Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Drugline nr 19426

Publicerat 2002-11-04

Question

Is venlafaxine compatible with breast-feeding?

Answer

A previous Drugline document (1) refers to a study on excretion of venlafaxine and its pharmacologically active metabolite O-desmethylvenlafaxine in human milk including three lactating women. The mean total infant dose (venlafaxine and O-desmethylvenlafaxine) was 8% (range 5-9%) of the maternal weight-adjusted dose. No drug-related negative effects were noted in the infants (1). An updated literature search revealed two additional studies including a total of eight breast-feeding mothers and nine infants (2-3). In the first study, serum concentrations of venlafaxine and O-desmethylvenlafaxine were measured in two mother-infant pairs. Venlafaxine was not detectable in the infants, but the metabolite was present at levels corresponding to 10% of the mothers' serum concentrations. Drug concentration was not measured in milk. No adverse effects were noted in the infants and their development over the first year appeared to be normal (2). The second study includes six breast-feeding women treated with 225-300 mg venlafaxine daily and their seven infants. The mean total drug exposure (venlafaxine and O-desmethylvenlafaxine) of the breast-fed infants was 6.4% (range 5.5-7.3%) of the mother's weight-adjusted dose. Venlafaxine could not be detected in the plasma of any infant, whereas low levels of O-desmethylvenlafaxine were detected in four out of the seven infants. No adverse effects were noted in the infants (3).

Conclusion

Venlafaxine and its pharmacologically active metabolite O-desmethylvenlafaxine are excreted into breast milk and have in a few studies been estimated to be 5-9% of the maternal weight-adjusted dose. No negative drug-related effects were noted in twelve infants breast-fed by mothers treated with venlafaxine. Based on present data venlafaxine seems to be compatible with breast-feeding. However, the infant should be carefully obseved for any undesirable effects and a normal development.

Annas A
Elwin CE

References

  1. Drugline no 16757 (year 2000)
  2. Hendrick V, Altshuler L, Wertheimer A, Dunn WA. Venlafaxine and breast-feeding. Am J Psychiatry 2001;158:2089-90.
  3. Ilett KF, Kristensen JH, Hackett LP, Paech M, Kohan R, Rampono J. Distribution of venlafaxine and its O-desmethyl metabolite in human milk and their effects in breastfed infants. Br J Clin Pharmacol 2002;53:17-22.

Senast ändrad 2018-09-20