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Two nursing mothers treated with zonisamide: Should breast‐feeding be avoided?
Author(s) -
Ando Hitoshi,
Matsubara Shigeki,
Oi Asako,
Usui Rie,
Suzuki Mitsuaki,
Fujimura Akio
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12143
Subject(s) - zonisamide , medicine , colostrum , breast milk , breast feeding , adverse effect , obstetrics , pediatrics , breastfeeding , epilepsy , biochemistry , chemistry , psychiatry , antibody , immunology , topiramate
Zonisamide, an antiepileptic drug, is excreted into breast milk, but information regarding the safety of breast‐feeding while using this drug is limited. We present the cases of two nursing mothers, taking 300 and 100 mg/day zonisamide. At 5 days after delivery, the milk concentrations and relative infant doses of the drug were 18.0 and 5.1 μg/mL, and 44 and 36%, respectively. In the first case, the mother fed colostrum and continued partial breast‐feeding thus reducing the relative infant dose to 8%. The neonatal serum concentration of zonisamide declined to below the limit of detection at day 34 after birth. In the second case, the mother breast‐fed partially until 2 weeks postpartum. No adverse effect was observed in the infants. These findings suggest that mothers taking zonisamide should not breast‐feed exclusively, but may not have to avoid partial breast‐feeding, with significant caution regarding adverse effects in infants.