Last update Sept. 4, 2022

Chlorpromazine

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Typical, first generation antipsychotic. A central nervous system tranquilizing agent with antipsychotic, anxiolytic and antiemetic properties. Oral or intramuscular administration 1 to 3 times a day.

It is excreted in breastmilk in very small to undetectable amounts (Zuppa 2010, Yoshida 1998, Ohkubo 1993, Wiles 1978, Uhlir 1973), even after maternal doses of 1200 mg. (Blacker 1962)

The urine levels of two infants whose mothers took chlorpromazine were very low, around 1 microgram/L. (Yoshida 1998)

In infants whose mothers were taking chlorpromazine, reports have ranged from no side effects (Wiles 1978, Ayd 1964, Kris 1957) with normal growth and neurological development (Lacey 1971, Kris 1962) to numbness and sedation (Lee 1993, Wiles 1978, Lacey 1971) with decreased developmental score at 12 and 18 months when taking other psychotropic medications at the same time. (Yoshida 1998)

Because it is a dopamine inhibitor, it produces an increase in prolactin levels and can increase milk production, having been used as a galactogogue. (Lawrence 2016 p670, Mannion 2012, Muresan 2011, Zuppa 2010, Gabay 2002)

The use of chlorpromazine during lactation is possible (Hale, Uguz 2021)Monitoring of drowsiness and development in infants is required (Klinger 2013, WHO 2002) and prescribing it at the lowest effective dose and, if possible, as monotherapy (Parikh 2014, Tényi 2000). Doses of 100 mg per day do not cause problems for the infant. (Lawrence 2016 p394)


See below the information of this related product:

Alternatives

  • Olanzapine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Perphenazine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Quetiapine Fumarate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Risperidone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Trifluoperazine Hydrochloride ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

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

Chlorpromazine in other languages or writings:

Tradenames

Main tradenames from several countries containing Chlorpromazine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 70 %
Molecular weight 319 daltons
Protein Binding 95 %
VD 20 l/Kg
pKa 9.3 -
Tmax 1 - 2 hours
30 hours
M/P ratio 0.5 -
Theoretical Dose 0.008 - 0.004 mg/Kg/d
Relative Dose 0.05 - 0.2 %

References

  1. 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
  2. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  3. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  4. Parikh T, Goyal D, Scarff JR, Lippmann S. Antipsychotic drugs and safety concerns for breast-feeding infants. South Med J. 2014 Abstract
  5. 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
  6. Mannion C, Mansell D. Breastfeeding self-efficacy and the use of prescription medication: a pilot study. Obstet Gynecol Int. 2012;2012:562704. Abstract Full text (link to original source) Full text (in our servers)
  7. Muresan M. Successful relactation--a case history. Breastfeed Med. 2011 Abstract
  8. Zuppa AA, Sindico P, Orchi C, Carducci C, Cardiello V, Romagnoli C. Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. J Pharm Pharm Sci. 2010;13(2):162-74. Abstract Full text (link to original source) Full text (in our servers)
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  10. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact. 2002 Aug;18(3):274-9. Abstract
  11. Yoshida K, Smith B, Craggs M, Kumar R. Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol Med. 1998 Abstract
  12. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  13. Ohkubo T, Shimoyama R, Sugawara K. Determination of chlorpromazine in human breast milk and serum by high-performance liquid chromatography. J Chromatogr. 1993 Abstract
  14. Wiles DH, Orr MW, Kolakowska T. Chlorpromazine levels in plasma and milk of nursing mothers. Br J Clin Pharmacol. 1978 Abstract Full text (link to original source) Full text (in our servers)
  15. Uhlír F, Rýznar J. Appearance of chlorpromazine in the mother's milk. Act Nerv Super (Praha). 1973 Abstract
  16. Lacey JH. Dichloralphenazone and breast milk. Br Med J. 1971 Abstract Full text (link to original source) Full text (in our servers)
  17. Kris EB. Children of mothers maintained on pharmacotherapy during pregnancy and postpartum. Curr Ther Res Clin Exp. 1965 Abstract
  18. Ayd FJ. Children born of mothers treated with chloropromazine during pregnancy. Clin Med. 1964;71:1758-63.(Cited in Hale 2017 p 192) 1964
  19. Blacker KH, Weinstein BJ, Ellman GL. Mothers milk and chlorpromazine. Am J Psychol 1962;114:178–9 (Cited in Hale 2017 p 192). 1962
  20. HOOPER JH Jr, WELCH VC, SHACKELFORD RT. Abnormal lactation associated with tranquilizing drug therapy. JAMA. 1961 Abstract
  21. KRIS EB, CARMICHAEL DM. Chlorpromazine maintenance therapy during pregnancy and confinement. Psychiatr Q. 1957 Abstract

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