Last update April 24, 2023
Short-acting benzodiazepine with anxiolytic effect. Used in states of anxiety and depression. Oral administration 3 times a day.
It is excreted in breast milk in a small amount, but it could be clinically significant: RD 2.7 - 9.3% (Nishimura 2021, Furugen 2019, Oo 1995)
Several authors have found no problems in infants of mothers treated with alprazolam (Saito 2022, Nishimura 2021), but some cases of mild sedation in infants whose mothers were taking alprazolam, alone (Ito 1993) or in combination with other sedatives (Kelly 2012), have been reported, and withdrawal syndrome in newborns and infants when the mothers discontinued alprazolam (Anderson 1989). Both facts indicate that the passage to breast milk, although scarce (<10% of maternal dose), may become clinically significant, therefore, especially in the neonatal period and in case of prematurity, it is preferable to use benzodiazepines with a faster action and less passage to breast milk.
Expert authors consider the use of this medication possible during lactation. (Uguz 2021)
While most benzodiazepines can lower prolactin levels, alprazolam increases them and can cause galactorrhea. (Petric 2011, Madhusoodanan 2010, Zemishlany 1990)
The occasional and low-dose use of benzodiazepines is compatible with breastfeeding. (Kelly 2012, Rubin 2004, Iqbal 2002, Hägg 2000, McElhatton 1994, Lee 1993, Kanto 1982)
Choose short-acting benzodiazepines and use the lowest effective dose (Rowe 2013), especially during the neonatal period and in prematurity, as they can accumulate in the infant during chronic use. (Sachs 2013, Amir 2011)
It is advisable to monitor drowsiness and adequate feeding of the infant. Bed-sharing with the baby is not recommended if this medicine is being taken due to increased risk of suffocation or sudden infant death. (UNICEF 2018, 2017, 2014 and 2013, Landa 2012, ABM 2008, UNICEF 2006)
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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