From the FDA Drug Label
Olanzapine is present in human milk. There are reports of excess sedation, irritability, poor feeding and extrapyramidal symptoms (tremors and abnormal muscle movements) in infants exposed to olanzapine through breast milk The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ZYPREXA and any potential adverse effects on the breastfed child from ZYPREXA or from the mother’s underlying condition Infants exposed to ZYPREXA should be monitored for excess sedation, irritability, poor feeding, and extrapyramidal symptoms (tremors and abnormal muscle movements)
Olanzapine use in breastfeeding: Olanzapine is present in human milk and may cause adverse effects in infants, including excess sedation, irritability, poor feeding, and extrapyramidal symptoms.
- Key considerations:
- Monitor infants for adverse effects
- Weigh the benefits of breastfeeding against the potential risks to the infant
- Consider the mother's clinical need for olanzapine 1
From the Research
Olanzapine is generally considered compatible with breastfeeding, and mothers taking olanzapine can usually continue breastfeeding their infants, as the amount of medication that transfers into breast milk is relatively low. The relative infant dose is estimated to be about 1-4% of the weight-adjusted maternal dose, which is below the 10% threshold often used to determine safety during lactation 2. Infants exposed to olanzapine through breast milk should be monitored for excessive sedation, poor feeding, developmental delays, and weight changes. Most studies have not shown significant adverse effects in breastfed infants whose mothers were taking therapeutic doses of olanzapine 3, 4. However, premature infants or those with impaired metabolic function may be at higher risk for side effects. If a mother needs to take olanzapine and wishes to breastfeed, the benefits of breastfeeding typically outweigh the potential risks. The medication should be taken immediately after breastfeeding to minimize infant exposure, and if possible, the lowest effective dose should be used. Any concerns about infant behavior or development should prompt immediate consultation with a healthcare provider. Some key points to consider when using olanzapine during breastfeeding include:
- Monitoring infant behavior and development closely
- Using the lowest effective dose of olanzapine
- Taking the medication immediately after breastfeeding to minimize infant exposure
- Being aware of the potential risks and benefits of olanzapine use during breastfeeding, as reported in studies such as 3 and 2.