Sumatriptan

Drug Levels and Effects:




Summary of Use during Lactation:


Because of the low levels of sumatriptan in breastmilk, amounts ingested by the infant are small. It also has poor oral bioavailability, further decreasing infant exposure to the drug. Some authors have suggested that withholding breastfeeding for 8 hours after a single subcutaneous injection would virtually eliminate infant exposure to the drug.[1] This maneuver might be helpful in extreme cases, such as in the mother of a preterm infant, but sumatriptan would not be expected to cause any adverse effects in most breastfed infants. One anecdotal report of lactation ceasing after a single injection of sumatriptan has not been verified.


Drug Levels:


Maternal Levels.

Five women who had been breastfeeding for 11 to 28 weeks received a single dose of sumatriptan 6 mg by subcutaneous injection. The peak milk level averaged 87.2 mcg/L (range 62 to 113 mcg/L) and it occurred 2.5 hours (range 1.7 to 3.5 hours) after the dose. The mean half-life in milk was 2.2 hours (range 1.2 to 3.1 hours). The authors calculated that an exclusively breastfed infant would receive 14.4 mcg in breastmilk with this dose, which is 3.5% of the weight-adjusted dosage.[1]

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


One author reported correspondence with the drug's manufacturer stating that of 3 women known to the manufacturer who used sumatriptan (dose and route unspecified) during breastfeeding none reported adverse effects on the infants.[2]


Possible Effects on Lactation:


One author reported correspondence with the drug's manufacturer stating that 1 woman who used a single injection of sumatriptan (dose unspecified) during breastfeeding had a cessation of lactation.[2]


Alternate Drugs to Consider:


Eletriptan


References:


1. Wojnar-Horton RE, Hackett LP, Yapp P et al. Distribution and excretion of sumatriptan in human milk. Br J Clin Pharmacol. 1996;41:217-21. PMID:8866921
2. Kristensen J.Sumatriptanand breastfeeding. Aust J Hosp Pharm. 1996;26:460. Letter.



Substance Identification:




Substance Name:

Sumatriptan

CAS Registry Number:

103628-46-2

Drug Class:


  • Serotonin Agonists


  • Administrative Information:




    LactMed Record Number:


    387


    Last Revision Date:


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