TRIPELENNAMINE

Fetal Risk Summary

The Collaborative Perinatal Project monitored 50,282 mother-child pairs, 100 of whom were exposed to tripelennamine in the 1st trimester (1, pp. 323–324). For use anytime during pregnancy, 490 exposures were recorded (1, pp. 436–437). In neither group was evidence found to suggest a relationship to major or minor malformations.

The illicit use of pentazocine and tripelennamine (T's and blue's) has been described in a number of cases (2,3,4 and 5). These cases are discussed in detail under the monograph for pentazocine (see Pentazocine).

Breast Feeding Summary

Tripelennamine is excreted into bovine milk but human studies have not been reported (6). The manufacturer considers the drug to be contraindicated in the nursing mother, possibly because of the increased sensitivity of newborn or premature infants to antihistamines (7).

References

1. Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977.
2. Dunn DW, Reynolds J. Neonatal withdrawal symptoms associated with “T's and Blues” (pentazocine and tripelennamine). Am J Dis Child 1982;136:644–5.
3. Pastorek JG II, Plauche WC, Faro S. Acute bacterial endocarditis in pregnancy: a report of three cases. J Reprod Med 1983;28:611–4.
4. Chasnoff IJ, Hatcher R, Burns WJ, Schnoll SH. Pentazocine and tripelennamine (“T's and Blue's”): effects on the fetus and neonate. Dev Pharmacol Ther 1983;6:162–9.
5. von Almen WF II, Miller JM Jr. “Ts and Blues” in pregnancy. J Reprod Med 1986;31:236–9.
6. O'Brien TE. Excretion of drugs in human milk. Am J Hosp Pharm 1974;31:844–54.
7. Product information. PBZ. Geigy Pharmaceuticals, 1990.