Lamotrigine Tablet while Breastfeeding

What is Lamotrigine Tablet used for?

Is Lamotrigine Tablet usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?

Lamotrigine while Breastfeeding

CAS Number: 84057-84-1

As high as therapeutic levels of this drug have been found in the serum of infants (35-50% of maternal serum level). Side-effects were not observed, neither developmental nor IC derangements at long term follow-up among hundreds of children of treated mothers. A case was published of apnea in a newborn baby whose mother was on a very high dose of Lamotrigine (850 mg a-day). During pregnancy, it increases the clearance of Lamotrigine and other antiepileptic medication that warrants an increase in dosage in this period. After birth, the serum level rapidly increases with a risk of harm on both the mother and the infant, whenever dose is not reduced to that previous from pregnancy. An infant, 1 1/2 months old, whose mother was on Lamotrigine, resulted affected with Abstinence Syndrome soon after sudden weaning.

Lamotrigine while Breastfeeding

CAS Number: 84057-84-1

Occasional adverse reactions have been reported in infants who receive lamotrigine in milk, but long-term exposure does not appear to affect infant growth and development. Breastfed infants whose mothers are taking lamotrigine have relatively high plasma lamotrigine levels. Neonates are particularly at risk for high plasma levels because their ability to metabolize the drug by glucuronidation is limited, plasma protein binding is relatively low, and maternal plasma and milk levels can rise dramatically in the immediate postpartum period if the dosage is not reduced to the prepregnancy dosage.[1][2] If lamotrigine is required by the mother, it is not necessarily a reason to discontinue breastfeeding, because many infants have been breastfed without adverse reactions. However, breastfed infants should be carefully monitored for side effects such as apnea, rash, drowsiness or poor sucking, including measurement of serum levels to rule out toxicity if there is a concern. Monitoring of the platelet count and liver function may also be advisable. If an infant rash occurs, breastfeeding should be discontinued until the cause can be established.

What should I do if I am breastfeeding mother and I am already exposed to Lamotrigine Tablet?

I am nursing mother and my doctor has suggested me to use Lamotrigine Tablet, is it safe?

If I am using Lamotrigine Tablet, will my baby need extra monitoring?

Who can I talk to if I have questions about usage of Lamotrigine Tablet in breastfeeding?