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Anafranil and breastfeeding/pregnancy

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  • Anafranil and breastfeeding/pregnancy

    hello I’ve just been diagnosed with OCD and have been put on anafranil. I’m breastfeeding my daughter who is 14 mths old, but we do want to try to get pregnant again in the next 6 mths. I seem to have trouble metabolizing SSRI’s-I’ve trued lexapro and Zoloft. Is anafranil considered ok with breastfeeding and pregnancy? Thankyou

  • #2
    Mel1108,

    Anafranil (clomipramine) is rated an L2-limited data-probably compatible. The amount that transfers into breast milk is only 2.8% of your dose. "Clomipramine is a tricyclic antidepressant frequently used for obsessive-compulsive disorder. Levels in milk appear low. Plasma levels of clomipramine in the breastfed infants were below the limit of detection, suggesting minimal transfer to the infant via milk. No untoward effects were noted in any of the infants. (Medications and Mothers' Milk database, Dr Thomas Hale PhD). Monitor your infant for sedation or irritability, dry mouth, not waking to feed/poor feeding, constipation, urinary retention, weight gain.

    Anafranil (clomipramine) is rated a P3-unknown. "There are no adequate or well controlled studies in pregnant women. Withdrawal symptoms, including jitteriness, tremor, and seizures, have been reported in neonates whose mothers had taken clomipramine hydrochloride until delivery. Clomipramine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. No teratogenic effects were observed in studies performed in rats and mice at doses up to 100 mg/kg, which is 24 times the maximum recommended human daily dose (MRHD) on a mg/kg basis and 4 times (rats) and 2 times (mice) the MRHD on a mg/m2 basis. Slight nonspecific embryo/fetotoxic effects were seen in the offspring of treated rats given 50 and 100 mg/kg and of treated mice given 100 mg/kg." (Medications and Mothers' Milk database, Dr Thomas Hale PhD). In normal doses this medication is probably ok ( a normal dose is 50mg twice a day). The animal studies listed are very high doses with only a slight increase in nonspecific embryo/fetotoxic effects.

    Sandra Lovato R.N.
    InfantRisk Center

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