Maprotiline use while Breastfeeding
Drugs containing Maprotiline: Ludiomil
Maprotiline Levels and Effects while Breastfeeding
Summary of Use during Lactation
If maprotiline is required by the mother, it is not a reason to discontinue breastfeeding. However, because there is little published experience with maprotiline during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
Maternal Levels. Milk maprotiline levels after a single oral dose of 100 mg have been reported to have a peak milk level at about 8 hours after a dose at about 110 mcg/L. During a regimen of 50 mg orally three times daily, milk levels of 180-260 mcg/L were reported at unstated times after various doses. Details of the above manufacturer's studies were not reported.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Although it is structurally a tetracyclic compound, maprotiline has pharmacologic actions similar to the tricyclic antidepressants.
Follow-up for 1 to 3 years in a group of 20 breastfed infants whose mothers were taking a tricyclic antidepressant found no adverse effects on growth and development. Two small controlled studies indicate that other tricyclic antidepressants have no adverse effect on infant development.
In another study, 25 infants whose mothers took a tricyclic antidepressant during pregnancy and lactation were tested formally between 15 to 71 months and found to have normal growth and development. One of the mothers was taking maprotiline.
Effects on Lactation and Breastmilk
Maprotiline has caused increased prolactin levels and galactorrhea in nonpregnant, nonnursing patients. The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs to Consider
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Adrenergic Uptake Inhibitors
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