Effects During Pregnancy and Lactation
◉ Overview of Lactation Use
No studies have been conducted on levomilacrimate in lactating women. However, the racemic form of levomilacrimate is present in low concentrations in breast milk and is not expected to have any adverse effects on breastfed infants. Lactating women should use levomilacrimate with caution, especially when breastfeeding newborns or premature infants, until more data become available. Breastfed infants should be monitored for restlessness, irritability, feeding difficulties, and poor weight gain.
◉ Effects on Breastfed Infants
No published information found as of the revision date.
◉ Effects on Lactation and Breast Milk
No specific published information found regarding levomilacrimate as of the revision date.
An observational study investigated the outcomes of 2,859 women who took antidepressants in the two years prior to pregnancy. Compared to women who did not take antidepressants during pregnancy, mothers who took antidepressants throughout all three stages of pregnancy were 37% less likely to breastfeed at discharge. Mothers who took antidepressants only in late pregnancy were 75% less likely to breastfeed at discharge. Mothers who took antidepressants only in early and mid-pregnancy were not less likely to breastfeed at discharge. The study did not specify the type of antidepressants used by the mothers. A retrospective cohort study analyzed hospital electronic medical records from 2001 to 2008, comparing women who took antidepressants in late pregnancy (n = 575), women with mental illness but not taking antidepressants (n = 1552), and mothers not diagnosed with mental illness (n = 30,535). Women treated with antidepressants were 37% less likely to breastfeed at discharge than women not diagnosed with mental illness, but there was no difference in the likelihood of breastfeeding compared to untreated mothers diagnosed with mental illness. None of the mothers took mirtazapine. A study of 80,882 Norwegian mother-infant pairs conducted between 1999 and 2008 showed that 392 women reported starting antidepressants postpartum, and 201 women reported starting antidepressants during pregnancy. Compared to a control group unexposed to antidepressants, taking antidepressants in late pregnancy was associated with a 7% lower likelihood of initiating breastfeeding, but had no effect on the duration of breastfeeding or the rate of exclusive breastfeeding. Compared to a control group unexposed to antidepressants, recent initiation or restart of antidepressant use was associated with a 63% lower likelihood of primary breastfeeding at 6 months, a 51% lower likelihood of any form of breastfeeding, and a 2.6-fold increased risk of abrupt cessation of breastfeeding. No specific antidepressants were mentioned in the study.

Bioorg Med Chem Lett.2008 Feb 15;18(4):1346-9;Psychopharmacology (Berl).2004 Sep;175(2):241-6;Psychopharmacology (Berl).2002 Jul;162(3):323-32.

Milnacipran (1S,2R)-isomer used to treat major depressive disorder.
See also: Levomilnacipran (containing the active moiety); Milnacipran hydrochloride (note moved to).

C15H23CLN2O

282.8089

282.149

175131-60-9

Milnacipran hydrochloride;101152-94-7;Milnacipran;92623-85-3;Milnacipran-d5 ((1S-cis) hydrochloride)

6917778

White to off-white solid powder

2

2

5

19

295

2

Cl[H].O=C([C@@]1(C2C([H])=C([H])C([H])=C([H])C=2[H])C([H])([H])[C@@]1([H])C([H])([H])N([H])[H])N(C([H])([H])C([H])([H])[H])C([H])([H])C([H])([H])[H]

XNCDYJFPRPDERF-NQQJLSKUSA-N

InChI=1S/C15H22N2O.ClH/c1-3-17(4-2)14(18)15(10-13(15)11-16)12-8-6-5-7-9-12/h5-9,13H,3-4,10-11,16H2,1-2H31H/t13-,15+/m0./s1

(1S,2R)-2-(aminomethyl)-N,N-diethyl-1-phenylcyclopropane-1-carboxamide;hydrochloride

F2695 F 2695 F-2695 F2695 hydrochloride Levomilnacipran Levomilnacipran HCl Fetzima.

2934.99.9001

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Note: Please store this product in a sealed and protected environment, avoid exposure to moisture.

Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)

H2O : ≥ 50 mg/mL (~176.80 mM)

Solubility in Formulation 1: 100 mg/mL (353.59 mM) in PBS (add these co-solvents sequentially from left to right, and one by one), clear solution; with sonication.

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 (Please use freshly prepared in vivo formulations for optimal results.)