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Mother with Efexor

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  • #1

    Mother with Efexor

    Hello!

    I have a mother who is breastfeeding 34+5 (now 36+0) born daughter. She has bipolar disorder and taking Efexor (venflaxasin) and Peratsin and Opamox. The mother is allowed to breastfeed but somehow it is uncertain whether we could encouradge her to exclusively bf or not. Our Neonatalogist is using Finnish database Lactbase which said that with venflaxasin babys dose is between 5,3-19,1% but no side effect for baby has not been proved.

    I would appreciete quick answer! :-)

    Warmly,
    Pia Ruohotie, RN, IBCLC from Finland
    Tags: None
  • #2
    Dear Pia,

    Efexor (venlafaxine) is a new serotonin reuptake inhibitor antidepressant. The RID(dose of drug infant receives through breastmilk) of Efexor is 6.8 to 8.1 % of mother's dose. The typical adult dose is 75 mg three times per day. The T max (time most concentrated in breastmilk) is 2.25 hours. The half-life is 5 hours which is how long it takes for half of the drug to be eliminated from the body. There have been no reports of adverse drug effects in infants via breastmilk.
    Peratsin (perphenazine) is a phenothiazine derivative The RID is 0.1 %. The typical dose 4 to 8 mg 2 to 3 times daily. The T max is 3 hrs and half-life is 8 to 20 hours. There have been no reported pediatric concerns via breastmilk but there is a risk of sedation; therefore, baby should be monitored closely for sedation. The rate of SIDS may be increased in infants exposed to phenothiazines.
    Opamox (oxazepam) is a typical benzodiazepine with a RID of 1 %. The typical dose is 10 to 30 mg 3 to 4 times daily. The T max is 1 to 2 hours. The half-life is 12 hours. Observe baby for sedation.
    If this mother was taking these medications during pregnancy, the baby would be at less risk for sedation than a drug naïve infant. Prematurity being combined with medications such as perphenazine may increase the risk of SIDS. The neonatologist may consider slowly increasing the amount of breastmilk the child receives after infant is term and monitor the baby closely for sedation. If you have further questions, please let me know.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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