YES its fine
For other data, click on the Table of ContentsDrug Levels and Effects:
Summary of Use during Lactation:
Lorazepam has low levels in
breastmilk, a short half-life relative to many other benzodiazepines,
and is administered directly to infants. Lorazepam
would not be expected to cause any adverse effects in breastfed infants
with usual maternal dosages. No special precautions are required.
Maternal Levels. Four women were given 3.5 mg of lorazepam orally 2 hours before undergoing cesarean section. Colostrum levels of lorazepam averaged 8.5 mcg/L at 4 hours after the dose; conjugated lorazepam metabolites were not measured. Another woman taking 2.5 mg orally twice a day for the first 5 days postpartum had milk levels of free and conjugated lorazepam
of 12 and 35 mcg/L, respectively, at an unspecified time on day 5.
Since infants can deconjugate and absorb glucuronides, the total drug
level is probably more important than the free drug alone. Using the
total amount excreted, an exclusively breastfed infant would receive
about 7 mcg/kg daily with this maternal dosage or about 8.5% of the
maternal weight-adjusted dosage. A woman who was 4 weeks postpartum was taking lorazepam 2.5 mg 1 to 3 times daily and lormetazepam, which is partially metabolized to lorazepam, 2 mg once daily. On day 5 of therapy after taking 2 doses of lorazepam in the previous 8 hours, her lorazepam milk level was 123 mcg/L. On day 6 after having taken 3 doses in the previous 24 hours, her milk lorazepam level was 89 mcg/L. On day 7, milk levels were 55 and 40 mcg/L at 14 and 18.5 hours after her last dose, respectively. Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants:
In one case, the newborn infant of a mother taking 2.5 mg of lorazepam orally twice daily for 5 days after delivery showed no signs of sedation.
Possible Effects on Lactation:
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider:
1. Summerfield RJ, Nielsen MS. Excretion of lorazepam into breast milk. Br J Anaesth. 1985;57:1042-3. Letter. PMID: 4041315
2. Whitelaw AGL, Cummings AJ, McFadyen IR. Effect of maternal lorazepam on the neonate. Br Med J (Clin Res Ed). 1981;282:1106-8. PMID: 6113019
3. Lemmer P, Schneider S, Muhe A, Wennig R. Quantification of lorazepam
and lormetazepam in human breast milk using GC-MS in the negative
chemical ionization mode. J Anal Toxicol 2007;31:224-6. PMID: 17555647
CAS Registry Number:
Hypnotics and SedativesAnti-Anxiety AgentsBenzodiazepines
The following information comes from MEDICATIONS AND MOTHERS’ MILK by Thomas Hale, 2010. He assigns every drug a lactation risk category: L1, safest; L2, safer; L3, moderately safe; L4, possible hazardous; and L5, contraindicated. He also lists if a drug has been reviewed and/or approved by the American Academy of Pediatrics (AAP) for use in nursing mothers. Possible risks to mother and baby are listed as well as possible effect on milk supply.
Listed as L3, moderately safe; pediatric concerns: None reported via milk, but observe for sedation. “It would appear from these studies that the amount of lorazepam secreted into milk would be clinically insignificant under most conditions.”
It is fine.. :o)
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