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

Haloperidol

April 17, 2016 (Very Low Risk)

It is excreted into breast milk in quite variable amounts that may be clinically significant, however, no clinical or developmental issues have been observed in infants whose mothers were treated with this drug.

In two out of four infants whose mothers took haloperidol and chlorpromazine simultaneously, showed decreased development scores between 12 and 18 months (Yoshida 1998).
On the other hand, no long-term developmental problems were observed in breastfed infants up to 12 months while the mother was taking Haloperidol and Olanzapine or Haloperidol and Amisulpride (Uguz 2015).

Haloperidol may induced an increase in prolactin release and can cause galactorrhea.

Alternatives

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.

Writings

  • هالوبيريدول (Arabic)
  • Галоперидол (Cyrillic)
  • 氟哌啶醇 (Chinese)
  • ハロペリドール (Japanese)
  • C21H23ClFNO2 (Molecular formula)

Drug trade names

References

  1. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016Abstract Full text (link to original source) Full text (in our servers)
  2. Uguz F. Breastfed Infants Exposed to Combined Antipsychotics: Two Case Reports. Am J Ther. 2015Abstract
  3. Parikh T, Goyal D, Scarff JR, Lippmann S. Antipsychotic drugs and safety concerns for breast-feeding infants. South Med J. 2014Abstract
  4. Klinger G, Stahl B, Fusar-Poli P, Merlob P. Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev. 2013Abstract
  5. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004Abstract
  6. Yasui-Furukori N, Kondo T, Suzuki A, Mihara K, Kaneko S. Comparison of prolactin concentrations between haloperidol and risperidone treatments in the same female patients with schizophrenia. Psychopharmacology (Berl). 2002Abstract
  7. Atmaca M, Kuloglu M, Tezcan E, Canatan H, Gecici O. Quetiapine is not associated with increase in prolactin secretion in contrast to haloperidol. Arch Med Res. 2002Abstract
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  9. Iqbal MM, Gundlapalli SP, Ryan WG, Ryals T, Passman TE. Effects of antimanic mood-stabilizing drugs on fetuses, neonates, and nursing infants. South Med J. 2001Abstract
  10. Tényi T, Csábi G, Trixler M. Antipsychotics and breast-feeding: a review of the literature. Paediatr Drugs. 2000Abstract
  11. Yoshida K, Smith B, Craggs M, Kumar R. Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol Med. 1998Abstract
  12. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993Abstract Full text (link to original source) Full text (in our servers)
  13. Froemming JS, Lam YW, Jann MW, Davis CM. Pharmacokinetics of haloperidol. Clin Pharmacokinet. 1989Abstract
  14. Kuniyoshi M, Inanaga K. Haloperidol and biperiden plasma levels in a pregnant atypical psychotic woman and a neonate--a case report. Kurume Med J. 1985Abstract
  15. Whalley LJ, Blain PG, Prime JK. Haloperidol secreted in breast milk. Br Med J (Clin Res Ed). 1981Abstract
  16. Stewart RB, Karas B, Springer PK. Haloperidol excretion in human milk. Am J Psychiatry. 1980Abstract
  17. Rao VA, Bishop M, Coppen A. Clinical state, plasma levels of haloperidol and prolactin: a correlation study in chronic schizophrenia. Br J Psychiatry. 1980Abstract
  18. Ananth J. Side effects in the neonate from psychotropic agents excreted through breast-feeding. Am J Psychiatry. 1978Abstract