Is Gabapentin compatible with breastfeeding? Do we have alternatives for Gabapentin?

Gabapentin

September 27, 2015 (Very Low Risk)

Antiepileptic drug that is also used in the treatment of neuropathic pain and Restless Leg Syndrome.

It is excreted into breast milk in clinically non-significant amount. No problem was observed in infants whose mothers were on this medication.
Plasma levels in those infants were undetectable or very low.

Alternatives

We do not have alternatives for Gabapentin since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Gabapentin Enacarbil

Writings

  • Γκαμπαπεντίνη (Greek)
  • Габапентин (Cyrillic)
  • 加巴喷丁 (Chinese)
  • ガバペンチン (Japanese)
  • C9 H17 NO2 (Molecular formula)

References

  1. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeeding Medicine. 2017 Full text (link to original source) Full text (in our servers)
  2. Jacob S, Nair AB. An Updated Overview on Therapeutic Drug Monitoring of Recent Antiepileptic Drugs. Drugs R D. 2016Abstract Full text (link to original source) Full text (in our servers)
  3. Grover S, Avasthi A. Mood stabilizers in pregnancy and lactation. Indian J Psychiatry. 2015Abstract Full text (link to original source) Full text (in our servers)
  4. Nofal WH, Mahmoud MS, Al Alim AA. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia? Saudi J Anaesth. 2014Abstract
  5. Pfizer. Gabapentin. Drug Summary. 2014 Full text (in our servers)
  6. Reimers A. New antiepileptic drugs and women. Seizure. 2014Abstract Full text (link to original source) Full text (in our servers)
  7. Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr. 2013Abstract Full text (link to original source) Full text (in our servers)
  8. Rapcencu AE, Lindhout D, Bulk S. Frequently asked questions on epilepsy, pregnancy and lactation: a EURAP-NL report. Seizure. 2012Abstract Full text (link to original source) Full text (in our servers)
  9. Short J, Downey K, Bernstein P, Shah V, Carvalho JC. A single preoperative dose of gabapentin does not improve postcesarean delivery pain management: a randomized, double-blind, placebo-controlled dose-finding trial. Anesth Analg. 2012Abstract
  10. Mercadé Cerdá JM, Sancho Rieger J, Mauri Llerda JA, López González FJ,Salas Puig X. Guías diagnósticas y terapéuticas de la Sociedad Española de Neurología 2012. 1. Guía oficial de práctica clínica en epilepsia. Guías SEN 2012 Full text (in our servers)
  11. Moore A, Costello J, Wieczorek P, Shah V, Taddio A, Carvalho JC. Gabapentin improves postcesarean delivery pain management: a randomized, placebo-controlled trial. Anesth Analg. 2011Abstract
  12. Harden CL, Pennell PB, Koppel BS, Hovinga CA, Gidal B, Meador KJ, Hopp J, Ting TY, Hauser WA, Thurman D, Kaplan PW, Robinson JN, French JA, Wiebe S, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Shafer PO, Le Guen C; American Academy of Neurology; et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of... Neurology. 2009Abstract Full text (link to original source) Full text (in our servers)
  13. AEMPS. Gabapentina. Ficha técnica. 2007 Full text (in our servers)
  14. Kristensen JH, Ilett KF, Hackett LP, Kohan R. Gabapentin and breastfeeding: a case report. J Hum Lact. 2006Abstract
  15. Pack AM. Therapy insight: clinical management of pregnant women with epilepsy. Nat Clin Pract Neurol. 2006Abstract
  16. Johannessen SI, Helde G, Brodtkorb E. Levetiracetam concentrations in serum and in breast milk at birth and during lactation. Epilepsia. 2005Abstract Full text (link to original source) Full text (in our servers)
  17. Tomson T. Gender aspects of pharmacokinetics of new and old AEDs: pregnancy and breast-feeding. Ther Drug Monit. 2005Abstract
  18. Ohman I, Vitols S, Tomson T. Pharmacokinetics of gabapentin during delivery, in the neonatal period, and lactation: does a fetal accumulation occur during pregnancy? Epilepsia. 2005Abstract Full text (link to original source) Full text (in our servers)
  19. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004Abstract
  20. Bar-Oz B, Nulman I, Koren G, Ito S. Anticonvulsants and breast feeding: a critical review. Paediatr Drugs. 2000Abstract