Sumatriptan / breast feeding - any pharmacists/doctors out there?

[Bunny2021]

I’ve been prescribed Sumatriptan for migraines by my GP. The GP knows I’m breastfeeding. The NHS guidance says Sumatriptan can be taken whilst breastfeeding. However the medicine leaflet that came with it says don’t breastfeed for 12 hours and throw any expressed milk away.

Please can someone advise? I’ve taken a dose but now worried that I won’t be able to feed until later tomorrow morning.

I think that it is the breastfeeding network that have a helpline you can call with dedicated pharmacists to help with questions like that. I will try and find a link.

Take a look at the link below, and double check with your GP if you’re still concerned?

www.breastfeedingnetwork.org.uk/migraines/

Not a doctor or pharmacist, but a quick Google indicates that it's a standard and accepted treatment for migraine in breastfeeding mothers, very little is excreted in milk, and the manufacturer's suggestion to withhold feeding for 12 hours is not considered necessary in the case of a healthy full term baby. www.ncbi.nlm.nih.gov/books/NBK501255/

"Drugs In Breastmilk - Is It Safe? - The Breastfeeding Network" www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/#:~:text='If%20you%20have%20specific%20questions,Helpline%20on%200300%20100%200212.%E2%80%9D

I was prescribed this for migraines in my second trimester and my GP said it's 100% safe and zero concerns taking it. I went to the pharmacy to collect and the pharmacist said don't take during pregnancy and got a big drug encyclopaedia out and showed me where it said it's not safe she was adamant I shouldn't take it. I was very confused and didn't take it in the end but luckily the migraines ended soon after.

Thanks everyone. Feeling reassured now!

@LittleCatDog

I was prescribed this for migraines in my second trimester and my GP said it's 100% safe and zero concerns taking it. I went to the pharmacy to collect and the pharmacist said don't take during pregnancy and got a big drug encyclopaedia out and showed me where it said it's not safe she was adamant I shouldn't take it. I was very confused and didn't take it in the end but luckily the migraines ended soon after.

I’m pregnant and my gp has told me not to take them

@TakeMyMoney seriously, I'm glad I didn't then! He literally said they're 100% safe to me. Phew!!

I was also told not to take them while pregnant and breastfeeding. That was 6 years ago though so there may have been an update since then.

Pregnancy and breastfeeding are very different conditions.

I'd phone the drugs in breast milk helpline if in any doubt. A physical book could be outdated.

I stopped breastfeeding (at 33 months so not the end of the world) because of that package insert! I found out two days later it wasn’t necessary. Glad you found out in time. Hope it works for you, it’s been a godsend for me.

I was prescribed these while TTC so gp said not to take once I get a positive test. Didn't take throughout pregnancy but now BF so would be interested to know whether safe to take!

Below is what the prescribing information for doctors state which will be in line with the patient leaflet. Both these documents are prepared by the company with regulatory approval and reflect latest knowledge. I prepare these documents as part of my job so would do what’s suggested. I wouldn’t want my child unnecessarily exposed to the drug.

Lactation

It has been demonstrated that following subcutaneous administration sumatriptan is secreted into breast milk. Infant exposure can be minimised by avoiding breast-feeding for 12 hours after treatment, during which time any breast milk expressed should be discarded.

@LittleCatDog it’s weird how they all give such different advice

There are very few drugs that are actually problematic in breastfeeding though and a whole heap of caution. There’s also conflation with pregnancy which is very different.

If something is excreted into breast milk its concentration is the same as in maternal blood. This can sound like a big deal, but given the baby then swallows it, actually usually isn’t. After going through the baby’s stomach a lot of drugs then go through the liver in first pass metabolism and then enter the baby’s blood stream. So usually not much, if any left. There are a few exceptions but they are things like drugs for MS, lithium, warfarin etc.

Pregnancy is completely different because for a drug that passes through the placenta fetal blood levels are the same as maternal blood levels.