N06AX16

It is a reuptake-inhibitor of Serotonin and Norepinephrine, and a precursor of Desvenlafaxine. Oral administration one to three times a day. 

It is excreted into breast milk in small to moderate amount that may be clinically significant (Pogliani 2019, Schoretsanitis 2018, Rampono 2011, Newport 2009, Misri 2006, Koren 2006, Berle 2004, Ilett 2002), which can reach 10% of the relative dose. ^{(Newport 2009, Ilett 1998)} 

Plasma levels in infants whose mothers take it are undetectable to low ^{(Rampono 211, Newport 2009, Berle 2004, Weissman 2004, Hendrick 2001, Ilett 2002 and 1998)}, sometimes between 10% ^{(Berle 2004)} and 37% ^{(Newport 2009)} of maternal levels.

However, side-effects in those infants have not been shown. Various studies failed to show short or long-term side-effects among infants whose mothers were on Venlafaxine, both on physical or psychomotor development. ^{(Pogliani 2019, Rampono 2011, Newport 2009, Misri 2006, Berle 2004, Hendrick 2003 y 2001, Ilett 2002 y 1998)}

It may induce galactorrhea and elevated prolactin levels. ^{(Camkurt 2017, Ashton 2007, Pae 2004)}

The poor extrauterine adaptation that may appear in neonates just after birth when the pregnant woman has been treated with selective reuptake-inhibitors of Serotonin like Venlafaxine or Mirtazapine ^{(Hale 2010)}, is seen to be mild if the baby is breastfed ^{(Kieviet 2013, Lanza 2009)}. Two newborns whose mothers were taking venlafaxine 300 and 375 mg daily during pregnancy experienced withdrawal symptoms in the first few days that improved when breastfeeding was instituted. ^{(Boucher 2009, Koren 2006)}

Various medical societies and expert consensus consider the use of this medication safe during breastfeeding. ^{(Hale, Sriraman 2015, Rowe 2013, Berle 2011, Patil 2011, Schaefer 2007, Gjerdingen 2003).}

See below the information of these related products:

• Desvenlafaxine Succinate (Safe substance and/or breastfeeding is the best option.)
• Maternal Depression (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)