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

Milnacipran

February 27, 2014 (High Risk)

Serotonin and Norepinephrine selective re-uptake inhibitor. Authorized for treatment of Fibromyalgia in some countries. Frequent and potential severe side effects have been found. At usual dose it does not induce galactorrhea.

Latest update failed to find relevant data on breastfeeding.

Pharmacokinetic data (low serum protein binding and high bioavailability) indicates that drug excretion into breast milk in significant amount is highly probable. Absorption by the infant is likely to be high as well.

A known alternative would be preferred until more information on the drug is available.

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.

Synonyms

  • Midalcipran

Drug trade names

References

  1. Trenque T, Herlem E, Auriche P, Dramé M. Serotonin reuptake inhibitors and hyperprolactinaemia: a case/non-case study in the French pharmacovigilance database. Drug Saf. 2011Abstract
  2. EMeA Questions and answers on the recommendation for the refusal of the marketing authorisation for Milnacipran EMA 2009 Full text (in our servers)
  3. EMeA Preguntas y respuestas sobre la recomendación de denegar la autorización de comercialización de\ Milnacipran EMA 2009
  4. Puozzo C, Panconi E, Deprez D. Pharmacology and pharmacokinetics of milnacipran. Int Clin Psychopharmacol. 2002Abstract
  5. EmeA Milnacipran Ficha técnica 2000 Full text (in our servers)
  6. Puozzo C, Leonard BE. Pharmacokinetics of milnacipran in comparison with other antidepressants. Int Clin Psychopharmacol. 1996Abstract