Abilify

[Pia R]

Hello!


We are looking for information about Abilify i.e. aripipratsole in Europe (one of the "newer" antipsychotic medicines). The mother is using Abilify 15 mg x 1 and the pediatricians and our national Medicines and breastfeeding service is saying that partial breastfeeding is possible. I checked the evidence about pharmacocinetics of arpipratsole and it seems to be 99% binding in plasma proteins so very little of it probably enters in mother?s milk. The baby is actually twins, now weeks 32+, the c-section is probably 36+.

The LactBase says, that there is none research about it?s actual amount in breastmilk. Do You have any further info about this medicine?

Sincerely,
Pia Ruohote, IBCLC
Helsinki University Hospital

[admin]

Pia:

We have one study.


In a small study of a single patient receiving 10 mg/day initially and then 15 mg subsequently, levels of aripiprazole in milk were reported to be 13 and 14 ?g/L on two consecutive days (15 and 16 after initiation of therapy). Maternal plasma levels at the same time were 71 and 71 ?g/L. Levels were drawn in the morning before aripiprazole administration. Thus it appears from this brief report that they were drawn approximately 24 hours post dose. Several reports (personal communication) of somnolence have been reported to this author. The infant should be monitored for somnolence.



Tom Hale Ph.D.



Schlotterbeck P, Leube D, Kircher T, Hiemke C, Grunder G. Aripiprazole in human milk . Int J Neuropsychopharmacol. 2007;10:433.

[Amanda IBCLC]

Do you have any more data this is medication? I have a patient whose baby is now 4 weeks old and she really needs to start taking this medication.

Amanda IBCLC
Sunderland Royal Infirmary
UK

[admin]

Amanda:

We have two studies, one mom taking 15 mg/day. Levels of aripiprazole in milk were reported to be 13 and 14 microgram/L on the two consecutive days and maternal plasma levels drawn at the same time as the milk samples were both 71 microgram/L.

In a second case report of a mother who took aripiprazole 18 mg daily in pregnancy (starting at 22 weeks gestation) and while breastfeeding, the maternal breast milk and infant plasma levels were found to be 38.7 microgram/L and 7.6 microgram/L. The milk and blood levels were drawn on postpartum day 6 as the mother discontinued breastfeeding at this time due to concerns of maternal fatigue. There was some speculation that the infants blood levels were more reflective of in utero exposure to the medication, rather than breast milk exposure because of the timing of the level being so close to birth and the long half life of the medication (75 hours).

Tom Hale Ph.D.

[Amanda IBCLC]

Thank you.
So we are talking about a relatively small infant dose?

Amanda