pregabalin and breastfeeding

Last edited 03/2022 and last reviewed 04/2022

Pregabalin and breastfeeding
  • pregabalin can be used while breastfeeding, but with caution and infant monitoring
  • there is very limited published evidence for the use of pregabalin in breastfeeding
    • limited data indicate that amounts of pregabalin in breastmilk are low and one infant breastfed for 3 months with no discernable adverse effects (2)
      • if pregabalin is required by the mother of an older infant, it is not a reason to discontinue breastfeeding, but until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant
Milk levels and infant absorption
  • the drug properties of pregabalin enable it to pass into breast milk
  • is a small molecule and does not bind to proteins, therefore there are lots of free drug molecules to pass into milk
  • data from one study shows that levels in milk are low and estimated at around 7% of the weight-adjusted maternal dose
  • a further study has demonstrated that infant serum levels are also low, and estimated to be around 8% of the maternal serum level (1)
Effects in infants
  • have been no adverse effects, reported in any of the infants exposed to date. Due to the low levels reported in breast milk and infant serum, side-effects would not be expected
  • are no data looking at long term infant effects
Monitoring the infant
  • although adverse effects are highly unlikely from gabapentin or pregabalin exposure via breast milk, as a precaution monitor the infant for:
    • feeding; the infant should be feeding well and continue to gain weight as expected
    • over sleepy; for example, not waking to feed or sleeping for longer and more often than expected
    • slowed breathing
    • gastro-intestinal disturbances, including diarrhoea and constipation
  • monitoring the infant will quickly pick up any potential issues, but usually further investigation is required before the cause can be identified
  • if any of these adverse effects occur, the mother should contact a healthcare professional for advice.

Reference:

Related pages:

antiepileptic drugs in pregnancy

pregabalin in pregnancy