Is Vigabatrin 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 Vigabatrin. 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 vigabatrin up to 2000 mg daily produce low levels in milk. Vigabatrin is approved for use in infants in one month and older and amounts in milk are far less than the approved infant dosage. Vigabatrin would not be expected to cause any adverse effects in breastfed infants.
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 nursing mothers were each receiving vigabatrin 1000 mg twice daily. One was also taking slow-release carbamazepine 200 mg twice daily. Milk samples were collected once predose and 3 and 6 hours after the dose at either 6 or 8 days postpartum. In both mothers, the inactive R-isomer was excreted into milk in higher concentrations than the active S-isomer. In the 2 mothers, average concentrations of the R-isomer were 1.7 mg/L in the predose sample, 2.1 mg/L at 3 hours and 3.1 mg/L at 6 hours after the dose. Average concentrations of the S-isomer were 0.4 mg/L in the predose sample, 0.4 mg/L at 3 hours and 0.8 mg/L at 6 hours after the dose. Using peak values, the authors estimated that the maximum dosage that the infant would receive in the mothers would be 2 to 3.6% of the weight-adjusted maternal dosage for the R-isomer and 0.6 to 0.96% of the maternal dosage for the S-isomer.[1]
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 Vigabatrin 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 “Vigabatrin” (LM1003). 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.