Is Dichloralphenazone safe while breastfeeding?

Effects on the breastfed infant

Minimal morning sedation occurred in a 5-month-old breastfed infant whose mother was taking 1.3 grams of dichloralphenazone (equivalent to about 1 gram of chloral hydrate) every evening plus chlorpromazine 100 mg 3 times daily. The infant's overall development was said to be normal at 3 months of age.[ 3 ]

Effects on milk supply

Relevant published information was not found as of the revision date.

Levels in milk

Dichloralphenazone is a chemical combination of chloral hydrate (64%) and antipyrine (36%). Maternal Levels. After 1.3 grams of dichloralphenazone (equivalent to about 830 mg of chloral hydrate) daily in a woman who was 5 months postpartum, milk trichloroethanol levels were found to range from 1.3 to 3.2 mg/L.[ 3 ] Antipyrine was given to 7 lactating women were 2 to 19 months postpartum. Each woman drank a single oral dose of 18 mg/kg of antipyrine in solution. Peak milk levels usually occurred 10 minutes after ingestion and ranged from about 10 to 30 mg/L. The antipyrine half-life in milk averaged 11.6 hours (range 5.7 to 21.7 hours). The authors estimated that a fully breastfed infant would ingest 6.4 mg of antipyrine after this maternal dose or 0.59% of the maternal dose (not weight-adjusted). Two of the women who were studied before and after pregnancy indicated that antipyrine clearance might be increased by about two-fold during lactation.[ 1 ] The time course of antipyrine appearance in milk is probably slower than above from dichloralphenazone in a tablet formulation. Infant Levels. After a 1.3 gram maternal dose of dichloralphenazone (equivalent to about 1 gram of chloral hydrate), trichloroethanol was detected in her 5-month-old breastfed infant's plasma 21 hours later.[ 3 ]

Alternatives LactMed lists

• Eletriptan
• Rizatriptan
• Sumatriptan
• Zolmitriptan