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Subject:
From:
Katherine Morrison <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 16 Mar 2011 14:23:21 -0400
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Perfect Liz.  Thanks!

Looks like the following would all be preferred over valium/diazepam:

*Lorazepam (Ativan)*
http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
search result "lorazepam"
*Summary of Use during Lactation:
Lorazepam has low levels in breastmilk, a short half-life relative to many
other benzodiazepines, and is administered directly to
infants. Lorazepam would not be expected to cause any adverse effects in
breastfed infants with usual maternal dosages. No special precautions are
required.
 *
*Midazolam (Versed)*
http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
search result: midazolam
*Maternal Levels. Twelve mothers were given a total of 30 doses of oral
midazolam 15 mg for sleep in the first 5 days postpartum if they requested
it. In 11 of the mothers, midazolam was unmeasurable (<3 mcg/L) in
breastmilk 7 hours after the dose. One of the mothers accidentally took a
second tablet (30 mg total) on one occasion and had a 7-hour milk level of 9
mcg/L. No accumulation occurred with repeated nightly doses in any of the
mothers. Two additional women who were 2 to 3 months postpartum had hourly
milk sampling after a single 15 mg dose. Peak milk levels of both the drug
and metabolite occurred at 1 and 2 hours after the dose in the 2 patients.
Peak milk levels of midazolam plus 1-hydroxymidazolam were about 13 mcg/L
and the average milk level over the 7-hour period was 6.7 mcg/L.[5] Using
these values, an infant exclusively nursing for 7 hours after a dose would
receive about 0.3 mcg of the drug plus metabolite. *

*Oxazepam (Serax)*
http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
search result: oxazepam
*Summary of Use during Lactation:
Oxazepam has low levels in breastmilk, a short half-life relative to many
other benzodiazepines, and is administration directly to infants. Oxazepam
would not be expected to cause any adverse effects in breastfed infants with
usual maternal dosages. No special precautions are required.

Drug Levels:
Oxazepam is a short-acting metabolite of diazepam. ** nordiazepam
(desmethyldiazepam) and temazepam, which are in turn metabolized to the
active metabolite oxazepam. *

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