Is Oxcarbazepine Safe in Breastfeeding

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

A derivative of carbamazepine with a very similar chemical structure and therapeutic action. It is rapidly and extensively metabolised to licarbazepine (MHD), its active metabolite. It is excreted in breast milk in clinically insignificant amounts (Lutz 2007, Bulau 1988) and no problems have been observed in infants whose mothers have taken it (Lutz 2007, Tomson 2007, Eisenschenk 2006, Gentile 2003, Bulau 1988). Plasma levels in these infants were very low, less than 5% of maternal plasma levels (Öhman 2009, Lutz 2007). Carbamazepine (see specific information) is considered compatible with breastfeeding by the American Academy of Pediatrics (AAP 2001) and thus appears on the list of WHO essential medicines (WHO/UNICEF 2002). Given the proven benefits of breastfeeding and despite the fact that there is a lack of reports on the safety of oxcarbazepine, several expert authors consider it safe to take during breastfeeding (Uguz 2016, Reimers 2014, Davanzo 2013, Bar-Oz 2000). Furthermore, as an integral and important part of the experience of motherhood, the American Academy of Neurology and the American Academy of Pediatrics advise that mothers undergoing anti-epileptic treatment can breastfeed (Pack 2006). Plasma levels of oxcarbazepine and its metabolite MHD decrease slightly during pregnancy and increase significantly in the immediate postpartum period. Therefore, close monitoring of these levels is required to adjust the dosage of the drug (Mazzucchelli 2006) See below the information of these related products:

Limited information indicates that oxcarbazepine would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsants.

Two infants were born to mothers who were taking oxcarbazepine (dosage not stated) during pregnancy and postpartum. One infant was breastfed for 1 week and the other for at least 4.5 months (extent not stated). Both infants developed normally.[1] One infant was breastfed (extent not stated) from day 3 to at least 6 months of age during maternal therapy with oxcarbazepine 300 mg 3 times daily. Examination of the infant at 13 months of age indicated normal development with no signs of mental retardation or neurologic deficit.[2] An epileptic woman took oxcarbazepine 600 mg twice daily throughout pregnancy and lactation. Her breastfed infant developed normally during the first 4 months of breastfeeding.[6] A woman took oxcarbazepine monotherapy throughout pregnancy and postpartum for complex partial seizures. She breastfed her infant with some formula supplementation (extent not stated) for 6 months while taking a an oxcarbazepine dosage of 900 mg twice daily. Her infant achieved all developmental milestones for the first 3 years of life.[7] An infant was breastfed (extent not stated) for 18 weeks by a mother who took oxcarbazepine 300 mg every 12 hours (9 mg/kg) during pregnancy and postpartum. At 23 days of age, liver function tests were normal. No adverse drug effects or developmental delay were seen up to age 5 years.[3] No adverse effects were reported in 10 newborns who were 4 to 23 days old who were breastfed during maternal intake of levetiracetam 1000 to 3000 mg daily. One mother was also taking tiagabine 30 mg daily, clobazam 45 mg daily and oxcarbazepine 600 mg daily.[8] An infant was born to a mother taking oxcarbazepine 150 mg twice daily during pregnancy and postpartum. About 12 hours after birth, the infant developed increased excitability, irritability, limb shaking, and increased muscle tone, which occurred every few minutes. The infant was allowed to breastfeed and excitability and muscle tension appeared to be lessened somewhat after feeding, but the increased muscle tone was not improved by day 7.[4]