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CLONAZEPAM/KLONOPIN and breastfeeding

Posted by on Jun. 17, 2010 at 4:49 PM
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1 mom liked this

anyone else taking .25-.5 mg a night to sleep?

i have a 10 1/2 month old and she doesnt nurse between 8pm and 7am.  i am taking .25 mg of clonazepam a night to sleep.

anyone know how okay this is? dr. hale states several times that its fine esp. with how old she is now.

just want some input!


by on Jun. 17, 2010 at 4:49 PM
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by on Jun. 17, 2010 at 4:54 PM
I just typed in google the name of the drug and this is what I found. Second paragraph down, read that one. I'm not sure if the dosage being so low might make a difference though. I'd call your local LLL, they have books that list drugs and their dangers or not associated with breastfeeding, they'll be able to give you lots of info.

FDA pregnancy category D. Klonopin may cause harm to an unborn baby, and may cause breathing or feeding problems in a newborn. But having a seizure during pregnancy could harm both the mother and the baby. Do not start taking Klonopin during pregnancy without telling your doctor you are pregnant.

Klonopin may pass into breast milk and could harm a nursing baby. Do not breast-feed a baby while taking Klonopin. The sedative effects of clonazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking Klonopin.

Clonazepam may be habit-forming and should be used only by the person it was prescribed for. Klonopin should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Read more:
by Group Admin -Tabitha on Jun. 17, 2010 at 5:30 PM

Heres what Lact med says..its 100% reliable for BF ing and meds

CASRN: 1622-61-3

For other data, click on the Table of Contents

Drug Levels and Effects:

Summary of Use during Lactation:
Only a small number of cases of breastfeeding with clonazepam have been reported. If clonazepam is required by the mother, it is not a reason to discontinue breastfeeding. Monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of psychotropic drugs. Monitoring of the infant's serum concentration may be indicated if excessive sedation occurs.

Drug Levels:
In published reports of anticonvulsant use during breastfeeding, most women were taking a combination of anticonvulsants. Some other anticonvulsants (e.g., phenytoin, carbamazepine) stimulate the metabolism of other drugs including anticonvulsants, whereas others (e.g., valproic acid) inhibit the metabolism of other drugs. Therefore, the relationship of the maternal dosage to the concentration in breastmilk can be quite variable, making calculation of the weight-adjusted percentage of maternal dosage less meaningful than for other drugs in this database.

Maternal Levels. A breastfed newborn infant whose mother was taking clonazepam during pregnancy and lactation (dosage not stated) had serum levels that increased from about 23 mcg/L at 24 hours of age to 43 mcg/L at 96 hours of age.[1]

Repeated milk clonazepam levels were between 11 and 13 mcg/L in a woman taking clonazepam in an unstated dosage.[2]

A mother taking clonazepam 2 mg twice daily had several milk level measurements on days 2 to 4 postpartum. The highest milk level was 10.7 mcg/L 4 hours after a dose. The authors calculated that an exclusively breastfed infant would receive a maximum of 2.5% of the maternal weight-adjusted dosage of clonazepam.[3]

Infant Levels. One preterm infant had cord blood levels of 19 mcg/L and was not breastfed until 72 hours after delivery. The infant's serum clonazepam level was 2.9 mcg/L at 120 hours after birth, and 1 mcg/L at day 14. The mother's serum level was 32 mcg/L at delivery and repeated milk clonazepam levels were between 11 and 13 mcg/L.[2]

A newborn infant was breastfeeding during a maternal dosage of clonazepam 2 mg twice daily. A pooled sample of infant serum from days 2 to 4 of age contained 4.7 mcg/L of clonazepam.[3]

Ten of 11 breastfed infants whose mothers were taking clonazepam in dosages of 0.25 to 2 mg daily had no detectable (assay limit varied from 5 to 14 mcg/L) clonazepam or metabolites in serum. The infants' average age was 7.9 weeks, but 6 were under 1 month of age. One 1.9 week-old-infant whose mother was taking clonazepam 0.5 mg daily had a serum concentration of 22 mcg/L.[4]

Effects in Breastfed Infants:
Excessive periodic breathing and prolonged apnea and cyanosis occurred in a newborn at 6 hours after birth at 36 weeks gestation and reoccurred repeatedly up to 10 days of age. The neonate was breastfed starting at 72 hours after delivery and her mother took clonazepam (dose not stated) during pregnancy and lactation. The repeated periodic breathing episodes continued up to 10 weeks of age and were possibly related to clonazepam in breastmilk. A neurodevelopmental examination was normal at 5 months of age.[2]

The infant of a mother taking clonazepam 1 mg daily during pregnancy and lactation was rated as highly apathetic and had decreased weight increase and slight neurologic signs at 4 weeks of age, but normal intelligence at 6 years of age.[5]

None of 11 infants whose mothers were taking clonazepam in dosages ranging from 0.25 to 2 mcg/L (including 4 who were taking other psychotropic drugs also) had any side effects reported by their mothers. The infants' average age was 7.9 weeks, but 6 were under 1 month of age.[4]

Possible Effects on Lactation:
Relevant published information was not found as of the revision date.

AAP Category:
Not listed, but other benzodiazepines are rated as having an unknown effect on the nursing infant but may be of concern.[6]

Alternate Drugs to Consider:
Dependent on the condition being treated.

by Group Admin -Tabitha on Jun. 17, 2010 at 5:31 PM

YOu have to take an anticonvulsant to sleep??

by on Jun. 22, 2010 at 10:17 AM

its an antianxiety med. i take it a few times a week, not every night. and i only take .25mg.

thanks guys! she is not nursing as much now:(  and im not too worried about it anymore.

by on Jun. 22, 2010 at 11:33 AM

 i used to take it for anxiety. when i went to a perinatologist while pregnant - they said i could continue taking it if i needed to. and i checked lactmed after i learned about that site. i was taking 1 mg/day - but preg and mommy hormones have really changed how i feel so i havent taken it in a looooong time. i wouldnt worry about the amount you are taking esp since you arent taking it every day.

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