Frågedatum: 2002-12-19
RELIS database 2002; id.nr. 19306, DRUGLINE
www.svelic.se
Utredningen som riktar sig till hälso- och sjukvårdspersonal, har utformats utefter tillgänglig litteratur och resurser vid tidpunkten för utredning. Innehållet i utredningen uppdateras inte. Hälso- och sjukvårdspersonal är ansvarig för hur de använder informationen vid rådgivning eller behandling av patienter.


Is olanzapine compatible with breast-feeding?



Fråga: Is olanzapine compatible with breast-feeding?

Sammanfattning: Olanzapine is excreted in the milk of lactating rats, but data on excretion in human breast milk is lacking. Three reports on breast-fed infants to mothers treated with olanzapine have been located in the literature. None of the reports indicates a risk for lactational exposure. However, due to limited data, olanzapine should, if possible be avoided, during lactation.

Svar: Data on excretion of olanzapine in human breast milk is lacking, but the drug has been reported to be excreted in the milk of lactating rats (1,2).

Three case reports describing infants whose mothers were treated with olanzapine during breast-feeding has been found in the literature. No adverse effects were noted in the infants. The concentration of olanzapine in breast milk was not measured in any case. In one case, the mother was treated with olanzapine (10 mg daily) from the 18th gestational week until delivery and during breast-feeding. After delivery, the plasma concentration of olanzapine in the infant were one third of the maternal plasma level, and during breast-feeding, it decreased to an undetectable level (2). The other reports describe one infant exposed at two months when the mother began treatment with olanzapine (10 mg daily) and another infant whose mother was treated with olanzapine (5 mg daily) during pregnancy and 6 days breast-feeding. The latter infant suffered from cardiomegaly, jaundice, somnolence, and heart murmur. Bottle-feeding was initiated on the seventh day, but the jaundice and sedation continued, suggesting a lack of relationship to exposure of olanzapine with the breast milk (3).

Although none of the reports indicates a risk for lactation exposure to olanzapine, breast-feeding could not be recommended until more data are available. Potential harm of infant lactation exposure to drugs should always be weighted against the need of treating the mother and the advantages with breast-feeding in every single case.

Referenser: