Is Clozapine Safe in Breastfeeding
Question
I am a breastfeeding mother and i want to know if it is safe to use Clozapine? Is Clozapine safe for nursing mother and child? Does Clozapine extracts into breast milk? Does Clozapine has any long term or short term side effects on infants? Can Clozapine influence milk supply or can Clozapine decrease milk supply in lactating mothers?
Clozapine lactation summary
- DrLact safety Score for Clozapine is 3 out of 8 which is considered Low Risk as per our analyses.
- A safety Score of 3 indicates that usage of Clozapine may cause some minor side effects in breastfed baby.
- Our study of different scientific research indicates that Clozapine may cause moderate to no side effects in lactating mother.
- Most of scientific studies and research papers declaring usage of Clozapine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
- While using Clozapine We suggest monitoring 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.
Answer by Dr. Ru: About Clozapine usage in lactation
We are working on a comment for this product.
Answer by DrLact: About Clozapine usage in lactation
Because there is little published experience with clozapine during breastfeeding, and sedation and adverse hematologic effects have been reported in breastfed infants, other agents are preferred.[1] If breastfeeding is undertaken by a mother who is taking clozapine, close monitoring of the infant for excessive sedation and periodic monitoring of the infant's white blood cell count is advisable. Several authoritative sources recommend that women taking clozapine not breastfeed.[2][3][4]
Clozapine Side Effects in Breastfeeding
Among 4 infants who were breastfed by mothers taking clozapine, 1 infant experienced drowsiness and 1 infant experienced agranulocytosis possibly caused by clozapine. Details of the cases are lacking.[7] A healthy female infant was born to a mother who took clozapine 100 mg daily throughout pregnancy and lactation. She was breastfed (extent not stated) up to 1 year of age. The infant developed normally except for speech which was delayed considerably. She did not achieve normal, fluent speech until the age of 5 years. The delayed speech development was possibly related to clozapine in breastmilk, but it could have been the result of exposure to the drug during gestation or could have been unrelated to clozapine.[8] One woman who took clozapine 100 mg daily in late pregnancy and postpartum partially breastfed her infant for 5 days. No neurodevelopmental disorders were detected in the infant after 32 months of follow-up.[6]
Clozapine Possible Effects in Breastfeeding
Unlike the phenothiazines, clozapine has a minimal effect on maternal serum prolactin levels.[9][10] However, a woman who had been taking clozapine plus high-dose haloperidol developed hyperprolactinemia and severe galactorrhea 2 weeks after stopping haloperidol and 4 days after starting valproic acid. A dose of cabergoline normalized her serum prolactin and galactorrhea ceased for the following 2 months of observation.[11] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs
Thiothixene(Unsafe)
Thioridazine(Unsafe)
Risperidone(Safe)
Quetiapine(Safe)
Pimozide(Unsafe)
Perphenazine(Safe)
Olanzapine(Safe)
Flupenthixol(Safe)
Zuclopenthixol(Safe)
Mesoridazine(Unsafe)
Loxapine(Unsafe)
Haloperidol(Safe)
Asenapine(Low Risk)
Fluphenazine(Low Risk)
Droperidol(Low Risk)
Clozapine(Low Risk)
Paliperidone(Safe)
Chlorpromazine(Low Risk)
Sulpiride(Safe)
Aripiprazole(Low Risk)
Ziprasidone(Unsafe)
Trifluoperazine(Safe)