gabapentin and breastfeeding

Last edited 03/2022 and last reviewed 03/2022

Gabapentin and breastfeeding
  • gabapentin is considered compatible with breastfeeding, but should be used with caution and infant monitoring (1)
  • published evidence for the use of gabapentin during breastfeeding is very limited. Data is from 10 mothers using gabapentin doses up to 2.1g daily
  • limited information indicates that maternal doses of gabapentin up to 2.1 grams daily produce relatively low levels in infant serum (2)
    • monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs
    • a single oral dose of either 300 mg or 600 mg given to the mother before cesarean section appeared to have no effect on breastfeeding initiation
    • expert consensus indicates that gabapentin is an acceptable choice for refractory restless leg syndrome during lactation
Breast milk levels and infant absorption
  • gabapentin is a small molecule with low protein binding, which enables it to pass into breast milk
  • limited evidence shows gabapentin only transfers in small amounts
    • levels in milk are estimated to be between 1.3 and 3.8% of the weight-adjusted maternal dose
    • infant serum levels of gabapentin were either low (4-12% of the mother’s serum level) or undetectable, and would not be expected to have any effect on the infant
Effects in infants
  • have been no published reports of adverse effects in infants exposed to gabapentin via breast milk
    • due to the low levels reported in breast milk and infant serum, side-effects would not be expected (1)
    • are no data looking at long term infant effects

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gabapentin