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Gabapentin can be used during breastfeeding, but there are important considerations and potential risks to be aware of. Here’s a breakdown of the guidelines and warnings for breastfeeding mothers taking gabapentin: 1. Gabapentin Transfer to Breast Milk. Gabapentin does pass into breast milk, but typically in low concentrations. An infant whose mother was taking gabapentin 36.7 mg/kg daily breastfed her infant 6 to 7 times daily for most of the first 1.6 months of life with some additional artificial feeding at night. The mother was also taking amitriptyline 2.5 mg daily. An infant whose mother was taking gabapentin 36.7 mg/kg daily breastfed her infant 6 to 7 times daily for most of the first 1.6 months of life with some additional artificial feeding at night. The mother was also taking amitriptyline 2.5 mg daily. Gabapentinand breastfeeding. gabapentin is considered compatible with breastfeeding, but should be used with caution and infant monitoring (1) published evidence for the use of gabapentin during breastfeeding is very limited. Data is from 10 mothers using gabapentin doses up to 2.1g daily Even if an AED can be safely taken by the breastfeeding mother, it is a good clinical practice to call the mother attention on the behavior, sleep, feeding patterns and growth of the nursing infant, especially in the first 2 months of life . When possible, we might advice to monitor the infant plasma levels, especially for the moderately safe AEDs. Background: The benefits of breastfeeding for both mother and infant are well documented. The World Health Organization recommends exclusive breastfeeding for the first four to six months of life Kaufman KR, Struck PJ. Gabapentin-induced sexual dysfunction. Epilepsy Behav. 2011;21(3):324-6. Kristensen JH, Ilett KF, Hackett LP, et al. Gabapentin and breastfeeding: A case report. J Hum Lact. 2006;22:426–8. Loudin, S, et al. (2017). An Atypical Withdrawal Syndrome in Neonates Prenatally Exposed to Gabapentin and Opioids. Nursing Considerations for Gabapentin. When administering or caring for patients taking gabapentin, nurses should consider several important factors. Nursing Assessment. 1. Assess the patient’s medical history, including any known allergies, previous adverse reactions to gabapentin or similar medications, and relevant medical conditions. Gabapentin is a medication that has been used to prevent and control partial seizures, treat some forms of nerve pain, and treat moderate-to-severe restless legs syndrome. Some brand names are Horizant®, Gralise® and Neurontin®. In one study of nine mothers taking primidone, their infants' phenobarbital plasma levels were 37% of their mothers' plasma levels. Both of these drugs have caused sedation and poor nursing in breastfed infants. Neonatal withdrawal syndromes including convulsions have also been reported after abrupt discontinuation of breastfeeding. A single oral dose of either 300 mg or 600 mg given to the mother before cesarean section appeared to have no effect on breastfeeding initiation.[1] An expert consensus guideline indicates that gabapentin is an acceptable choice for refractory restless leg syndrome during lactation.[2] The aim of this study was to describe the milk-plasma ratio and relative infant dose of gabapentin in a breastfeeding mother and to determine the well-being of her exposed infant. The mother-infant pair was studied over a 24-hour dose interval at steady state. Gabapentinand breastfeeding. gabapentin is considered compatible with breastfeeding, but should be used with caution and infant monitoring (1) published evidence for the use of gabapentin during breastfeeding is very limited. Data is from 10 mothers using gabapentin doses up to 2.1g daily Gabapentin is an anticonvulsant used in the prevention of partial seizures. It is frequently used for neuropathic pain including diabetic neuropathy, radiculopathy, shingles, and trigeminal neuralgia. Gabapentin is considered compatible with breastfeeding, but should be used with caution and infant monitoring. Published evidence for the use of gabapentin during breastfeeding is very limited. Data is from 10 mothers using gabapentin doses up to 2.1g daily. pain are amitriptyline, gabapentin and pregabalin. Amitriptyline Amitriptyline has been used for many years even in breastfeeding women as an antidepressant as well as to treat neuropathic pain. Mothers taking amitriptyline should be counselled to take care with co-sleeping as their natural responses will be altered. -Some authorities suggest discontinuing nursing or discontinuing use of this drug while breastfeeding due to the potential for serious adverse reactions in the breastfed infant. With maternal doses up to 2.1 g/day, estimated doses for fully breastfed infants are 0.2 to 1.3 mg/kg/day (equivalent to 1.3 to 3.8% of the maternal weight-adjusted dose). Patient Teaching Associated with Gabapentin. Take gabapentin exactly as prescribed, at evenly spaced intervals. Do not stop taking gabapentin abruptly; gradual discontinuation is required. Avoid alcohol while taking gabapentin. Take antacids at least 2 hours apart from gabapentin. Report any unusual changes in mood or thoughts of self-harm. This sheet is about exposure to gabapentin in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider. Generic Name: gabapentin. Brand Name: Apo-Gabapentin (CAN), Gen-Gabapentin (CAN), Neurontin. Classification: Antiepileptic. Pregnancy Category C. Dosage & Route. Available forms : Capsules—100, 300, 400 mg; tablets—100, 300, 400, 600, 800 mg; oral solution—250 mg/5 mL. ADULTS. Epilepsy: Starting dose is 300 mg PO tid, then titrated up as
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