Is reboxetine compatible with breast-feeding?
Reboxetine is a selective noradrenergic uptake inhibitor with a half-life of 13 hours and a bioavailability of at least 60% (1). It has a pKa of 8.34, a high plasma protein binding (97%) and a low lipophilicity (2).
There is only one published study, where transfer of reboxetine to breast milk has been investigated. Four mother-infant pairs were studied. The mothers had been treated with reboxetine a mean of 2.5 months, and the median single daily dose of reboxetine was 6 mg (range 4-10 mg). The mothers´ average maximum plasma concentration was 245 ug/l (range 181-330 ug/l), which is similar to previous reports and consistent with the dose. The mean milk/plasma ratio was only 0.06, and the total relative infant dose was in average 2% (range 1.4-2.5%) of the maternal weight-adjusted dose. Blood samples were taken from the four breastfed infants. In one of the infants reboxetine was undetectable, and in the other three the concentrations were 2.6 ug/l, 2.3 ug/l and 5 ug/l, respectively. None of the infants had any drug-related adverse effects (2).
Reboxetine is excreted into breast milk. Based on four cases, the total relative infant dose has been calculated to be 1.4-2-5% of the maternal weight-adjusted dose. No adverse effects have been observed. Based on these four cases, reboxetine seems to be compatible with breast-feeding. However, the infant should be observed for undesirable effects.
Senast ändrad 2018-09-20