The amount of fluvoxamine in milk is unlikely to be a cause of adverse effects in breastfed infants.
The aim of this study was to characterize milk/plasma (M/P) ratio, as well as relative infant dose and well-being, in 2 breastfeeding women taking fluvoxamine. The women (37 and 34 years old) and their infants (26 and 0.75 months old) were studied over a 24-hour dose interval at steady state. Fluvoxamine concentrations were measured by high-performance liquid chromatography. Infant exposure was measured as concentration in milk multiplied by an estimated milk production of 0.15 L/kg/d and normalized to the weight-adjusted maternal dose. M/P values of 1.34 and 1.21 were calculated for subjects 1 and 2, respectively, and relative infant doses were estimated to be 1.38% and 0.8%, respectively. No adverse effects in the infants were detected by the mother or on clinical examination, and fluvoxamine was not detected in the infants' plasma (limit of detection 2 micrograms/L). These limited data support the prescription of fluvoxamine to breastfeeding mothers after a careful, individual risk/benefit analysis is undertaken.
Kristensen
Judith H
JH
Department of Pharmacy, King Edward Memorial and Princess Margaret Hospitals, Bagot Road, Subiaco 6008, Western Australia.
Hackett
L Peter
LP
Kohan
Rolland
R
Paech
Michael
M
Ilett
Kenneth F
KF
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000032:analysis / Q000493:pharmacokinetics*; D001942:Breast Feeding / Q000009:adverse effects; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D005260:Female; D016666:Fluvoxamine / Q000032:analysis / Q000493:pharmacokinetics*; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000378:metabolism*; D008297:Male; D008895:Milk, Human / Q000737:chemistry / Q000378:metabolism*
D018687:Antidepressive Agents, Second-Generation; D016666:Fluvoxamine