Is Flupenthixol safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Flupenthixol. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A woman took flupenthixol 1 mg and nortriptyline 100 mg daily during pregnancy and flupenthixol 4 mg and nortriptyline 125 mg daily immediately postpartum. She exclusively breastfed her infant. Over a 4-month period, the infant showed no signs of adverse drug effects and had normal motor development with a maternal dosage of flupenthixol 2 mg daily and nortriptyline 75 mg daily.[ 3 ]
Effects on milk supply
Flupenthixol can increase serum prolactin and has caused galactorrhea.[ 4 - 8 ] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Levels in milk
Maternal Levels. Three women received the cis isomer of flupenthixol, cis-(z)-flupenthixol, during pregnancy and nursing; 2 of the women were receiving a depot injection. Milk cis-(z)-flupenthixol concentrations on days 4 and 41 postpartum from the woman receiving 40 mg every 2 weeks were 0.8 and 1.8 mcg/L, respectively. Milk cis-(z)-flupenthixol concentrations on day 17 postpartum from the woman receiving 60 mg every 3 weeks was 1.8 mcg/L. In the mother taking 2 mg of cis-(z)-flupenthixol orally every day, a milk concentration on day 30 postpartum was 1.8 mcg/L; however, the collection time was not stated.[ 2 ] One woman received flupenthixol during pregnancy and postpartum. She took a daily oral dose of 1 mg of flupenthixol during pregnancy and 4 mg daily starting on the first day postpartum. Milk samples were taken 7 times over 36 hours on days 6 and 7 postpartum. The highest milk flupenthixol level of 6.8 mcg/L occurred 4.5 hours after the dose, and the average of the milk levels was 2.8 mcg/L. Milk flupenthixol levels measured on day 20 postpartum at 2 hours after the dose averaged 2.2 mcg/L with a maternal dose of 3 mg daily. On day 48 postpartum, flupenthixol was undetectable ( 2 mcg/L) in milk 3.5 hours after a maternal dosage of 2 mg daily. Milk levels taken after feeding were much higher than those taken before feeding, probably because of higher concentrations in the more fat-rich hindmilk. The authors estimated that an exclusively breastfed infant would receive 0.4 mcg/kg daily or 0.6% of the maternal weight-adjusted dosage.[ 3 ] Infant Levels. A woman took flupenthixol 1 mg and nortriptyline 100 mg daily during pregnancy and flupenthixol 4 mg and nortriptyline 125 mg daily immediately postpartum. Her exclusively breastfed infant had flupenthixol serum concentrations of 0.2 mcg/L and 0.3 mcg/L on days 6 and 7 postpartum, respectively.[ 3 ]
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.