Last update June 14, 2022

C23 H27 FN4 O2

Compatible

Safe product and/or breastfeeding is the best option.

An atypical or second generation antipsychotic indicated in the treatment of schizophrenia, manic episodes of bipolar disorder and persistent aggression in dementias such as Alzheimer's. Oral administration in two daily doses.

Risperidone and its active metabolite (paliperidone) are excreted in breastmilk in very small amounts.(Weggelaar 2011, Aichhorn 2005, Ilett 2004, Hill 2000).

No problems have been observed in infants whose mothers were taking it. (Viguera 2022, Aichhorn 2005, Ilett 2004, Ratnayake 2002)

The plasma levels of these infants were undetectable or very low. (Weggelaar 2011, Aichhorn 2005, Ilett 2004)

A one-month-old infant whose mother was treated daily with 1.5 mg of risperidone and 0.8 mg of haloperidol had no problems during the first month of life. Sedation and poor nutrition appeared when the dose of haloperidol was increased to 1.5 mg daily. (Uguz 2019).

Risperidone causes, more frequently (OR 4.3; 1.3-14.3) than quetiapine, increased levels of prolactin and galactorrhea (Trinchieri 2021, Glocker 2021, Agapoff 2020, Sakaguchi 2019, Kc 2018, Pratheesh 2011, Afzal 2007, Holzer 2006, Madhusoodanan 2006, Ilett 2004, Haddad 2004, Kearns 2000, Popli 1998). Some authors have suggested its use as a galactogogue. (Parashar 2007)

Expert authors consider this medication possible with caution during breastfeeding. (Hale, Uguz 2021, Parikh 2014, Klinger 2013) and preferable to antipsychotics derived from phenothiazine (Rowe 2013), although other alternatives, such as olanzapine or quetiapine, may be preferable. (Hale, LactMed, Pacchiarotti 2016)


See below the information of these related products:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

C23 H27 FN4 O2 is Risperidone in Molecular formula.

Is written in other languages:

Groups

C23 H27 FN4 O2 belongs to these groups or families:

Tradenames

Main tradenames from several countries containing C23 H27 FN4 O2 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 77 - 88 %
Molecular weight 411 daltons
Protein Binding 77 - 90 %
VD 1 - 2 l/Kg
pKa 8.76 -
Tmax 1 - 2 hours
3 - 20 hours
M/P ratio 0.4 -
Theoretical Dose 0.001 - 0.008 mg/Kg/d
Relative Dose 2.8 - 4.3 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. Viguera AC, Vanderkruik R, Gaccione P, Caplin PS, Kobylski LA, Freeman MP, Cohen LS. Breastfeeding practices among women taking second-generation antipsychotics: findings from the National Pregnancy Registry for Atypical Antipsychotics. Arch Womens Ment Health. 2022 Apr;25(2):511-516. Consulted on April 7, 2022 Abstract
  4. Trinchieri A, Perletti G, Magri V, Stamatiou K, Trinchieri M, Montanari E. Drug-induced gynecomastia: A systematic review and meta-analysis of randomized clinical trials. Arch Ital Urol Androl. 2021 Dec 21;93(4):489-496. Abstract
  5. Uguz F. A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation. Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126. Abstract
  6. Glocker C, Grohmann R, Engel R, Seifert J, Bleich S, Stübner S, Toto S, Schüle C. Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015. Eur Arch Psychiatry Clin Neurosci. 2021 Dec;271(8):1425-1435. Abstract
  7. Agapoff JR 4th, Olson DJ, White S, Huynh V. Rapid and Sustained Resolution of Risperidone Associated Hyperprolactinemia and Galactorrhea With Low-Dose Lurasidone. J Clin Psychopharmacol. 2020 Jul/Aug;40(4):410-412. Abstract
  8. Sakaguchi S, Aizawa K. Galactorrhea Induced by Risperidone. Intern Med. 2019 Dec 15;58(24):3609-3610. Abstract
  9. Uguz F. Adverse Events in a Breastfed Infant Exposed to Risperidone and Haloperidol. Breastfeed Med. 2019 May 28. Abstract
  10. Kc Y, Baldridge HM, Ojha R. Symptomatic Extreme Elevation of Prolactin Related to Risperidone Use. Prim Care Companion CNS Disord. 2018 Sep 20;20(5). pii: 17l02208. Abstract
  11. Pacchiarotti I, León-Caballero J, Murru A, Verdolini N, Furio MA, Pancheri C, Valentí M, Samalin L, Roigé ES, González-Pinto A, Montes JM, Benabarre A, Crespo JM, de Dios Perrino C, Goikolea JM, Gutiérrez-Rojas L, Carvalho AF, Vieta E. Mood stabilizers and antipsychotics during breastfeeding: Focus on bipolar disorder. Eur Neuropsychopharmacol. 2016 Oct;26(10):1562-78. Abstract
  12. Parikh T, Goyal D, Scarff JR, Lippmann S. Antipsychotic drugs and safety concerns for breast-feeding infants. South Med J. 2014 Abstract
  13. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  14. Klinger G, Stahl B, Fusar-Poli P, Merlob P. Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev. 2013 Mar-Apr;10(3):308-17. Review. Abstract
  15. Weggelaar NM, Keijer WJ, Janssen PK. A case report of risperidone distribution and excretion into human milk: how to give good advice if you have not enough data available. J Clin Psychopharmacol. 2011 Feb;31(1):129-31. Abstract
  16. Pratheesh PJ, Praharaj SK, Srivastava A. Euprolactinemic gynecomastia and galactorrhea with risperidone-fluvoxamine combination. Psychopharmacol Bull. 2011;44(1):70-3. Abstract
  17. Parashar A, Varma A, Sharp B. Risperidone as galactagogue? J Hum Lact. 2007 Abstract
  18. Afzal KI, Briones DF, DeVargas C. Risperidone-induced polydipsia and polyphagia associated with galactorrhea, abdominal pain, and rapid weight gain in an adolescent Hispanic female. CNS Spectr. 2007 Nov;12(11):818-20. Erratum in: CNS Spectr. 2007 Dec;12(12):883. Abstract
  19. Madhusoodanan S, Moise D. Risperidone-induced hyperprolactinemia in adolescents: A case series. J Clin Psychiatry. 2006 Jul;67(7):1110-3. Abstract
  20. Holzer L, Eap CB. Risperidone-induced symptomatic hyperprolactinaemia in adolescents. J Clin Psychopharmacol. 2006 Apr;26(2):167-71. Abstract
  21. Aichhorn W, Stuppaeck C, Whitworth AB. Risperidone and breast-feeding. J Psychopharmacol. 2005 Mar;19(2):211-3. Abstract
  22. Ilett KF, Hackett LP, Kristensen JH, Vaddadi KS, Gardiner SJ, Begg EJ. Transfer of risperidone and 9-hydroxyrisperidone into human milk. Ann Pharmacother. 2004 Feb;38(2):273-6. Epub 2003 Dec 30. Abstract
  23. Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs. 2004 Abstract
  24. Ratnayake T, Libretto SE. No complications with risperidone treatment before and throughout pregnancy and during the nursing period. J Clin Psychiatry. 2002 Jan;63(1):76-7. No abstract available. Abstract
  25. Hill RC, McIvor RJ, Wojnar-Horton RE, Hackett LP, Ilett KF. Risperidone distribution and excretion into human milk: case report and estimated infant exposure during breast-feeding. J Clin Psychopharmacol. 2000 Apr;20(2):285-6. No abstract available. Abstract
  26. Kearns AE, Goff DC, Hayden DL, Daniels GH. Risperidone-associated hyperprolactinemia. Endocr Pract. 2000 Abstract
  27. Popli A, Gupta S, Rangwani SR. Risperidone-induced galactorrhea associated with a prolactin elevation. Ann Clin Psychiatry. 1998 Abstract

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