Summary of Use during Lactation

Data from two women indicate that 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. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Drug Levels

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]

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.

Alternate Drugs to Consider

Zaleplon, Zolpidem

References

1.

Ishikawa H, Furugen A, Nishimura A, et al. Validated UPLC-MS/MS method for quantification of melatonin receptor agonists and dual orexin receptor antagonists in human plasma and breast milk: Application to quantify suvorexant and lemborexant in clinical samples. J Pharm Biomed Anal 2024;251:116432. [PubMed: 39180895]

Substance Name

Suvorexant

CAS Registry Number

1030377-33-3

Drug Class

Breast Feeding

Lactation

Milk, Human

Hypnotics and Sedatives

Orexin Receptor Antagonists

Sleep Aids, Pharmaceutical