Last update: Dec. 27, 2019
Minimal risk for breastfeeding and infant.
Piracetam analog with nootropic and anti-epileptic effect. Authorized for use in children from 1 month of age in Europe.
Oral administration twice daily.
It is excreted in breast milk in small amounts, much lower than the dose used for newborns and infants (Kohn 2016, Tomson 2007, Johannesson 2005, Greenhill 2004, Kramer 2002). The plasma levels of infants whose mothers take them are low or undetectable, less than usual therapeutic levels (Paret 2014, Tomson 2007, Johannesson 2005, Kramer 2002).
No problems have been observed in infants whose mothers have taken it (Lattanzi 2017, Tomson 2007, Johannesson 2005), except one case of hypotonia in a 7 days old premature, and sedation and vomiting in a 25-day infant, whose mothers also took other anti epileptic drugs (Paret 2014, Kramer 2002).
Seizures along with neonatal abstinence syndrome in a botlle fed neonate whose mother had taken Levetiracetam and Phenobarbital in pregnancy ocurred. Symptoms disappeared after initiation of breastfeeding (Rauchenzauner 2011).
Serum levetiracetam levels decrease by 50% during pregnancy due to accelerated renal elimination. After delivery, the concentrations rise to pre-pregnancy levels in a week, so it is advisable to reduce the dose given to the mother and monitor the clinical condition of the newborn (Reimers 2014, Lopez 2009, Harden 2009, Westin 2008, Tomson 2007).
Several experts consider the use of this medication to be safe or very probably safe during breastfeeding (Hale 2019, Crettenand 2018, Briggs 2017, Rapcencu 2012, O'Connor 2009, Schaefer 2007, Pennell 2006, Pack 2006, Crawford 2008 y 2005, Greenhill, 2004).
We do not have alternatives for Levetiracetam 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.
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