Tweet
A mother receiving levetiracetam 1000mg BD and Topiramate 150mg BD is to nurse a 3 day old baby. How compatible is this medication combination with lactation?
-
-
Yomna88,
Levetiracetam is rated an L2-limited data-probably compatible. The amount that transfers into breast milk is 3.4-7.8% of moms dose. This medication is probably ok to breastfeed with especially if the mom took this during pregnancy since the infant is probably exposed to more in utero than through breast milk. Monitor for sedation or irritability, not waking to feed/poor feeding and weight gain.
Topiramate is rated an L3-limited data-probably compatible. The amount that transfers is 24.68-55.65% of moms dose. Monitor for sedation or irritability, not waking to feed/poor feeding, diarrhea and weight loss.
If this were the only anti-convulsant the mom was on, it would also probably be ok as the infant is probably exposed to more in utero than breast milk, however with both medications this becomes somewhat risky.
I spoke with Dr Hale he advised these medications together should be used with great caution. The combination could cause side effects in the infant, monitor for all side effects previously mentioned as well as a slowed breathing rate and apnea. If the infant is symptomatic we would recommend trying half breast milk and half formula.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519
Comment