Carisoprodol Pregnancy and Breastfeeding Warnings

Overview
If you become pregnant, contact your doctor. you will need to discuss the benefits and risks using Carisoprodol while you are pregnant. Carisoprodol is found in breast mil. If you are or will be breast-feeding while you use Carisoprodol, check with your doctor. Discuss any possible risks to your baby.

Carisoprodol Pregnancy Warnings

Animal studies have reported reduced testes weight and sperm motility. The significance of these findings for human fertility is unknown.

Carisoprodol has been assigned to pregnancy category C by the FDA. Animal studies have reported that carisoprodol crosses the placenta and results in adverse effects on fetal growth and postnatal survival. However, animal studies have not adequately evaluated the teratogenic effects of carisoprodol. There are no controlled data in human pregnancy. Carisoprodol should only be given during pregnancy when benefit outweighs risk.

Carisoprodol Breastfeeding Warnings

Carisoprodol is excreted into human milk in concentrations two to four times that in the maternal plasma. Adverse effects in nursing infants have not been reported but are theoretically possible. Caution is recommended if carisoprodol is administered to a nursing woman.

In one case report, a breast-fed infant received about 4% to 6% of the maternal daily dose through breast milk and experienced no adverse effects. However, milk production was inadequate and the baby was supplemented with formula. In animal lactation studies, female offspring survival and offspring weight at weaning were decreased. This suggests that maternal use of carisoprodol may lead to reduced or less effective infant feeding (due to sedation) and/or decreased milk production.

Carisoprodol Levels and Effects while Breastfeeding

Summary of Use during Lactation

If carisoprodol is required by the mother, it is not necessarily a reason to discontinue breastfeeding. Slight sedation has occurred in a breastfed newborn infant who was exposed during pregnancy and lactation; sedation might be more pronounced in newborns who are exposed for the first time during nursing. Other agents may be preferred, especially while nursing a newborn or preterm infant, or when other drugs that can cause sedation are used simultaneously.

Drug Levels

Carisoprodol is metabolized almost entirely to meprobamate which contributes to the overall sedative effect. Carisoprodol has a half-life of 4 hours and meprobamate has a half-life of about 10 hours.[1]

Maternal Levels. A mother was taking carisoprodol 700 mg three times daily during pregnancy and lactation. Maternal trough breastmilk levels of carisoprodol and meprobamate were measured before the first morning dose on 4 consecutive days at steady-state (time postpartum not stated). Average minimum breastmilk levels were 0.9 mg/L for carisoprodol and 11.6 mg/L for meprobamate. The authors calculated that the minimum infant dose of the drug plus metabolite was 1.9 mg/kg daily or 4.1% of the maternal weight-adjusted dosage. Extrapolating these results to an average (rather than minimum) dose, the authors estimated that an exclusively breastfed infant would receive 3 mg/kg daily or 6% of the maternal weight-adjusted dosage.

A woman who was suspected to have been abusing carisoprodol had the drug and meprobamate detectable in breastmilk for 2 consecutive days after hospitalization; only meprobamate was detectable on day 3.[2]

A woman took carisoprodol 700 mg orally four times daily at 4- to 6-hour intervals during pregnancy and lactation for spasms of the back muscles. At 1 week postpartum, breastmilk samples were obtained 2 and 3.5 hours after doses of the drug. Two hours after a dose, carisoprodol concentration in milk was 1.4 mg/L and meprobamate was 10.9 mg/L. At 3.5 hours after the following dose, carisoprodol concentration in milk was 0.8 mg/L and meprobamate was 17.1 mg/L. The authors estimated that the maximum intake of carisoprodol plus meprobamate was 2.7 mg/kg daily or 6.9% of the maternal weight-adjusted dosage.

Infant Levels. A mother took carisoprodol 700 mg orally four times daily at 4- to 6-hour intervals during pregnancy and lactation. At 1 week postpartum, her exclusively breastfed infant had unmeasurable serum concentrations of carisoprodol (<2 mg/L) and meprobamate (<4 mg/L) 2 hours after nursing (3.5 hours after the mother's previous dose). The investigators hypothesized that either the dose received by the infant was low or the infant's metabolism of the drugs may have been stimulated from the exposure during pregnancy.

Effects in Breastfed Infants

A mother taking carisoprodol 700 mg plus propoxyphene 70 mg and acetaminophen 900 mg 3 times daily and partially breastfeeding her infant noticed no unusual behavior or adverse reactions in her infant. The infant grew normally and at 6 months of age, examination by a pediatrician found normal psychomotor development.

A mother took carisoprodol 700 mg orally four times daily at 4- to 6-hour intervals during pregnancy and while exclusively nursing her newborn infant. Slight sedation of the infant was noted during the first month of life.

Effects on the Central Nervous System

Effects on the Central Nervous System

Soma acts directly on the central nervous system rather than directly on skeletal muscles. The drug seems to interrupt neuronal communication with the spinal cord and certain areas of the brain, resulting in sedation and altered perception of pain. The main effects of this drug may result from its general sedating effect. 


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Before Taking Soma

Do not use Soma if you are allergic to carisoprodol or meprobamate (Equanil, Miltown), or if you have porphyria.

Before using Soma, tell your doctor if you are allergic to any drugs, or if you have:

• epilepsy or other seizure disorder;
• liver disease; or
• kidney disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Soma.

Soma may be habit-forming and should be used only by the person it was prescribed for. Soma should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. You may have withdrawal symptoms when you stop using Soma after using it over a long period of time. Withdrawal symptoms include stomach pain, sleep problems, headache, nausea, and seizure (convulsions). Do not stop using Soma suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. Soma may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Soma passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child younger than 12 years old..

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Important information about Soma

This medication may be habit-forming and should be used only by the person it was prescribed for. Soma should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. You may have withdrawal symptoms when you stop using Soma after using it over a long period of time. Do not stop using Soma suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. Soma can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase drowsiness and dizziness caused by Soma.


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How is it abused?

Abusers typically ingest Soma orally. Many abusers take it in combination with other drugs to enhance the effects of those drugs. Alcohol, codeine, diazepam, heroin, hydrocodone (especially Vicodin), meprobamate, and propoxyphene commonly are abused in combination with Soma. Abusers who combine Soma with Vicodin claim that this combination produces effects similar to those of heroin.