Zonisamide | Avpak Breastfeeding
Most health expert recommend six month of exclusive breastfeeding but statics suggest that numbers are not good, almost 95% mothers start breastfeeding but this number drops to 40% in first three month and further it drops to 15% till fifth month. Sometime its due to need of medication usage. Because of these statics its important to provide good information on safety of drugs in breastfeeding so that it can be improved when possible. In this FAQ sheet we will discuss about exposure to Zonisamide | Avpak while breastfeeding. We will also discuss about common side effects and warnings associated with Zonisamide | Avpak.

What is Zonisamide | Avpak used for?

Zonisamide capsules are indicated as adjunctive therapy in the treatment of partial seizures in adults with epilepsy.

Is Zonisamide | Avpak usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?

Zonisamide | Avpak low risk for breastfeeding
Zonisamide is the one and only active ingredient present in Zonisamide | Avpak. Zonisamide in itself is a low risk drug for lactation so it is easy to understand that Zonisamide | Avpak also comes in category of Low Risk item while breastfeeding. Below is the summary of Zonisamide in breastfeeding.

Statement of Manufacturer/Labeler about breastfeeding usage
Use in Nursing Mothers Zonisamide is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from zonisamide, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account the importance of the drug to the mother.

Zonisamide | Avpak Breastfeeding Analsys

Zonisamide while Breastfeeding

Low Risk

CAS Number: 68291-97-4

Zonisamide is excreted in breast milk in amounts that could be clinically significant, since the infant receives a relative dose well above 10% (Pack 2006, Crawford 2005, Tomson 2005, Shimoyama 1999, Kimura 1998). In spite of this high excretion in breast milk, infants who were breastfed by mothers taking zonisamide had no clinical problems (Shimoyama 1999) and their plasma zonisamide levels were only 15 to 17% of those measured in the mother (Kawada 2002, abstracts-P55 2011). Due to poor pharmacokinetics for breastfeeding with low protein binding and slow drug elimination (Jacob 2016) and the limited existing literature in relation to breastfeeding (Reimers 2014), it may be advisable to choose antiepileptics whose safety is better known (Hutchinson 2013, Davanzo 2013). If it is administered during breastfeeding, use the minimum effective dose (Reimers 2014) and monitor the infant's appetite, weight curve, psychomotor development, irritability, diarrhea, dehydration or acidosis, and it may be desirable to measure monthly plasma levels in the infant (Davanzo 2013, Pennell 2003). Some authors propose partial breastfeeding to decrease the dose that the infant receives through breast milk (Ando 2014).

Zonisamide | Avpak Breastfeeding Analsys - 2

Zonisamide while Breastfeeding

CAS Number: 68291-97-4

Zonisamide | Avpak and breastfeeding

Limited information indicates that maternal doses of zonisamide up to 400 mg daily produce high levels in milk and infant serum, but serum levels in neonates decrease during the first month of life while nursing. Although no adverse reactions have been reported in breastfed infants, the number of infants reported have been small. Alternative drugs are preferred, but if it must be given, monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger or exclusively breastfed infants and when using combinations of anticonvulsant drugs. Some clinicians recommend that mothers taking zonisamide only partially breastfeed in order to reduce the exposure of the infant to the drug and to consider monitoring infants' serum zonisamide concentrations.[1]

Zonisamide | Avpak safe for breastfeeding

What should I do if already breastfed my kid after using Zonisamide | Avpak?

Zonisamide | Avpak is in the category of low risk, if you have already used it then its not a big deal if health and behavior of baby is good. However your health care provider shall be aware of the fact that you have used Zonisamide | Avpak so you should inform him based on your convenience.

I am nursing mother and my doctor has suggested me to use Zonisamide | Avpak, is it safe?

Zonisamide | Avpak comes in category of low risk and if your doctor is aware that you are breastfeeding it should be ok to use without much concerns.

If I am using Zonisamide | Avpak, will my baby need extra monitoring?

Not much monitoring required while using Zonisamide | Avpak

Who can I talk to if I have questions about usage of Zonisamide | Avpak in breastfeeding?

National Womens Health and Breastfeeding Helpline: 800-994-9662 (TDD 888-220-5446) 9 a.m. and 6 p.m. ET, Monday through Friday

National Breastfeeding Helpline: 0300-100-0212 9.30am to 9.30pm, daily
Association of Breastfeeding Mothers: 0300-330-5453
La Leche League: 0345-120-2918
The Breastfeeding Network supporter line in Bengali and Sylheti: 0300-456-2421
National Childbirth Trust (NCT): 0300-330-0700

National Breastfeeding Helpline: 1800-686-268 24 hours a day, 7 days a week

Telehealth Ontario for breastfeeding: 1-866-797-0000 24 hours a day, 7 days a week