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My Dr. would like to start me on Venlafaxine but didn’t have much information on if it’s safe while breastfeeding- just looking for advice. Thanks!
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Dsalt:
Its fine. RID < 8%.
Tom Hale Ph.D.
In a study of 11 women consuming an average of 194.3 mg/day of venlafaxine, the theoretical infant dose of venlafaxine and desvenlafaxine was 0.208 mg/kg/day, or a relative infant dose of 8.1% of the maternal dose. The maximum level in milk occurred at 8 hours after maternal ingestion. Infant plasma levels for V + ODV were 37.1% of maternal levels. No adverse effects were noted in any of the infants.[2]
One woman receiving high dose venlafaxine (300 mg daily) in pregnancy (reduced to mono-therapy at 20 weeks) and lactation had an infant with signs of poor neonatal adaptation, poor feeding and failure to thrive at 1 month of age.[3] On day 3 of life the infant was thought to have seizure activity, uncoordinated suck and was easily fatigued. The infant had ongoing concerns with poor feeding (interruptions due to fatigue and distress) and poor weight gain. It should be noted that this infant was initially breastfed with additional formula given via a nasogastric tube. Once breast milk was stopped, the infant was noted to be more alert and demonstrated weight gain within 7 days. Thus the authors of this case report question if the ongoing breast milk exposure contributed to the poor weight gain and failure to thrive by 1 month of age or if these concerns should only be attributed to the poor neonatal adaptation from in-utero exposure.
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