From the Research
Reboxetine is considered to have a moderate safety profile during breastfeeding, but medications like sertraline or paroxetine are generally preferred due to their more established safety records, as indicated by the most recent and highest quality study available 1. When considering the use of reboxetine during breastfeeding, it's essential to weigh the benefits of treating the mother's condition against the potential risks to the infant. The amount of reboxetine transferred to breast milk is relatively small, with infants receiving approximately 1-2% of the maternal weight-adjusted dose. However, monitoring the infant for unusual drowsiness, feeding difficulties, or irritability is recommended. Some key points to consider when making this decision include:
- The drug's relatively short half-life of about 13 hours, which means that timing doses immediately after breastfeeding and avoiding breastfeeding during peak drug concentrations (2-4 hours after dosing) may further minimize infant exposure.
- The importance of using current, accurate resources, such as LactMed, to assess the safety of medications during breastfeeding, as suggested by 2.
- The need to balance the mother's need for treatment against potential risks to the infant, and to make this decision in consultation with healthcare providers, as emphasized by 3 and 1.
- The availability of alternative medications with more established safety profiles, such as sertraline or paroxetine, which may be preferred first-line options if clinically appropriate, as indicated by 4 and 1.