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  • Xyrem and Breastfeeding?

    Hi, Dr Hale and Infant Risk!

    Thanks for this website and for taking the time to maintain it and answer individual questions; it's an invaluable resource. <3

    I'm pregnant with my second child and in the process of being diagnosed with either narcolepsy or idiopathic hypersomnia. My neurologist has said that while Xyrem is on the table for my specific case, she is very reluctant to start titrating me to my proper dose while I'm pregnant. I'm hoping to be able to discuss the possibility of doing so after pregnancy is over, while I'm breastfeeding the baby (probably after he's sleeping through the night, heh), but she doesn't seem to have a lot of resources on the effect of Xyrem on breastmilk and said she'd prefer to hold off until after weaning. Since I'd like to be able to live like a normal human somewhat before then, I'd really like to see if there's any way to start the medication sooner than that.

    Your page on Narcolepsy during pregnancy and breastfeeding ( [url]http://www.infantrisk.com/content/narcolepsy-pregnancy-and-breastfeeding[/url] ) does say that Xyrem is Pregnancy Category B, but doesn't have any information on Xyrem and breastfeeding; as that page was created 5.5 years ago, I'm hoping there's more data available now.

    So, in short: Do you know what effect Xyrem has on breastmilk and/or the breastfeeding infant, and what measures should a breastfeeding mother take (if any) to safely use Xyrem? Any specific study information I can pass along to the neurologist would be especially appreciated.

    Thank you so much for taking the time to read this, and have a great day!

    -cytherea.

  • #2
    Cytherea,

    Xyrem (sodium oxybate) is rated an L4-no data-possibly hazardous. [COLOR=#333333][FONT=lucida grande]No data are available on the transfer of oxybate into human breastmilk, but due to the low molecular weight and low protein binding, it is likely this medication will be secreted into human milk and be passed to a breastfeeding infant. Due to the sedative properties of this drug, this product should be used very cautiously in breastfeeding mothers, if at all. I spoke with Dr Hale about this medication and he said he does not recommend taking this medication while breastfeeding. He suggest trying low doses of d[/FONT][/COLOR][COLOR=#333333][FONT=lucida grande]extroamphetamine instead of the xyrem, but you would need to speak to your Dr about this or other medications he could recommend as substitutes. [/FONT][/COLOR]

    [COLOR=#333333][FONT=lucida grande]I hope this helps.

    Sandra Lovato R.N.
    InfantRisk Center
    806-352-2519[/FONT][/COLOR]

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