Last update: Dec. 17, 2018

Gabapentin

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Antiepileptic drug that is also used in the treatment of neuropathic pain and Restless Leg Syndrome.
Oral administration three times a day

It is excreted into breast milk in clinically non-significant amount. No problem was observed in infants whose mothers were on this medication (Reimers 2014, Kristensen 2006, Ohman 2005).
Plasma levels in those infants were undetectable or very low (Kristensen 2006, Ohman 2005).

Although not recommended for breastfeeding in some older articles (Mercadé 2012, Harden 2009), several medical societies, experts and expert consensus, consider the use of this medication safe during breastfeeding (Crettenand 2018, Reece 2017, Briggs 2017, Hale 2017 p 411, Picéchietti 2015, Davanzo 2013, Pack 2006, Kristensen 2006, Bar-Oz 2000).

Alternatives

We do not have alternatives for Gabapentin since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Gabapentin is also known as


Gabapentin in other languages or writings:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 %
Molecular weight 171 daltons
Protein Binding < 3 %
VD 0,8 l/Kg
Tmax 2 - 3 hours
T1/2 5 - 7 hours
M/P ratio 0,8 - 1,3 -
Theoretical Dose 0,2 - 1,3 mg/Kg/d
Relative Dose 1,3 - 3,8 %
Relat.Ped.Dose 0,8 - 5,2 %

References

  1. Crettenand M, Rossetti AO, Buclin T, Winterfeld U. [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?] Nervenarzt. 2018 Abstract
  2. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  3. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  4. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. 11th edition (acces on line) 2017
  5. Jacob S, Nair AB. An Updated Overview on Therapeutic Drug Monitoring of Recent Antiepileptic Drugs. Drugs R D. 2016 Abstract Full text (link to original source) Full text (in our servers)
  6. Picchietti DL, Hensley JG, Bainbridge JL, Lee KA, Manconi M, McGregor JA, Silver RM, Trenkwalder C, Walters AS; International Restless Legs Syndrome Study Group (IRLSSG).. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep Med Rev. 2015 Abstract
  7. Grover S, Avasthi A. Mood stabilizers in pregnancy and lactation. Indian J Psychiatry. 2015 Abstract Full text (link to original source) Full text (in our servers)
  8. Pfizer. Gabapentin. Drug Summary. 2014 Full text (in our servers)
  9. Reimers A. New antiepileptic drugs and women. Seizure. 2014 Abstract Full text (link to original source) Full text (in our servers)
  10. Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr. 2013 Abstract Full text (link to original source) Full text (in our servers)
  11. Rapcencu AE, Lindhout D, Bulk S. Frequently asked questions on epilepsy, pregnancy and lactation: a EURAP-NL report. Seizure. 2012 Abstract Full text (link to original source) Full text (in our servers)
  12. Mercadé Cerdá JM, Sancho Rieger J, Mauri Llerda JA, López González FJ,Salas Puig X. Guías diagnósticas y terapéuticas de la Sociedad Española de Neurología 2012. 1. Guía oficial de práctica clínica en epilepsia. Guías SEN 2012 Full text (in our servers)
  13. Harden CL, Pennell PB, Koppel BS, Hovinga CA, Gidal B, Meador KJ, Hopp J, Ting TY, Hauser WA, Thurman D, Kaplan PW, Robinson JN, French JA, Wiebe S, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Shafer PO, Le Guen C; American Academy of Neurology; et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of... Neurology. 2009 Abstract Full text (link to original source) Full text (in our servers)
  14. AEMPS. Gabapentina. Ficha técnica. 2007 Full text (in our servers)
  15. Kristensen JH, Ilett KF, Hackett LP, Kohan R. Gabapentin and breastfeeding: a case report. J Hum Lact. 2006 Abstract
  16. Pack AM. Therapy insight: clinical management of pregnant women with epilepsy. Nat Clin Pract Neurol. 2006 Abstract
  17. Ohman I, Vitols S, Tomson T. Pharmacokinetics of gabapentin during delivery, in the neonatal period, and lactation: does a fetal accumulation occur during pregnancy? Epilepsia. 2005 Abstract Full text (link to original source) Full text (in our servers)
  18. Tomson T. Gender aspects of pharmacokinetics of new and old AEDs: pregnancy and breast-feeding. Ther Drug Monit. 2005 Abstract
  19. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004 Fall;11(2):e257-66. Epub 2004 Dec 8. Abstract
  20. Bar-Oz B, Nulman I, Koren G, Ito S. Anticonvulsants and breast feeding: a critical review. Paediatr Drugs. 2000 Mar-Apr;2(2):113-26. Review. Abstract

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