Cymbalta during Pregnancy & Breastfeeding

by on May 11, 2012

Cymbalta (Duloxetine) may be contraindicated for certain people, including pregnant and breastfeeding women.

The effects of Cymbalta on pregnancy are usually focused on the fetus, but the drug can also affect the pregnant woman herself. For instance, duloxetine has been associated with orthostatic hypotension, a condition where blood pressure suddenly drops as a person stands up due to blood pooling in the legs. Since blood pressure naturally drops during pregnancy because of the expanded circulatory system, Cymbalta can cause extreme hypotension, putting the mother and the fetus at risk. Another reason pregnant women shouldn’t take the drug is to avoid urinary retention which may require catheterization.

The Fetus

Various fetal side effects of Cymbalta have been found to result in low birthweights, preterm deliveries and unexplained fetal deaths, especially when the drug was taken towards the last trimester of pregnancy.

In other studies, 33% of babies born to mothers who took SSNRI’s exhibited withdrawal symptoms such as tremors, a high-pitched cry, feeding and sleeping problems and even seizures. Perhaps the most serious side effect of Cymbalta on fetuses is failure of the ductus arteriosus (a tube that transports oxygen to fetal lungs through blood) to close, causing pulmonary hypertension and abnormal blood circulation upon birth.

Cymbalta During Breastfeeding

There are no definitive studies proving that Cymbalta affects breastfed infants, but medical professionals are inclined to discourage its use during breastfeeding. This is because Cymbalta may be passed into breastmilk.

The presence of duloxetine in the child’s system may thus complicate the process of prescribing medicines for the pediatric patient. For example, paracetamol, which is frequently prescribed for child pains, is known for its hepatotoxic properties and so is Cymbalta. When taken together, these two medicines can wreak havoc on the child’s liver.

Can Cymbalta ever be Prescribed to Pregnant or Breastfeeding Women?

Cymbalta is considered a Category D medicine by the U.S. Food and Drugs Administration, meaning there is proof of human fetal risk from taking the drug, but prescribing it may be necessary in life-threatening situations where there are no safer alternatives.

For example, duloxetine may be prescribed to a pregnant woman who is experiencing intense attacks of fibromyalgia and is unresponsive to any other medicine. Knowing that extreme pain causes hypertension, which can be life-threatening, Cymbalta may be prescribed as the dangers of not taking it are greater than those posed by its side effects.

Cymbalta is a central nervous system or CNS-acting drug whose administration requires the strictest level of supervision by a medical professional. If you have been on Cymbalta and are planning to have a baby, make sure you inform your doctor early on so you can be weaned off the drug slowly, avoid withdrawal symptoms and shift to a safer treatment when possible.