Cinnarizine Safety During Breastfeeding
Cinnarizine is contraindicated during breastfeeding and should not be used by nursing mothers.
Evidence-Based Recommendation
Cinnarizine is explicitly listed as contraindicated during breastfeeding in a comprehensive review of anti-migraine drugs, which assessed lactation risk for commonly used medications 1
This contraindication places cinnarizine in the same category as other medications deemed unsafe for nursing mothers, including high-dose aspirin, ergotamine, and methysergide 1
Safe Alternatives
If cinnarizine was being considered for migraine prophylaxis or vestibular disorders, safer alternatives compatible with breastfeeding include:
Metoprolol and propranolol are considered safe beta-blockers during breastfeeding for migraine prophylaxis 1
Verapamil is also assessed as safe for use during lactation 1
Amitriptyline is compatible with breastfeeding for migraine prevention 1
Clinical Considerations
The decision to avoid cinnarizine is based on its pharmacological properties and lack of safety data demonstrating compatibility with breastfeeding 1
Most medications are actually compatible with breastfeeding, and only a small number are truly contraindicated, making it important to identify specific unsafe agents like cinnarizine 2, 3
When prescribing for lactating mothers, the fundamental principle is risk-benefit assessment, with preference for well-studied drugs that have minimal milk transfer or pose no apparent risk to infant health 4
Practical Approach
Do not prescribe cinnarizine to breastfeeding women 1
Select from the safe alternatives listed above based on the specific indication (migraine prophylaxis, vertigo, etc.) 1
Breastfeeding should not be interrupted unnecessarily, as the benefits typically outweigh risks when appropriate medications are chosen 2, 3