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

Paliperidone

July 2, 2015 (Very Low Risk)

Risperidone and its metabolite (Paliperidone) are excreted into breast milk in non-significant amount. Untoward effect has not been observed on breastfed infants of treated mothers. Serum levels were very low or undetectable in these infants.

May be a cause of galactorrhea.

Thera are two types of Paliperidone: oral and intramuscular (Depo). Depo type (Paliperidone Palmitate) requires intramuscular administration with a Time to Max of 13 days and a Half-time of 25 to 50 days. That would be a reason to use during breastfeeding a non-depot (oral) medication like Risperidone or any suggested alternative, as a safer choice.

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

  • 9-Hidroxyrisperidone
  • RO-76477

Writings

  • باليبيريدون (Arabic)
  • Палиперидон (Cyrillic)
  • 帕利哌酮 (Chinese)
  • パリペリドン (Japanese)

Drug trade names

References

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  2. Weggelaar NM, Keijer WJ, Janssen PK. A case report of risperidone distribution and excretion into human milk: how to give good advice if you have not enough data available. J Clin Psychopharmacol. 2011Abstract
  3. Parashar A, Varma A, Sharp B. Risperidone as galactagogue? J Hum Lact. 2007Abstract
  4. Aichhorn W, Stuppaeck C, Whitworth AB. Risperidone and breast-feeding. J Psychopharmacol. 2005Abstract
  5. Curtis V. Women are not the same as men: specific clinical issues for female patients with bipolar disorder. Bipolar Disord. 2005Abstract
  6. Ilett KF, Hackett LP, Kristensen JH, Vaddadi KS, Gardiner SJ, Begg EJ. Transfer of risperidone and 9-hydroxyrisperidone into human milk. Ann Pharmacother. 2004Abstract
  7. Gentile S. Clinical utilization of atypical antipsychotics in pregnancy and lactation. Ann Pharmacother. 2004Abstract
  8. Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs. 2004Abstract
  9. Ratnayake T, Libretto SE. No complications with risperidone treatment before and throughout pregnancy and during the nursing period. J Clin Psychiatry. 2002Abstract
  10. Hill RC, McIvor RJ, Wojnar-Horton RE, Hackett LP, Ilett KF. Risperidone distribution and excretion into human milk: case report and estimated infant exposure during breast-feeding. J Clin Psychopharmacol. 2000Abstract
  11. Kearns AE, Goff DC, Hayden DL, Daniels GH. Risperidone-associated hyperprolactinemia. Endocr Pract. 2000Abstract
  12. Kleinberg DL, Davis JM, de Coster R, Van Baelen B, Brecher M. Prolactin levels and adverse events in patients treated with risperidone. J Clin Psychopharmacol. 1999Abstract
  13. Popli A, Gupta S, Rangwani SR. Risperidone-induced galactorrhea associated with a prolactin elevation. Ann Clin Psychiatry. 1998Abstract