Sumatriptan use while Breastfeeding
Drugs containing Sumatriptan: Imitrex, Treximet, Zecuity, Onzetra Xsail, Imitrex Nasal, Sumavel DosePro, Imitrex Statdose, Zembrace SymTouch, Alsuma
Sumatriptan Levels and Effects while Breastfeeding
Summary of Use during Lactation
Because of the low levels of sumatriptan in breastmilk, amounts ingested by the infant are small. It also has poor oral bioavailability, further decreasing infant exposure to the drug. Some authors have suggested that withholding breastfeeding for 8 hours after a single subcutaneous injection would virtually eliminate infant exposure to the drug. This maneuver might be helpful in extreme cases, such as in the mother of a preterm infant, but sumatriptan would not be expected to cause any adverse effects in most breastfed infants. One anecdotal report of lactation ceasing after a single injection of sumatriptan has not been verified.
Maternal Levels. Five women who had been breastfeeding for 11 to 28 weeks received a single dose of sumatriptan 6 mg by subcutaneous injection. The peak milk level averaged 87.2 mcg/L (range 62 to 113 mcg/L) and it occurred 2.5 hours (range 1.7 to 3.5 hours) after the dose. The mean half-life in milk was 2.2 hours (range 1.2 to 3.1 hours). The authors calculated that an exclusively breastfed infant would receive 14.4 mcg in breastmilk with this dose, which is 3.5% of the weight-adjusted dosage.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One author reported correspondence with the drug's manufacturer stating that of 3 women known to the manufacturer who used sumatriptan (dose and route unspecified) during breastfeeding none reported adverse effects on the infants.
Effects on Lactation and Breastmilk
One author reported correspondence with the drug's manufacturer stating that 1 woman who used a single injection of sumatriptan (dose unspecified) during breastfeeding had a cessation of lactation.
Alternate Drugs to Consider
1. Wojnar-Horton RE, Hackett LP, Yapp P et al. Distribution and excretion of sumatriptan in human milk. Br J Clin Pharmacol. 1996;41:217-21. PMID: 8866921
2. Kristensen J. Sumatriptan and breastfeeding. Aust J Hosp Pharm. 1996;26:460. Letter.
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