Levocabastine

Drug Levels and Effects:




Summary of Use during Lactation:


Because absorption from the eye is limited, levocabastine 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.


Drug Levels:


Maternal Levels.

There are no published reports of the excretion of levocabastine into breastmilk. The manufacturer reports that levocabastine was found in breast milk of one nursing woman after ophthalmic administration of the drug (dose and duration not stated). The daily dosage of levocabastine that the infant would receive was calculated to be about 0.5 mcg.[1]

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


There are no reports of infants breastfed during maternal therapy with levocabastine. In one telephone follow-up study, mothers reported irritability and colicky symptoms in 10% of infants exposed to variousantihistaminesand drowsiness was reported in 1.6% of infants. None of the reactions required medical attention.[2]


Possible Effects on Lactation:


Antihistaminesin relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[3][4] However, suckling-induced prolactin secretion is not affected byantihistaminepretreatment of postpartum mothers.[3] Whether lower oral doses ofantihistamineshave 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.


References:


1. Livostin package insert. Novartis Opthalmics. Duluth GA. January 2006
2. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID:8498418
3. Messinis IE, Souvatzoglou A, Fais N et al. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985;8:143-6. PMID:3928731
4. Pontiroli AE, De Castro e Silva E, Mazzoleni F et al. The effect of histamine and H1 and H2 receptors on prolactin and luteinizing hormone release in humans: sex differences and the role of stress. J Clin Endocrinol Metab. 1981;52:924-8. PMID:7228996



Substance Identification:




Substance Name:

Levocabastine

CAS Registry Number:

79516-68-0

Drug Class:


Antihistamines

Administrative Information:




LactMed Record Number:


156


Last Revision Date:


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