6/21/2023 0 Comments Antihistamine creamSkip the Topical CreamsĪnd don’t be tempted to try topical therapies, either. “Taking medication at this point is more about preventing another versus treating the existing one,” says Adam Friedman, MD, a professor and chair of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, DC.īut don’t reach for aspirin and nonsteroidal anti-inflammatory drugs, as they could make your hives worse, he says. Elmariah says - and you can continue taking the antihistamine until you do so or your doctor tells you otherwise. If you break out in hives again after the medicine wears off, take it for three to five days and then stop to see if you get more hives. ( 3) Do Use OTC AntihistaminesĪ 24-hour over-the-counter antihistamine like loratadine and pseudoephedrine (Claritin), cetirizine (Zyrtec), or fexofenadine (Allegra), or a short-acting allergy medication like diphenhydramine (Benadryl) can help relieve itching and discomfort, says Sarina Elmariah, MD, PhD, a board-certified dermatologist at Massachusetts General Hospital in Boston.Īntihistamines are designed to reduce or block histamine, a chemical in your body that’s responsible for hives’ welt-like bumps and itching. But there are steps you can take to relieve the itching and perhaps prevent another hive from coming. ( 2) There’s not much you can do to make them go away more quickly during that time. While they may seem alarming, most hives disappear within 24 hours. Considering the minimal exposure of a nursing infant to the drugs through breast milk, maternal use of loratadine, desloratadine, or fexofenadine in a standard therapeutic dose is unlikely to result in adverse effects in nursing infants and is considered to be compatible with breastfeeding.Hives can show up as a solo lesion or in clusters. 20 The maximum infant dose of fexofenadine based on the highest concentration of fexofenadine in breast milk would be 9 μg/kg daily (ie, 0.45% of the daily dose given to the mother in mg/kg). The pharmacokinetics of fexofenadine in breast milk were studied in 4 lactating women taking 60 mg of terfenadine every 12 hours. Assuming the breast milk intake by an infant is 150 mL/kg daily, the maximum infant loratadine-equivalent dose based on the highest concentration of loratadine and desloratadine in breast milk was estimated to be 7.3 μg/kg daily (ie, 1.1% of the daily dose given to the mother in mg/kg). The pharmacokinetics of loratadine and its metabolite desloratadine in breast milk were studied in 6 lactating women after a single oral dose of 40 mg of loratadine, 19 which is 4 times the current standard therapeutic dose. 18 Therefore, short-term or occasional use of the older generation antihistamines would not be expected to be a concern during breastfeeding.Īmong the second-generation H 1 blockers, data on drug concentration in breast milk are available for loratadine, desloratadine, and fexofenadine. None of the reactions required medical attention. 16, 17 In a telephone follow-up study conducted by Motherisk, 10% of mothers reported irritability and colicky symptoms in their infants exposed to various antihistamines, and drowsiness was reported in 1.6% of infants. 15Īlthough the data regarding the use of first-generation antihistamines and breastfeeding is limited, only minimal amounts of these drugs have been reported to be secreted in breast milk. 3, 14 Furthermore, a recent meta-analysis conducted by Motherisk comparing 2694 male infants exposed to loratadine in utero with 450 413 unexposed controls also failed to confirm such an association. 12 However, a further analysis from the Swedish registry reported an increased risk of hypospadias, 13 although this association has not been confirmed by the other studies. 11 Another study comparing 210 pregnant women exposed to loratadine and 267 women exposed to other antihistamines with 929 women in a control group also failed to show an association with loratadine. 6 A Motherisk study prospectively following 161 loratadine-exposed women and an equal number of unexposed controls confirmed the safety of loratadine use in pregnancy. 10 A Swedish registry study involving 292 loratadine-exposed women did not suggest an increased risk of major malformations. Desloratadine is a major metabolite of loratadine therefore, data pertaining to safety of loratadine might be extrapolated to desloratadine.
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