Data from two women indicate that amounts of suvorexant in milk are very low. If suvorexant is required by the mother, it is not a reason to discontinue breastfeeding. If suvorexant is used, monitor the infant for sedation, especially if the infant is a newborn or preterm. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Drug Levels
Maternal Levels. Two women were taking suvorexant 20 mg at night. They provided milk samples “a few days” after delivery. One woman provided a sample before a dose and 70 minutes after a dose. The concentrations in those samples were 1.36 and 2.85 mcg/L. The second woman provided samples a few days and one month after delivery taken at unknown times the day after taking the drug. The milk concentrations were 3.47 and 4.09 mcg/L, respectively. The authors estimated the relative infant dosages to be 0.17 and 0.2% in the two women, respectively.[1]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Ishikawa H, Furugen A, Nishimura A, et al. Validated UPLC-MS/MS method for quantification of melatonin receptor agonists and dual orexin receptor antagonists in human plasma and breast milk: Application to quantify suvorexant and lemborexant in clinical samples. J Pharm Biomed Anal 2024;251:116432. [PubMed: 39180895]
Substance Identification
Substance Name
Suvorexant
CAS Registry Number
1030377-33-3
Drug Class
Breast Feeding
Lactation
Milk, Human
Hypnotics and Sedatives
Orexin Receptor Antagonists
Sleep Aids, Pharmaceutical
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