Meprobamate and Breastfeeding

Summary of use during lactation

Because there is little published experience with meprobamate during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant, or when other drugs that can cause sedation are used simultaneously. If meprobamate is required by the mother, it is not necessarily a reason to discontinue breastfeeding. Monitor the infant for sedation, poor feeding and poor weight gain.

Drug levels in milk and infant serum

Maternal Levels. One author reported a personal communication from the manufacturer. The manufacturer reports that 6 lactating women who were given a single 800 mg oral dose of meprobamate had peak milk meprobamate concentrations 4 hours after the dose.[1] The muscle relaxant carisoprodol is metabolized to meprobamate. A mother taking carisoprodol 700 mg three times daily during pregnancy and lactation had trough breastmilk levels of carisoprodol and meprobamate measured before the first morning dose on 4 consecutive days at steady-state (time postpartum not stated). Average minimum breastmilk levels were 0.9 mg/L for carisoprodol and 11.6 mg/L for meprobamate. The authors calculated that the minimum infant dose of the drug plus metabolite was 1.9 mg/kg daily or 4.1% of the maternal weight-adjusted dosage. Extrapolating these results to an average (rather than minimum) dose, the authors estimated that an exclusively breastfed infant would receive 3 mg/kg daily or 6% of the maternal weight-adjusted dosage.[2] A woman who was suspected to have been abusing carisoprodol had the drug and meprobamate detectable in breastmilk for 2 consecutive days after hospitalization; only meprobamate was detectable on day 3.[3] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

One paper reported that some psychiatric patients receiving meprobamate alone or in combination with other psychotropic drugs developed galactorrhea. Further details of meprobamate use were not reported.[4]

Alternative drugs to consider

Lorazepam, Oxazepam

References

1. Ayd FJ. Excretion of psychotropic drugs in human breast milk. Int Drug Ther Newsl 1973;8:33-40.
2. Nordeng H, Zahlsen K, Spigset O. Transfer of carisoprodol to breast milk. Ther Drug Monit 2001;23:298-300.11360042 PubMed
3. Bailey DN, Briggs JR. Carisoprodol: An unrecognized drug of abuse. Am J Clin Pathol 2002;117:396-400.11888078 PubMed
4. Hooper JH, Jr, Welch VC, Shackelford RT. Abnormal lactation associated with tranquilizing drug therapy. JAMA 1961;178:506-7.14448766 PubMed