Is Zolpidem safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Zolpidem. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
The mother of a newborn was taking 5 to 10 mg of zolpidem nightly. At the one-month checkup, no adverse effects were noted by the patient s pediatrician.[ 3 ] Three infants were breastfed by mothers taking zolpidem 5 mg daily (n = 2) or as needed (n = 1). No abnormalities were found at the one-month checkup.[ 4 ] An infant was partially breastfed by a mother taking zolpidem 5 mg daily and bromazepam 6 mg daily. No abnormalities were found at the infant s 1-month and the 3-month checkups.[ 5 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Five nursing mothers who were 3 to 4 days postpartum were given a single oral dose of zolpidem 20 mg. Milk collected 3 hours after the dose contained between 0.76 and 3.88 mcg of zolpidem. This corresponded to 0.004 to 0.019% of the maternal dosage. The drug was undetectable ( 0.5 mcg/L) in milk 13 and 16 hours after the dose. The authors estimated the half-life in milk to average 2.6 hours.[ 2 ] A woman was taking zolpidem 5 mg nightly for sleep. Breastmilk concentrations were measured at 3 times postpartum: day 1 at 8.2 hours after a dose the concentration was 12.8 mcg/L; day 2 at 9 hours after the dose the concentration was 6.4 mcg/L; day 3 at 2.2 hours after the dose the concentration was 26.5 mcg/L. The authors estimated the maximum infant dose to be 4 mcg/kg daily based on the day 3 value.[ 3 ] Two pregnant women took zolpidem 5 mg doses daily during pregnancy and postpartum. One woman had a breastmilk zolpidem concentration of 10.1 mcg/L at 6.5 hours after a dose on day 6 postpartum. The other woman had milk zolpidem concentrations ranging from 0.6 mcg/L mcg/L at 18.1 hours after a dose on day 2 postpartum to 4.8 mcg/L at 10.1 hours after a dose on day 3 postpartum. A third woman who took a 5 mg dose as needed had a milk level of 3.4 mcg/L at 17.2 hours after a dose on day 1 postpartum. On day 7, 105 hours after a dose, zolpidem was undetectable in milk.[ 4 ] A woman taking zolpidem 5 mg daily provided 3 milk samples on day 6 postpartum at 35.7 to 69.8 hours after the last dose. Milk zolpidem concentrations were all 0.1 mcg/L.[ 5 ] Infant Levels. Three infants were breastfed by mothers taking zolpidem 5 mg daily (n = 2) or as needed (n = 1). The infants were breastfed 4 to 6 times daily. All of the infants had undetectable ( 0.05 mcg/L) serum levels of zolpidem.[ 4 ] An infant was partially breastfed by a mother taking zolpidem 5 mg daily. A serum concentration of 20 mcg/L at 5.8 hours after the dose on day 1 postpartum probably reflects tran
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.