Is Lacosamide Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Lacosamide? Is Lacosamide safe for nursing mother and child? Does Lacosamide extracts into breast milk? Does Lacosamide has any long term or short term side effects on infants? Can Lacosamide influence milk supply or can Lacosamide decrease milk supply in lactating mothers?

• DrLact safety Score for Lacosamide is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Lacosamide may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Lacosamide may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Lacosamide .
• It is recommended to evaluate the advantage of not breastfeeding while using Lacosamide Vs not using Lacosamide And continue breastfeeding.
• While using Lacosamide Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
• Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Antiepileptic drug which is not considered by the FDA and EMA an indication for treatment of neuropathic pain for lack of definite proof. At latest update, relevant data on its excretion into breast milk were not found. Because of its pharmacokinetics, excretion into breast milk in significant amount is likely. Until more information on this drug is available, other options that are known to be safer are recommended, especially when the baby is a newborn or a premature.

Limited information indicates that a maternal dose of 200 mg daily produce low levels in milk. Dosages up to 400 mg daily appeared to not adversely affect development in 3 infants who were breastfed for 7 to 9 months. Until more data are available lacosamide should only be used with careful monitoring during breastfeeding, especially while nursing a newborn or preterm infant. The manufacturer recommends that breastfeeding be discontinued during lacosamide therapy.

A pregnant woman suffered blood clots in the sinuses and 2 small intracranial hemorrhages followed by status epilepticus at 8 weeks of gestation. She was treated with levetiracetam 1000 mg and lacosamide 100 mg twice daily as well as enoxaparin and labetalol for the rest of her pregnancy and postpartum. Her infant was delivered at 36 weeks gestation and about 50% breastfed for the first days of life. The infant was sleepy and fed poorly, but pauses in breastfeeding did not improve the infant's condition. Breastfeeding was discontinued at 15 days postpartum and the infant gradually improved. The infant showed normal development at 7 months of age.[1] Lacosamide and levetiracetam were probably the cause of the infant's sedation and poor feeding. One center reported 3 mothers with epilepsy who took lacosamide while breastfeeding their infants. The extent of breastfeeding was not clearly stated, but one woman only partially breastfed her infant. The first mother took levetiracetam 2000 mg daily plus lacosamide 200 mg twice daily and breastfed her infant for 7 months with no infant adverse effects at 24 months of age. The second mother took lacosamide 300 mg daily and partially breastfed her infant for 8 months with normal developmental milestones at 6, 12 and 18 months of age. The third mother took lacosamide 400 mg daily and breastfed for 9 months without any feeding or alertness problems and no cognitive alterations or developmental delays at 36 months of age.[3]