Is it safe to breastfeed while taking Dayvigo (lemborexant)?

Breastfeeding Safety with Dayvigo (Lemborexant)

Dayvigo (lemborexant) is not recommended during breastfeeding due to lack of safety data and potential risks to the infant.

Understanding Lemborexant and Breastfeeding

• Dayvigo (lemborexant) is a dual orexin receptor antagonist approved for the treatment of insomnia in adults 1, 2
• There are currently no published studies on the safety of lemborexant during breastfeeding 3
• Without specific safety data, the potential risks to breastfeeding infants cannot be adequately assessed 3

General Principles for Medication Use During Breastfeeding

• Most medications taken by breastfeeding mothers are compatible with breastfeeding, but some require caution or are contraindicated 4
• When evaluating medication safety during breastfeeding, factors to consider include:
  • Relative infant dose (RID) - medications with RID <10% are generally considered safe 5
  • Pharmacokinetic properties (half-life, protein binding, molecular weight) 6
  • Potential for accumulation in the infant 6
  • Infant's age and health status 6

Alternative Sleep Medications During Breastfeeding

For breastfeeding mothers requiring treatment for insomnia, consider these alternatives with established safety profiles:

• First-line options:

  • Non-pharmacological interventions (sleep hygiene practices, cognitive behavioral therapy for insomnia) 3
  • Short-term use of certain benzodiazepines with short half-lives and low RID values (<10%) 5

• If medication is necessary:

  • Choose medications with established safety data during breastfeeding 3
  • Select agents with short half-lives to minimize accumulation 6
  • Time medication administration to minimize infant exposure (typically immediately after breastfeeding) 6

Important Considerations

• All breastfed infants whose mothers are taking medications should be monitored for unusual symptoms or changes in feeding patterns 4
• The benefits of breastfeeding generally outweigh the theoretical risks of most medications 3
• When using any medication while breastfeeding, the infant should be observed for unusual drowsiness, poor feeding, or other adverse effects 6

Clinical Decision-Making

• Given the complete lack of safety data for lemborexant during breastfeeding, it should be avoided 3
• If insomnia treatment is necessary during breastfeeding, consult the most current information from resources like LactMed for medication options with established safety profiles 4
• The decision to use any medication during breastfeeding should involve a careful risk-benefit assessment and shared decision-making between the healthcare provider and patient 3