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Sandomigran & Amitriptyline

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  • Sandomigran & Amitriptyline

    Hello all,

    I have had an inquiry from a 36 week pregnant mother who is taking the following medicines for migraines:

    Amitriptyline HCL TA 10mg (ACT) 1 tablet nocte
    Sandomigran 0.5mg (pizotifen) 2 tablets nocte.

    She has been taking them for about 2 years. Before this, she would have migraines on a daily basis.

    Are these medicines compatible with breastfeeding and is the combination of the two likely to have an effect on her newborn baby?



  • #2
    Hi, thanks for your post.

    There is not much information published about Sandomigran (pizotifen) or the related drug, cyproheptadine, in breastmilk. It is hard to say if this would be dangerous or not. Judging from the chemical properties of the drug, it is likely to be in the breastmilk in significant quantities, but unlikely to cause any real problems for a healthy infant. Sandomigran has anti-histamine and anti-cholinergic effects that may cause the baby to become sedated, constipated, or overheated. If the baby has problems that could be attributable to the medication, the first step would be to replace the night feedings with hydrolyzed formula in order to avoid the period of peak drug concentration in the milk.

    Amitriptyline is a very safe drug to use in breastfeeding women. Less than 3% of the mother's dose ends up in the milk and no side effects have been reported in babies exposed via milk. Amitriptyline + Sandomigran does not present any additional risk over the two components individually.

    For anyone reading this, please post again or call us at the InfantRisk Center, (806)352-2519, if this has not completely answered your question. I would also appreciate you filling out a 2 minute survey about your time on the forum:

    -James Abbey, MD