Betahistine (SERC) and Breastfeeding

[Lactation Clinic]

Dear InfantRisk Center,
A mother receives Betahistine (SERC) 24 mg 1 tablet 2 times a day. It was categorized as L4 in Hale's Medications and Mothers' Milk (2021). I am not sure how to manage breastfeeding in this case. According to the previous discussion in this forum (2012), the mother should wait 4 hours. I am not sure about the current recommendation, please suggest. Thank you very much for your kind help.

[kaytlin]

Hello again,

We have no data on betahistine in milk, but believe it could adversely affect the baby. Luckily, the drug is metabolized very quickly and we expect milk levels to peak and drop just as quickly. Waiting 4 hours to breastfeed after a dose should allow for adequate metabolization of the drug to reduce the infant risk to an acceptable level. With twice-daily dosing, a four-hour withhold might be inconvenient but achievable. Monitor the infant for rash and GI symptoms such as vomiting, gastrointestinal pain, abdominal distension and bloating.

Kaytlin Krutsch, PharmD

[Lactation Clinic]

Dear Dr. Krutsch,

Thank you so much for your valuable suggestion.
This mother will be really glad to hear this good news.