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Breastfeeding Moms Breastfeeding Moms

Is Ativan safe to take while bf?

Posted by on Nov. 4, 2011 at 4:36 PM
  • 5 Replies
Does anyone know?
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by on Nov. 4, 2011 at 4:36 PM
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tabi_cat1023
by Group Mod - Tabitha on Nov. 4, 2011 at 5:00 PM

YES its fine

Lorazepam
CASRN: 846-49-1

For other data, click on the Table of Contents


Drug 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.


Drug Levels:
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.[1]

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.[2] 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.[3]

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.[2]


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


Alternate Drugs to Consider:
Midazolam, Oxazepam


References:
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



Substance Identification:


Substance Name: Lorazepam

CAS Registry Number: 846-49-1

Drug Class:
Hypnotics and Sedatives
Anti-Anxiety Agents
Benzodiazepines

Pink.Daisies.23
by on Nov. 4, 2011 at 5:13 PM
Tabi beat me to the medical part, but yes. I took it as needed after dd was born. Baby could act a little sleepy depending on dosage and age, but I never noticed that with my daughter.
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Christy619
by on Nov. 4, 2011 at 5:15 PM
Thank you :)
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maggiemom2000
by Ruby Member on Nov. 4, 2011 at 5:59 PM

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.

LORAZEPAM (Ativan)

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.”

catholicmamamia
by on Nov. 5, 2011 at 2:00 AM

It is fine.. :o) 

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