Lactation carbamazepine

Lactation Carbamazepine and its epoxide metabolite are transferred into breast milk. Because of the potential for serious adverse reactions, decide whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. 

Drugs that may affect tetracyclines include antacids containing aluminum, calcium, or magnesium iron salts zinc salts barbiturates bismuth salts carbamazepine cholestyramine colestipol phenytoin rifamycins urinary alkalinizers (eg, sodium lactate, potassium citrate). 

Carbamazepine therapy is occasionally associated with hepatic toxicity, usually a hypersensitivity hepatitis that appears after a latency period of several weeks and involves increases in ALT, AST, and lactate dehydrogenase levels. Cholestasis is also possible, with increases in bilirubin and alkaline phosphatase concentrations. Mild, transient increases in transaminase levels generally do not necessitate discontinuation of carbamazepine. If ALT or AST levels increase more than three times the upper limit of normal, carbamazepine should be discontinued. 

Iqbal MM, Sohhan T, Mahmud SZ The effects of lithium, valproic acid, and carbamazepine during pregnancy and lactation. J Toxicol Clin Toxicol 2001 39 381. [PMID 11527233]... 

In seven lactating women the mean concentrations of carbamazepine in milk and plasma samples were 15 and 26 pmol/l respectively the concentrations of carbamazepine 10,11-epoxide were 5 and 8 qmol/1 respectively (75). The mean milk/plasma ratios were 0.64 and 0.79 respectively. The amounts of carbamazepine and carbamazepine 10,11-epoxide that a breast-feeding child is likely to consume are thus very small. 

The most commonly used mood-stahilizing medications used for the treatment of bipolar disorder include hthium, valproic acid, and carbamazepine. Each of these agents has unique therapeutic profiles to consider in the context of treatment of pregnant and lactating women. 

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