betahistine

[Marga]

Betahistine dihydrochloride is a histamine analogue for the treatment of Menieres syndrome. Is this safe during breastfeeding?

[cpride]

Dear Marga,

There are no data on the amount of betahistine dihydrochloride in breastmilk. The drug has a low molecular weight and low protein binding which suggests that the drug would enter breastmilk readily. The drug does have a short plasma half-life of 3 to 4 hours, and the time to peak would be 3 to 5 hours. Dr. Hale stated that betahistine would likely be compatible with breastfeeding, but mom should not breastfeed until 4 hours after her dose allowing the first half-life to pass. She should observe infant for allergic symptoms such as nausea, vomiting, diarrhea and skin rash. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[Marga]

Thank you for your reply, I have passed on the information to my daughter. She is due to have her baby in 3 weeks and was diagnosed with Menieres about two months ago. She has been quite debilitated by the attacks and is concerned about looking after baby, driving, and returning to work when baby is 6 months old, and so is keen to start the medication when baby is about 6 weeks old. I'm not sure that waiting 4 hours is going to compatible with breastfeeding at that early stage, and just hope there is an improvement after baby is born (hoping the probable diagnosis is not correct). Thank you again, however, for this very useful information.

[ummi]

Hi,

I have been prescribed to take 1/2 of " novo betahistine - 24mg" tablet. What I understand from the prev. posts is that it's ok to take it while breastfeeding? I'm still scared to take it as I exclusively breastfeed (No formula)...should I skip breastfeeding for 5hours after I take this medication? I don't want to stop breastfeeding and don't want to harm my 9 month old either...please suggest me what's the best.

regards,
Ummi

[admin]

Ummi:

We don't have any lactation data on this drug. I'd suggest you wait 3-4 hours after taking the drug before breastfeeding. It is beneficial that your infant is 9 months, as your milk volume is probably slightly lower, and your infant is more capable of handling any of this drug that he/she might be exposed to.

Observe for GI symptoms such as Vomiting, gastrointestinal pain, abdominal distension and bloating. These symptoms are more likely in you, and very unlikely in your infant.

This drug just stimulates histamine-1 receptors and blocks histamine-3 receptors.

I'd suggest you go back to breastfeeding and just observe your infant closely. Any gut side effects, then you know what is causing the problem.

Tom Hale PhD.
InfantRisk Center

[hlevine0312]

Hello Dr. Hale and Team,

I need to resume Betahistine for AutoImmune Inner Ear Disease.

I am exclusively breastfeeding.

Is it safe to attempt to take the medication and continue breastfeeding?

Are there any other timing or other considerations?

best,
hazel

[nicholec]

Hi Hazel,

We still do not have data on betahistine in milk, but believe it could adversely affect the baby. We have it rated as an L4. This drug is metabolized very quickly and we expect milk levels to peak and drop within a 4 hr window. 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. There are alternatives such as dimenhydrinate (L2) that you could talk to your doctor about to avoid having to wait 4 hrs between feeds. If you decide to nurse on betahistine, monitor the infant for rash and GI symptoms such as vomiting, gastrointestinal pain, abdominal distension and bloating.

Nichole Campbell, APRN, NP-C