Summary of use during lactation
The amounts of suvorexant in milk are very low. If suvorexant is required by the mother, it is not a reason to discontinue breastfeeding. If suvorexant is used, monitor the infant for sedation, especially if the infant is a newborn or preterm.
Drug levels in milk and infant serum
Maternal Levels. Two women were taking suvorexant 20 mg at night. They provided milk samples “a few days” after delivery. One woman provided a sample before a dose and 70 minutes after a dose. The concentrations in those samples were 1.36 and 2.85 mcg/L. The second woman provided samples a few days and one month after delivery taken at unknown times the day after taking the drug. The milk concentrations were 3.47 and 4.09 mcg/L, respectively. The authors estimated the relative infant dosages to be 0.17 and 0.2% in the two women, respectively.[1,2] The manufacturer reports a study in which a single 20 mg dose of suvorexant was given to 12 healthy lactating women. The mean amount of suvorexant recovered in breastmilk was 0.011 mg following a 20 mg maternal dose. The calculated mean daily infant dose was 0.002 mg/kg based on the actual infant body weight. The relative infant dose of the drug plus its metabolite hydroxysuvorexant was less than 1% of the maternal dose. Approximately 82% of the amount of suvorexant excreted in breast milk was excreted by 24 hours after a single maternal dose administration. 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
Relevant published information was not found as of the revision date.
Alternative drugs to consider
Zaleplon, Zolpidem
Source: Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, NCBI Bookshelf. Check LactMed for the most recent revision.
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