Is Bivaracetam safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Bivaracetam. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Three infants, including one pair of twins, were breastfed while their mothers were taking brivaracetam. The twins were partially breastfed twice daily by a mother taking only brivaracetam and the other infant was exclusively breastfed by a mother taking brivaracetam, lacosamide and perampanel for 6 weeks, then partially breastfed. None of the infants exhibited reduced wakefulness or feeding problems. At one year of age, the mothers reported normal development.[ 1 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
In published reports of anticonvulsant use during breastfeeding, most women were taking a combination of anticonvulsants. Some other anticonvulsants (e.g., phenytoin, carbamazepine) stimulate the metabolism of other drugs including anticonvulsants, whereas others (e.g., valproic acid) inhibit the metabolism of other drugs. Therefore, the relationship of the maternal dosage to the concentration in breastmilk can be quite variable, making calculation of the weight-adjusted percentage of maternal dosage less meaningful than for other drugs in this database. Maternal Levels. Two mothers with seizure disorders were reported in one paper. The first mother was taking brivaracetam 75 mg twice daily during pregnancy and breastfeeding. On day 5 postpartum, 12 hours after her prior dose, her milk brivaracetam levels were 3.6 micromoles/L (764 mcg/L) in foremilk and 3.2 micromoles/L (679 mcg/L) in hindmilk. On week 3 postpartum, 12 hours after her prior dose, her milk brivaracetam levels were 3.4 (722 mcg/L) micromoles/L in foremilk and 3.2 micromoles/L (679 mcg/L) in hindmilk. A second mother was taking brivaracetam 100 mg twice daily. The second mother was taking brivaracetam 100 mg twice daily as well as lacosamide 200 mg twice daily, and perampanel 8 mg daily. Her milk brivaracetam levels were 5 micromoles/L (1.06 mg/L) on day 5 postpartum 12 hours after the previous dose and 4.5 micromoles/L (955 mcg/L) on week 5 postpartum 13 hours after the previous dose.[ 1 ] Infant Levels. Three infants were breastfed by mothers taking brivaracetam during pregnancy and breastfeeding. One pair of twins had umbilical cord concentrations of 4.1 and 4.2 micromoles/L (870 and 892 mcg/L) at birth, one hour after that previous maternal dose of 75 mg (taken twice daily), but both infants, who were partially breastfed twice daily had undetectable ( 0.47 micromoles/L; 100 mcg/L) serum concentrations at 5 days and 3 weeks postpartum. The second mother was taking brivaracetam 100 mg twice daily as
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.