding is confirmed in these scientific publications:- https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/15-analgesia-and-anesthesia-protocol-english.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/27050859
- http://www.scielo.br/pdf/anp/v74n3/0004-282X-anp-74-03-0262.pdf
- http://www.unicef.org.uk/Documents/Baby_Friendly/Statements/UNICEF_UK_statement_bed_sharing_research_210513.pdf
- http://www.pap.es/files/1116-1449-pdf/pap53_10.pdf
- http://www.bfmed.org/Media/Files/Protocols/VERSION%20FINAL%20PROTOCOLO%206_Spanish.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/18333768
- http://www.bfmed.org/Media/Files/Protocols/Protocol_6.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/16831611
- http://www.gastrojournal.org/article/S0016-5085(06)00865-1/pdf
- http://www.ncbi.nlm.nih.gov/pubmed/15195178
- http://tidsskriftet.no/pdf/pdf2004/1390-1.pdf
- http://whqlibdoc.who.int/hq/2002/55732.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/3928731
- http://www.ncbi.nlm.nih.gov/pubmed/2866055
- http://www.ncbi.nlm.nih.gov/pubmed/6856418
- http://www.ncbi.nlm.nih.gov/pubmed/7088637
- http://www.ncbi.nlm.nih.gov/pubmed/7228996
- http://www.ncbi.nlm.nih.gov/pubmed/14459680