Last update Feb. 27, 2014

Milnacipran

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

Serotonin and Norepinephrine selective re-uptake inhibitor. Authorized for treatment of Fibromyalgia in some countries. Frequent and potential severe side effects have been found. At usual dose it does not induce galactorrhea.

Latest update failed to find relevant data on breastfeeding.

Pharmacokinetic data (low serum protein binding and high bioavailability) indicates that drug excretion into breast milk in significant amount is highly probable. Absorption by the infant is likely to be high as well.

A known alternative would be preferred until more information on the drug is available.

Alternatives

  • Duloxetine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Paroxetine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Pregabalin (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Sertraline 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.

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

Milnacipran is also known as


Group

Milnacipran belongs to this group or family:

Tradenames

Main tradenames from several countries containing Milnacipran in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 85 - 90 %
Molecular weight 283 daltons
Protein Binding 13 %
VD 5 - 6 l/Kg
Tmax 2 - 4 hours
6.1 - 8. 1 hours

References

  1. Trenque T, Herlem E, Auriche P, Dramé M. Serotonin reuptake inhibitors and hyperprolactinaemia: a case/non-case study in the French pharmacovigilance database. Drug Saf. 2011 Abstract
  2. EMeA Questions and answers on the recommendation for the refusal of the marketing authorisation for Milnacipran EMA 2009 Full text (in our servers)
  3. EMeA Preguntas y respuestas sobre la recomendación de denegar la autorización de comercialización de \ Milnacipran EMA 2009
  4. Puozzo C, Panconi E, Deprez D. Pharmacology and pharmacokinetics of milnacipran. Int Clin Psychopharmacol. 2002 Abstract
  5. EmeA Milnacipran Ficha técnica 2000 Full text (in our servers)
  6. Puozzo C, Leonard BE. Pharmacokinetics of milnacipran in comparison with other antidepressants. Int Clin Psychopharmacol. 1996 Abstract

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