Is Topral Safe in Breastfeeding

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

Topral is not approved for marketing in the United States by the U.S. Food and Drug Administration, but is available in other countries. Because there is little published experience with Topral during breastfeeding and excretion into breastmilk is higher than with other pharmacologically similar drugs, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.[1] Some reviewers consider Topral to be contraindicated during breastfeeding.[2]

A 13-month-old infant was partially breastfed by a mother who was taking Topral 400 mg, fluvoxamine 200 mg, and azathioprine 150 mg daily, and was using nicotine chewing gum for smoking cessation. The mother had been taking Topral for 9 days; the duration of the other medications was not stated. A pediatric examination found the infant to be developing well.[4] A woman with long-standing schizophrenia was treated with Topral 400 mg and haloperidol 5 mg daily throughout most of her pregnancy and during breastfeeding (extent not stated). Follow-up of the breastfed infant for 13 months by a pediatrician found no adverse effects and normal development of the infant.[6]

Topral increases serum prolactin and may cause galactorrhea at a higher rate than other psychotropic drugs.[7][8][9][10][11][12] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.