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Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

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Drugs and Lactation Database (LactMed) [Internet].

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Sumatriptan

Last Revision: January 20, 2020.

Estimated reading time: 1 minute

CASRN: 103628-46-2

image 135018088 in the ncbi pubchem database

Drug Levels and Effects

Summary of Use during Lactation

BBecause of the low levels of sumatriptan in breastmilk, amounts ingested by the infant are small. It also has poor oral bioavailability, further decreasing infant exposure to the drug. Some authors have suggested that withholding breastfeeding for 8 hours after a single subcutaneous injection would virtually eliminate infant exposure to the drug.[1] The manufacturer recommends withholding breastfeeding for 12 hours after a dose. Withholding breastfeeding might be helpful in extreme cases, such as in the mother of a preterm infant, but sumatriptan would not be expected to cause any adverse effects in most breastfed infants. One anecdotal report of lactation ceasing after a single injection of sumatriptan has not been verified.

Drug Levels

Maternal Levels. Five women who had been breastfeeding for 11 to 28 weeks received a single dose of sumatriptan 6 mg by subcutaneous injection. The peak milk level averaged 87.2 mcg/L (range 62 to 113 mcg/L) and it occurred 2.5 hours (range 1.7 to 3.5 hours) after the dose. The mean half-life in milk was 2.2 hours (range 1.2 to 3.1 hours). The authors calculated that an exclusively breastfed infant would receive 14.4 mcg in breastmilk with this dose, which is 3.5% of the weight-adjusted dosage.[1]

Eight women who were at least 1 month postpartum using sumatriptan to treat migraine provided milk samples at intervals over a 24-hour period after a single dose. The authors estimated the weight-adjusted infant dosage to be 0.7% (range 0.2 to 1.8%).[2]

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

Effects in Breastfed Infants

One author reported correspondence with the drug's manufacturer stating that of 3 women known to the manufacturer who used sumatriptan (dose and route unspecified) during breastfeeding none reported adverse effects on the infants.[2]

Effects on Lactation and Breastmilk

One author reported correspondence with the drug's manufacturer stating that 1 woman who used a single injection of sumatriptan (dose unspecified) during breastfeeding had a cessation of lactation.[3]

Alternate Drugs to Consider

Eletriptan

References

1.
Wojnar-Horton RE, Hackett LP, Yapp P, et al. Distribution and excretion of sumatriptan in human milk. Br J Clin Pharmacol. 1996;41:217–21. [PubMed: 8866921]
2.
Amundsen S, Nordeng H, Fuskevåg OM, et al. Transfer of triptans into human breast milk and estimation of infant drug exposure through breastfeeding. Reprod Toxicol. 2019;88:141. [CrossRef]
3.
Kristensen J. Sumatriptan and breastfeeding. Aust J Hosp Pharm. 1996;26:460. Letter.

Substance Identification

Substance Name

Sumatriptan

CAS Registry Number

103628-46-2

Drug Class

Breast Feeding

Lactation

Serotonin Agonists

Vasoconstrictor Agents

Serotonin 5-HT1 Receptor Agonists

Triptans

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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