Lithium Pregnancy and Breastfeeding Warnings

Lithium is also known as: Eskalith, Eskalith-CR, Lithium Carbonate ER, Lithobid, Lithonate, Lithotabs

Lithium Pregnancy Warnings

One retrospective study of 101 women concluded that rates of recurrence of bipolar disorder during the first 40 weeks after lithium discontinuation were similar for pregnant and nonpregnant women but then sharply increased postpartum.

Lithium has been assigned to pregnancy category D by the FDA. Use of lithium in the first trimester has been associated with congenital defects, particularly cardiac defects such as Ebstein's anomaly, although recent studies (including a prospective study of 148 women on lithium) have concluded that lithium is not a major human teratogen. Lithium toxicity (such as cyanosis, hypotonia, atrial flutter and bradycardia) has been reported in neonates whose mothers took lithium during pregnancy. There is no controlled data in human pregnancy. Lithium should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

Lithium Breastfeeding Warnings

Lithium toxicity in breast- fed infants, including cyanosis, electrocardiogram abnormalities, and hypotonia have also been reported. Some feel this toxicity may be due to the relatively immature kidney function in neonates and is especially likely to occur during times of dehydration. In a study involving 10 nursing mothers (mean lithium dose 850 mg/day; range 600 to 1200 mg/day), breast milk and maternal serum lithium concentrations averaged 0.35 meq/L and 0.76 meq/L, respectively, compared with a mean infant serum concentration of 0.16 meq/L. The breast milk/maternal serum and infant serum/breast milk lithium concentration ratios averaged 0.53 meq/L and 0.50 meq/L, respectively, and the infant/maternal serum lithium concentration ratio was 0.24 meq/L. There were no obvious adverse growth or developmental effects on the infants; however, several instances of elevated thyroid-stimulating hormone (TSH), blood urea nitrogen, and creatinine were reported.

Lithium is excreted into and accumulates in human milk. Lithium achieves serum levels in nursing infants which are one-third to one-half of therapeutic levels. Lithium is considered contraindicated during breast-feeding by the American Academy of Pediatrics (as well as by the manufacturer).

See Also...

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Wolters Kluwer Health and Drugs.com is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2008 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web5)