Is Suvorexant safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Suvorexant. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
The amounts of suvorexant in milk are very low. If suvorexant is required by the mother, it is not a reason to discontinue breastfeeding. If suvorexant is used, monitor the infant for sedation, especially in a newborn or preterm infant.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Two women were taking suvorexant 20 mg at night. They provided milk samples “a few days” after delivery. One woman provided a sample before a dose and 70 minutes after a dose. The concentrations in those samples were 1.36 and 2.85 mcg/L. The second woman provided samples a few days and one month after delivery taken at unknown times the day after taking the drug. The milk concentrations were 3.47 and 4.09 mcg/L, respectively. The authors estimated the relative infant dosages to be 0.17 and 0.2% in the two women, respectively.[1,2]
The manufacturer reports a study in which a single 20 mg dose of suvorexant was given to 12 healthy lactating women. The peak milk levels of 27.19 mcg/L at 2 hours after the dose. The mean amount of suvorexant recovered in breastmilk was 0.011 mg following a 20 mg maternal dose. The calculated mean daily infant dose was 0.00155 mg/kg based on the actual infant body weight. The relative infant dose of suvorexant was 0.691%. The relative infant dose of the drug plus its metabolite hydroxysuvorexant was less than 1% of the maternal dose.[3]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Suvorexant is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Suvorexant” (suvorexant). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.