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Second-generation antihistamine that does not cross the blood-brain barrier, state devoid of sedative or antimuscarinic effects (AEMPS 2015). It is used in allergic rhinoconjunctivitis and cutaneous pruritus Administration orally or as eye drops.
It is excreted in breast milk in a clinically insignificant amount and no problems have been observed in infants whose mothers took it. Plasma levels in these infants were below the limit of detection. (Iwasa 2019)
The 2nd generation antihistamines are considered safe during lactation because of their lack of sedative effect due to their failure to cross the blood-brain barrier.
The small dose and poor plasma absorption of most topical ophthalmic preparations make passage of significant amount into breast milk unlikely. Ophthalmic Epinastine achieves a negligible plasma concentration: 0.042 ng/ml (Allergan 2018 and 2012). In ophthalmic administration, absorption can be minimized by pressing the tear duct (inner canthus of the eye) with the finger for 1 minute. Its ophthalmic use is also compatible with breastfeeding.