The amount of fluvoxamine in milk is unlikely to be a cause of adverse effects in breastfed infants

J Hum Lact. 2002 May;18(2):139-43. doi: 10.1177/089033440201800205.

Abstract

The aim of this study was to characterize milk/plasma (M/P) ratio, as well as relative infant dose and well-being, in 2 breastfeeding women taking fluvoxamine. The women (37 and 34 years old) and their infants (26 and 0.75 months old) were studied over a 24-hour dose interval at steady state. Fluvoxamine concentrations were measured by high-performance liquid chromatography. Infant exposure was measured as concentration in milk multiplied by an estimated milk production of 0.15 L/kg/d and normalized to the weight-adjusted maternal dose. M/P values of 1.34 and 1.21 were calculated for subjects 1 and 2, respectively, and relative infant doses were estimated to be 1.38% and 0.8%, respectively. No adverse effects in the infants were detected by the mother or on clinical examination, and fluvoxamine was not detected in the infants' plasma (limit of detection 2 micrograms/L). These limited data support the prescription of fluvoxamine to breastfeeding mothers after a careful, individual risk/benefit analysis is undertaken.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents, Second-Generation / analysis
  • Antidepressive Agents, Second-Generation / pharmacokinetics*
  • Breast Feeding / adverse effects
  • Child, Preschool
  • Chromatography, High Pressure Liquid
  • Female
  • Fluvoxamine / analysis
  • Fluvoxamine / pharmacokinetics*
  • Humans
  • Infant, Newborn
  • Lactation / metabolism*
  • Male
  • Milk, Human / chemistry
  • Milk, Human / metabolism*

Substances

  • Antidepressive Agents, Second-Generation
  • Fluvoxamine