Is Trifluoperazine 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 Trifluoperazine. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Limited information indicates that maternal doses of trifluoperazine up to 10 mg daily do not affect the breastfed infant. Very limited long-term follow-up data indicate no adverse developmental effects when other phenothiazines are used alone. A safety scoring system finds trifluoperazine to be not recommended during breastfeeding.[1] Because there is little published experience with trifluoperazine during breastfeeding, other antipsychotic agents may be preferred, especially wile nursing an newborn or preterm infant.
Effects on the breastfed infant
Two mothers taking trifluoperazine 5 and 10 mg per day orally breastfed their infants from 1 week and 8 weeks of age, respectively. Mental and psychomotor development were normal at various times up to 30 months of age.[2]
One infant was breastfed from birth during maternal trifluoperazine 10 mg daily in addition to clonazepam 0.25 mg daily and valproic acid 500 mg daily. No adverse effects in the infant were reported by the mother (follow-up time unspecified).[3]
One mother began taking trifluoperazine (dosage unspecified) 2 months postpartum while breastfeeding her infant. She also started olanzapine 10 mg daily, paroxetine and procyclidine (dosages unspecified). The infant experiences no adverse reactions.[4]
Effects on milk supply
Phenothiazines cause galactorrhea in 26 to 40% of female patients.[5,6] Hyperprolactinemia appears to be the cause of the galactorrhea.[7-10] The hyperprolactinemia is caused by the drug's dopamine-blocking action in the tuberoinfundibular pathway.[11]
Levels in milk
Maternal Levels. Two mothers taking trifluoperazine 5 and 10 mg per day orally had undetectable milk levels (<1 mcg/L) of trifluoperazine.[2]
Infant Levels. Trifluoperazine was undetectable (<2 mcg/L) in urine at 86 days of age in an infant whose mother was taking trifluoperazine 10 mg daily.[2]
The infant of one mother who was taking trifluoperazine 10 mg per day orally while breastfeeding had a serum trifluoperazine level of 1 mcg/L. The infant was 1.9 weeks old when tested and the mother had been taking trifluoperazine during pregnancy which might have contributed to the infant's serum level.[3]
Alternatives LactMed lists
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Trifluoperazine” (LM269). 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.