Last update Sept. 8, 2021

Etafenoxine

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

It is a benzoxazine with an anxiolytic effect (Vicente 2020, Sartori 2019, Stein 2015, Nguyen 2006).
Oral administration in two to three daily doses.

At the date of the last update we did not find any published data on its excretion in breast milk.

Its high plasma protein binding (Nuss 2019) make it unlikely its excretion into breast milk in significant amounts.

Product with very few bibliographic references and marketed in few countries. Drug not approved by the FDA or the EMA (Sartori 2019); pending review of the risk / benefit ratio of this medicine (EMA 2021, Malta 2021).
It produces temporary drowsiness. Serious skin reactions, liver and intestinal toxicity, and menstrual disturbances have been reported (EMA 2021, Malta 2021, Sartori 2019, Cottin 2016, Moch 2012, Mennecier 2003).

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

Somnolence and adequate feeding of the infant should be monitored.
Bed-sharing with the baby is not recommended if drugs are used due to increased risk of suffocation or sudden infant death (ABM 2019, UNICEF 2020 & 2008, 2017, 2014 & 2013, Landa 2012, ABM 2008, UNICEF 2006).

Alternatives

  • Lorazepam (Safe substance and/or breastfeeding is the best option.)
  • Oxazepam (Safe substance and/or breastfeeding is the best option.)

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

Etafenoxine is also known as Etifoxine Hydrochloride.


Etafenoxine in other languages or writings:

Group

Etafenoxine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Etafenoxine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 90 %
Molecular weight 337 daltons
Protein Binding 888 - 95 %
Tmax 2 - 3 hours
6 (Metab.act: 24) hours

References

  1. EMA - European Medicines Agency. EMA starts review of anxiety medicine Stresam (etifoxine). EMA/351669/2021/06/05 2021 Full text (link to original source) Full text (in our servers)
  2. Malta Medicines Authority. EMA starts review of anxiety medicine Stresam (etifoxine). Circular Number P09/2021. 2021 Full text (in our servers)
  3. Vicente B, Saldivia S, Hormazabal N, Bustos C, Rubí P. Etifoxine is non-inferior than clonazepam for reduction of anxiety symptoms in the treatment of anxiety disorders: a randomized, double blind, non-inferiority trial. Psychopharmacology (Berl). 2020 Nov;237(11):3357-3367. Abstract
  4. (ABM): Blair PS, Ball HL, McKenna JJ, Feldman-Winter L, Marinelli KA, Bartick MC; Academy of Breastfeeding Medicine.. Bedsharing and Breastfeeding: The Academy of Breastfeeding Medicine Protocol #6, Revision 2019. Breastfeed Med. 2020 Jan;15(1):5-16. Abstract Full text (link to original source) Full text (in our servers)
  5. Sartori SB, Singewald N. Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacol Ther. 2019 Dec;204:107402. Abstract Full text (link to original source)
  6. Nuss P, Ferreri F, Bourin M. An update on the anxiolytic and neuroprotective properties of etifoxine: from brain GABA modulation to a whole-body mode of action. Neuropsychiatr Dis Treat. 2019 Jul 3;15:1781-1795. Abstract Full text (link to original source)
  7. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  8. UNICEF. Ball H, Blair PS. (For UNICEF UK). Caring for your baby at night. Health professional´s guide. 2017 Full text (link to original source) Full text (in our servers)
  9. Cottin J, Gouraud A, Jean-Pastor MJ, Dautriche AD, Boulay C, Geniaux H, Auffret M, Bernard N, Descotes J, Vial T. Safety profile of etifoxine: A French pharmacovigilance survey. Fundam Clin Pharmacol. 2016 Apr;30(2):147-52. Abstract
  10. Stein DJ. Etifoxine versus alprazolam for the treatment of adjustment disorder with anxiety: a randomized controlled trial. Adv Ther. 2015 Jan;32(1):57-68. Abstract Full text (link to original source)
  11. UNICEF UK. Statement on co-sleeping following publication of new NICE postnatal guidance. Infosheet. 2014 Full text (link to original source) Full text (in our servers)
  12. UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. None 2013 Full text (link to original source) Full text (in our servers)
  13. L.Landa Rivera, M.Díaz-Gómez, A.Gómez Papi, J.M.Paricio Talayero, C.Pallás Alonso, M.T.Hernández Aguilar, J.Aguayo Maldonado, J.M.Arena Ansotegui, S.Ares Segura, A.Jiménez Moya, J.J.Lasarte Velillas, J.Martín Calama, M.D.Romero Escós. El colecho favorece la práctica de la lactancia materna y no aumenta el riesgo de muerte súbita del lactante. Dormir con los padres. Rev Pediatr Aten Primaria. 14:53-60 2012 Full text (link to original source) Full text (in our servers)
  14. Moch C, Rocher F, Lainé P, Lacotte J, Biour M, Gouraud A, Bernard N, Descotes J, Vial T. Etifoxine-induced acute hepatitis: a case series. Clin Res Hepatol Gastroenterol. 2012 Oct;36(5):e85-8. Abstract
  15. ABM - Comité de protocolos de la Academia médica de lactancia materna (Academy of Breastfeeding Medicine). Protocolo Clínico de la ABM #6: Lineamientos sobre la práctica de dormir al bebé junto con la madre y la lactancia materna Revisión, marzo de 2008. Breastfeeding Medicine 2008 Full text (link to original source) Full text (in our servers)
  16. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008 Abstract Full text (link to original source) Full text (in our servers)
  17. Nguyen N, Fakra E, Pradel V, Jouve E, Alquier C, Le Guern ME, Micallef J, Blin O. Efficacy of etifoxine compared to lorazepam monotherapy in the treatment of patients with adjustment disorders with anxiety: a double-blind controlled study in general practice. Hum Psychopharmacol. 2006 Apr;21(3):139-49. Erratum in: Hum Psychopharmacol. 2006 Dec;21(8):562. Abstract
  18. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  19. Mennecier D, Rimlinger H, Gidenne S, Moulin O, Marzars H, Thiolet C, Farret O. [Etifoxine chlorhydrate-induced acute hepatitis]. Gastroenterol Clin Biol. 2003 Nov;27(11):1050-1. French. No abstract available. Abstract

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