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Flumazenil and Breastfeeding?

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  • Flumazenil and Breastfeeding?

    Hello, Dr Hale and nurses!

    I finally have my diagnosis: Idiopathic hypersomnia.

    I forwarded my neurologist to your website for the wonderful information you have on CNS stimulants and we're going to give one of the ones you've recommended in other threads a try once my son is about six months old.

    I've been doing more research in the meantime on idiopathic hypersomnia, and the latest findings seem to be centered around the GABA[A] receptors, naturally occurring benzodiazepines, and Flumazenil's effect on same, which seems to be pretty favourable for the use of Flumazenil for treatment of idiopathic hypersomnia and the accompanying daytime sleepiness.

    I did find this one article in PubMed: Binding of drugs in milk: the role of casein in milk protein binding. (Pharm Res. 1990 Jun;7(6):633-7. Stebler T, Guentert TW.) ([url]http://www.ncbi.nlm.nih.gov/pubmed/2367331[/url]) which says in its abstract:

    [COLOR=#000000][FONT=arial]The benzodiazepine antagonist [/FONT][/COLOR][COLOR=#000000][FONT=arial]flumazenil[/FONT][/COLOR][COLOR=#000000][FONT=arial] showed the lowest overall binding [of the substances they tested for] in milk and in casein solution. [/FONT][/COLOR]
    But, of course, I don't have access to the full article and am insufficiently knowledgeable to say what the appropriate levels would be, anyway. So, do you think Flumazenil would be okay to take while breastfeeding at any age of infant/toddler?

    Thank you so much for your invaluable knowledge and assistance!

  • #2
    Cytherea,

    Flumazenil is rated an L3- no data-probably compatible. I spoke with Dr Hale about the use of the flumazenil for your idiopathic hypersomnia and he said it would probably be ok to take while breastfeeding since it has poor oral bioavailability of about 16%, and it has a short terminal half-life of 40-80 minutes. We would recommend if you use this medication to take it right after breastfeeding so you have a longer break period of at least 2 hours before feeding again, and to monitor your infant for agitation.

    I hope this helps.

    Sandra Lovato R.N.
    InfantRisk Center
    806-2519

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