Last update: May 27, 2018

Pregabalin

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Anti-epileptic drug with structural properties similar to Gabapentin. Also used in the treatment of anxiety disorders, neuropathic pain and fibromyalgia.
Oral administration in two - three daily doses.

It is excreted in breast milk in small amounts, probably not clinically significant (Lockwood 2016).
In a mother who took it during pregnancy, very high milk levels were found at 48 hours after birth, probably due to a transplacental passage (Ohman 2011).
No side effects were observed in the infant (Ohman 2011).

Slight difficulty of breastfeeding has been reported in 7% of newborns of mothers who were given a dose of pregabalin prior to cesarean section (El Kenany 2016).

Several authors and experts agree that the use of this medication is safe during lactation, monitoring possible side effects (drowsiness) in the infant (Crettenand 2018, Reece 2017, Davanzo 2013).

Because less experience has been published than with other drugs of the same group, alternatives that are known as safer should be considered of choice during the neonatal period or in case of preterm babies.

Alternatives

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

Pregabalin in other languages or writings:

Group

Pregabalin belongs to this group or family:

Tradenames

Main tradenames from several countries containing Pregabalin in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 90 %
Molecular weight 159 daltons
Protein Binding 0 %
VD 0,56 l/Kg
pKa 4,8 -
Tmax 1 - 2 hours
T1/2 5 - 7 hours
M/P ratio 0,4 - 0,8 -
Theoretical Dose 0,3 mg/Kg/d
Relative Dose 6 %

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. 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)
  3. 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)
  4. El Kenany S, El Tahan MR. Effect of preoperative pregabalin on post-caesarean delivery analgesia: a dose-response study. Int J Obstet Anesth. 2016 Abstract
  5. Lockwood PA, Pauer L, Scavone JM, Allard M, Mendes da Costa L, Alebic-Kolbah T, Plotka A, Alvey CW, Chew ML. The Pharmacokinetics of Pregabalin in Breast Milk, Plasma, and Urine of Healthy Postpartum Women. J Hum Lact. 2016 Abstract
  6. EMA. Pregabalin. Drug Summary. 2015 Full text (in our servers)
  7. EMA. Pregabalina. Ficha técnica. 2015 Full text (in our servers)
  8. 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)
  9. Ohman I, De Flon P, Tomson T. Pregabalin kinetics in the neonatal period, and during lactation. Epilepsia. 52 (Suppl 6):249-50 (poster 824). 2011 Full text (link to original source) Full text (in our servers)
  10. Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet. 2010 Abstract

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