Activity Three: Medicines Information Enquiry Sebastian Moore

Dear Vicky

Just getting back to about your enquiry regarding what medication would be suitable for a breastfeeding
mother with hay fever.

For a breastfeeding mother with hay fever there are three options I would recommend, that is an oral
antihistamine (Loratadine) or the combined use of an intranasal spray (budesonide) and eye drops
(sodium cromoglicate).

The conservative approach for this mother would be the combined use of the intranasal spray
budesonide, branded Butacort, and the eye drops, sodium cromoglicate, branded Rexacom. These two
medications are well known to be compatible with breastfeeding. However, these two options do lack
convenience, as well as not providing instant relief, with budesonide taking two to three days to see an
affect, and sodium cromoglicate taking three to six weeks to see an affect.

My first choice for your patient would be Loratadine (10mg once daily tablets). Loratadine is an effective
and immediate relief for hay fever symptoms, however it is known to be excreted into breastmilk.
Loratadine is used by breastfeeding mothers inNew Zealand however, and the New Zealand Formulary
states it is compatible with breastfeeding. I see no reason to discourage its use, as long as the mother
does so with caution.

I hope this helps, and if you have any other questions please do not hesitate to contact me again.

Kind regards

Sebastian

References:

Best Practice Advocacy Centre New Zealand. (2018). Bpac.org.nz. Retrieved 22 February 2018,
from https://bpac.org.nz/bpj/2009/november/docs/bpj24_hayfever_pages14-23.pdf
Drugs and Lactation Database (LactMed). (2018). Toxnet.nlm.nih.gov. Retrieved 22 February
2018, from https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
New Zealand Medicine Formulary. (2018). Nzf.org.nz. Retrieved 22 February 2018, from
http://www.nzf.org.nz
Powell, R., Du Toit, G., Siddique, N., Leech, S., Dixon, T., & Clark, A. et al. (2007). BSACI
guidelines for the management of chronic urticaria and angio-oedema. Clinical &
Experimental Allergy, 37(5), 631-650. http://dx.doi.org/10.1111/j.1365-2222.2007.02678.x
Rutter, P., & Newby, D. Community pharmacy Australia and New Zealand 3ed.
 Activity Three: Medicines Information Enquiry Sebastian Moore

Dear Vicky

Just getting back to about your enquiry regarding what medication would be suitable for a breastfeeding
mother with hay fever.

For a breastfeeding mother with hay fever there are two options I would recommend:

 Oral antihistamine: (Loratadine)

 Combined use of an intranasal spray (budesonide) and eye drops (sodium cromoglicate).

The conservative approach would be the combined use of the intranasal spray budesonide, branded
Butacort, and the eye drops, sodium cromoglicate, branded Rexacom. These two medications are well
known to be compatible with breastfeeding. However, these two options do lack convenience, as well as
not providing instant relief.1

My first choice for your patient would be Loratadine (10mg, once daily tablets). Loratadine is an
effective and immediate relief for hay fever symptoms, however it is known to be excreted into
breastmilk.2 However, the New Zealand Formulary states it is compatible with breastfeeding.3 Thus, I see
no reason to discourage its use, as long as the mother does so with caution.

I hope this helps, and if you have any other questions please do not hesitate to contact me again.

Kind regards

Sebastian

21/02/18

1
Best Practice Advocacy Centre New Zealand. (2018). Bpac.org.nz. Retrieved 22 February 2018,
from https://bpac.org.nz/bpj/2009/november/docs/bpj24_hayfever_pages14-23.pdf
2
Drugs and Lactation Database (LactMed). (2018). Toxnet.nlm.nih.gov. Retrieved 22 February
2018, from https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
3
New Zealand Medicine Formulary. (2018). Nzf.org.nz. Retrieved 22 February 2018, from
http://www.nzf.org.nz/nzf_1848