Last update March 17, 2019
A centrally-acting anticholinergic indicated chronically in Parkinson's disease and for occasional use in parkinsonian syndromes induced by drugs that can cause extrapyramidal side effects (Desma 2016, AEMPS 2014, Hagen 2001).
Oral or parenteral administration 2 to 4 times a day.
Since the last update we have not found any published data on its excretion in breast milk.
Its pharmacokinetic data (very large volume of distribution and high percentage of protein binding: Desma 2016, AEMPS 2014, Brocks 1999) makes it unlikely it will transfer into breastmilk in significant amounts.
Its low oral bioavailability (Desma 2016, AEMPS 2014, Grimaldi 1986) hinders transfer to infant plasma from breastmilk, except in premature infants and the immediate neonatal period when there may be increased intestinal permeability.
Although levels in milk could not be measured after administration of biperiden, plasma levels in a mother were 4.4 micrograms/L (Kuniyoshi 1985). Assuming that 100% of the breastmilk is excreted, the dose received by the infant would be 0.0007 mg/kg/day, which would mean a negligible relative dose, between 0.4 and 1.3%.
Expert authors believe that the use of this medication is probably safe during breastfeeding (Schaefer 2007, p733).
Despite its anticholinergic and dopaminergic effects, changes in prolactin levels have not been observed (Yisak 1993).
We do not have alternatives for Biperiden.
Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.
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