Can you take azelastine while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Small occasional doses of azelastine nasal spray would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use of the nasal spray may cause drowsiness and other effects in the infant or decrease the milk supply, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established. Infant rejection of the breast might occur because of the bitter taste of the drug. The oral, nonsedating antihistamines are preferred alternatives.
Because absorption from the eye is limited, azelastine would not be expected to cause any adverse effects in breastfed infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
Quoted from Azelastine — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised January 15, 2026.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of azelastine. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much azelastine gets into breastmilk
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information on azelastine was not found as of the revision date. In one telephone follow-up study, mothers reported irritability and colicky symptoms 10% of infants exposed to various antihistamines and drowsiness was reported in 1.6% of infants. None of the reactions required medical attention.
Effects on milk supply
Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women. However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers. Whether lower oral doses of antihistamines have the same effect on serum prolactin or whether the effects on prolactin have any consequences on breastfeeding success have not been studied. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Frequently asked questions
Can you take azelastine while breastfeeding?
Small occasional doses of azelastine nasal spray would not be expected to cause any adverse effects in breastfed infants. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of azelastine while breastfeeding?
LactMed lists Cetirizine, Desloratadine, Fexofenadine, Levocetirizine, Loratadine as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does azelastine pass into breastmilk?
LactMed's measured drug levels for azelastine are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking azelastine?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on azelastine
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.