Several medications being recommended: Zonisamide, Symlin

[Lauralynne]

I've been diagnosed with a metabolic disorder and the doctor is recommended a course of treatment including several medications. I'm still nursing my 21 month old frequently and am concerned about the effect on him.
The medications I can't find the info on are Zonisamide and Symlin. (Wellbutrin, Byette or Victoza, and acarbose are the other medications I would be on but have found info).
Can anyone help? Thanks in advance,
Laura

[cpride]

Dear Lauralynne,

We do not have data on pramlintide acetate (Symlin), but it is a large peptide and thus unlikely to enter milk in clinically relevant amounts. Based on this kinetic information, pramlintide acetate is likely compatible with breastfeeding. Observe your child for poor appetite, dizziness, and lethargy. Zonisamide (Zonegran), however, is in the possibly hazardous category. The relative infant dose (amount of your dose that is secreted into breastmilk) is high at 28.9% to 36.8%. Typically, medications compatible with breastfeeding are less than 10%. Significant caution is recommended with this medication as a number of pediatric adverse effects have been noted in older children who have taken this medication directly. For your particular child, since he is older and getting smaller quantities of milk compared to a young infant would be at less risk, but we can not say no risk. You may talk with your physician to see if there is another medication that could be used instead of zonisamide that would be less risky. If there is, please call us at the InfantRisk Center, 806-352-2519. We are open Monday through Friday, 8 to 5, CDT. We can discuss the options given to you by your physician and their compatibility with breastfeeding. If you do decide to continue breastfeeding, you should observe your child for agitation, poor appetite, dizziness, headache, speech problems, and changes in mental status.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

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