Trihexyphenidyl

Drug Levels and Effects:




Summary of Use during Lactation:


Limited information indicates that maternal doses of trihexyphenidyl up to 4 mg daily together withhaloperidoldid not produce any adverse effects in breastfed infants. Long-term use of trihexyphenidyl might reduce milk production or milk letdown, but a single dose is not likely to interfere with breastfeeding. During long-term use, observe for signs of decreased lactation (e.g., insatiety, poor weight gain).


Drug Levels:


Maternal Levels.

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

Infant Levels.

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


Effects in Breastfed Infants:


One woman with schizophrenia took trihexyphenidyl andhaloperidolduring 3 pregnancies and postpartum. The trihexyphenidyl dose was 4 mg daily in all 3 pregnancies. She breastfed (extent not stated) all 3 children for 6 to 8 months using the same doses. Development was age-appropriate in all children aged 16 months at 8 years of age at the time of assessment.[1]


Possible Effects on Lactation:


Anticholinergics can inhibit lactation in animals, apparently by inhibiting growth hormone and oxytocin secretion.[2][3][4][5][6] Anticholinergic drugs can also reduce serum prolactin in nonnursing women.[7] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

One woman with schizophrenia took trihexyphenidyl andhaloperidolduring 3 pregnancies and postpartum. She was able to breastfeed (extent not stated) all 3 children for 6 to 8 months.[1] The prolactin elevating effect ofhaloperidolmight have counteracted any prolactin lowering effect of trihexyphenidyl.


References:


1. Mendhekar DN, Andrade C. Uneventful use ofhaloperidoland trihehexyphenidyl during three consecutive pregnancies. Arch Womens Ment Health. 2011;14:83-4. PMID:21116668
2. Aaron DK, Ely DG, Deweese WP et al. Reducing milk production in ewes at weaning using restricted feeding and methscopolamine bromide. J Anim Sci. 1997;75:1434-42. PMID:9250502
3. Powell MR, Keisler DH. A potential strategy for decreasing milk production in the ewe at weaning using a growth hormone release blocker. J Anim Sci. 1995;73:1901-5. PMID:7592071
4. Daniel JA, Thomas MG, Powell MR, Keisler DH. Methscopolamine bromide blocks hypothalmic-stimulated release of growth hormone in ewes. J Anim Sci. 1997;75:1359-62. PMID:9159285
5. Bizzarro A, Iannucci F, Tolino A et al. Inhibiting effect of atropine on prolactin blood levels after stimulation with TRH. Clin Exp Obstet Gynecol. 1980;7:108-11. PMID:6788407
6. Svennersten K, Nelson L, Juvnas-Moberg K. Atropinization decreases oxytocin secretion in dairy cows. Acta Physiol Scand. 1992;145:193-4. PMID:1636447
7. Masala A, Alagna S, Devilla L et al. Muscarinic receptor blockade by pirenzepine: effect on prolactin secretion in man. J Endocrinol Invest. 1982;5:53-5. PMID:6808052



Substance Identification:




Substance Name:

Trihexyphenidyl

CAS Registry Number:

144-11-6

Drug Class:


  • Antiparkinson Agents

  • Muscarinic Antagonists

  • Parasympatholytics


  • Administrative Information:




    LactMed Record Number:


    769


    Last Revision Date:


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