Tranylcypromine and Breastfeeding

Summary of use during lactation

Because little information is available on the use of tranylcypromine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

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

Effects in breastfed infants

A woman with severe depression took tranylcypromine 100 to 120 mg daily, as well as pimozide, diazepam and alprazolam during pregnancy and postpartum. She breastfed her infant until about 2 weeks postpartum when the infant developed abdominal distension and feeding intolerance. The symptoms resolved on discontinuation of breastfeeding.[1]

Effects on lactation and breastmilk

Nine subjects were treated with an average dose of 29 mg daily (range 10 to 40 mg daily) of oral tranylcypromine for an average of 16 days. Serum prolactin levels increased by 3 mcg/L.[2]The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternative drugs to consider

Nortriptyline, Paroxetine, Sertraline

References

1. KennedyD WebsterWS HillM Abnormal pregnancy outcome associated with high-dose maternal tranylcypromine therapy: Case report and literature review. Reprod Toxicol 2017 69 146 9 28237611 PubMed
2. PriceLH CharneyDS HeningerGR Effects of tranylcypromine treatment on neuroendocrine, behavioral, and autonomic responses to tryptophan in depressed patients. Life Sci 1985 37 809 18 4033356 PubMed