Is Vonoprazan safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Vonoprazan. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A woman with peripartum cardiomyopathy and severe nonsustained ventricular tachycardia gave birth to twins. Vonoprazan 10 mg daily as well as amiodarone, bisoprolol, edoxaban, febuxostat, imidapril, and pitavastatin were started postpartum. Breastfeeding began 39 days after birth when the daily intake of breastmilk was 160 mL for the first infant and 120 mL for the second, smaller infant. Breastmilk was mixed with infant formula and accounted for approximately one-quarter of their total daily milk intake. The mother breastfed in infants for approximately two months after starting breastfeeding and the infants had no bleeding tendency. At 3 years of age, both infants had a tendency toward obesity, but no other complications or developmental delay.[ 3 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Concentrations of vonoprazan were measured in breastmilk from 15 healthy lactating women following administration of vonoprazan 20 mg once daily (n = 5) or twice daily (n = 10) for 4 days. With the 20 mg vonoprazan once daily regimen, an average peak milk concentration of 20.9 mcg/L occurred at 1.9 hours after the dose and the average concentration of vonoprazan in breastmilk was 7.55 mcg/L. The estimated mean daily infant dose was 0.4 mg/kg, representing 0.128% of the maternal weight-adjusted dose or RID. With the 20 mg twice daily dosage regimen, an average peak milk concentration of 24.7 mcg/L occurred at 1.9 hours after the dose and the average concentration of vonoprazan in breastmilk was 13.3 mcg/L. The estimated average total amount of vonoprazan present in breastmilk over 24 hours was 9 mcg. The estimated mean daily infant dose was 1.5 mcg/kg, representing 0.269% of the maternal weight-adjusted dosage or RID.[ 1 , 2 ] Infant Levels. Relevant published information was not found as of the revision date.
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.