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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK501765_"><span class="title" itemprop="name">Moclobemide</span></h1><p class="small">Last Revision: <span itemprop="dateModified">October 15, 2024</span>.</p><p><em>Estimated reading time: 3 minutes</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 71320-77-9</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/135010768" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135010768" alt="image 135010768 in the ncbi pubchem database" /></a><div id="LM857.Drug_Levels_and_Effects"><h2 id="_LM857_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM857.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Moclobemide is not approved for marketing in the United States by the U.S. Food and Drug Administration, but is available in other countries. Limited information indicates that maternal doses of moclobemide up to 900 mg daily produce low levels in milk. Although several breastfed infants apparently experienced no adverse effects during maternal use of moclobemide, no rigorous, long-term data are available. Until more data are available, moclobemide should only be used with careful monitoring during breastfeeding, especially while nursing a newborn or preterm infant.</p></div><div id="LM857.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Six mothers who were 3 to 5 days postpartum were given a single dose of 300 mg of moclobemide by mouth. Milk samples were taken before the dose and 3, 6, 9, 12 and 24 hours after the dose. Peak milk levels of moclobemide and its major inactive metabolite, Ro 12-8095, occurred 3 hours after the dose. The average 24-hour excretion of moclobemide in milk was 0.17 mg (range 0.11 to 0.28 mg) and of Ro 12-8095 was 0.1 mg (range 0.05 to 0.14 mg). The active metabolite, Ro 12-5637, was not detectable (assay limit not stated) in breastmilk. The authors estimated that this amount would be equal to approximately 1% of the weight-adjusted maternal dosage.[<a class="bk_pop" href="#LM857.REF.1">1</a>]</p><p>Eight women were being treated for postpartum depression with moclobemide in daily dosages ranging from 300 mg to 900 mg. After at least 2 weeks of therapy, single blood and milk samples were collected from each patient within 4 hours after the dose. Average breastmilk levels were as follows: 300 mg daily (n = 2), 1.6 mg/L; 450 mg daily (n = 3), 1.24 mg/L; 600 mg daily (n = 2), 2 mg/L and 900 mg (n = 1) 5.3 mg/L. The Ro12-5637 metabolite was not detected and the Ro12-8095, was not quantified.[<a class="bk_pop" href="#LM857.REF.2">2</a>] Using data in presented in the paper, the maximum amount of moclobemide that an infant would receive is estimated to be about 4% (range 2% to 6%) of the maternal weight-adjusted dosage. Average infant doses should be less than this.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM857.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Nine women were being treated for postpartum depression with moclobemide in daily dosages ranging from 150 mg to 900 mg. All breastfed (extent not stated) their infants during therapy, but the duration of infant exposure to moclobemide in breastmilk was not stated. Maternal reports of infant weight gain, milestones and behavioral effects as well as clinical observation by the authors indicted no adverse effects in the breastfed infants.[<a class="bk_pop" href="#LM857.REF.2">2</a>]</p><p>Four women who took moclobemide in dosages of 300 mg to 1200 mg daily during pregnancy were followed up in the neonatal period and at 1 year postpartum. All women breastfed (extent not stated) their infants. One woman ceased breastfeeding at 2 months postpartum because of severe gastroesophageal reflux in the infant; two other mothers breastfed beyond 12 months. The duration of breastfeeding in the fourth infant was not sated. All infants achieved developmental milestones.[<a class="bk_pop" href="#LM857.REF.3">3</a>]</p></div><div id="LM857.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Moclobemide increases serum prolactin in males and has caused galactorrhea in women.[<a class="bk_pop" href="#LM857.REF.4">4</a>-<a class="bk_pop" href="#LM857.REF.7">7</a>] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.</p></div><div id="LM857.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM857.REF.1">Pons
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G, Schoerlin
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MP, Tam
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YK, et al.
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Moclobemide excretion in human breast milk.
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Br J Clin Pharmacol
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1990;29:27-31.
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[<a href="/pmc/articles/PMC1380057/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1380057</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/2297459" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2297459</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM857.REF.2">Buist
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A, Dennerstein
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L, Maguire
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KP, et al.
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Plasma and human milk concentrations of moclobemide in nursing mothers.
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Hum Psychopharmacol
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1998;13:579-82. doi:10.1002/(SICI)1099-1077(1998120)13:8<579::AID-HUP45>3.0.CO;2-4 [<a href="http://dx.crossref.org/10.1002/(SICI)1099-1077(1998120)13:8<579::AID-HUP45>3.0.CO;2-4" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="LM857.REF.3">Taylor
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T, Kennedy
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D. Safety of moclobemide in pregnancy and lactation, four case reports.
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Birth Defects Res A Clin Mol Teratol
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2008;82:413. doi:10.1002/bdra.20478 [<a href="http://dx.crossref.org/10.1002/bdra.20478" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="LM857.REF.4">Koulu
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M, Scheinin
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M, Kaarttinen
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A, et al.
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Inhibition of monoamine oxidase by moclobemide: Effects on monoamine metabolism and secretion of anterior pituitary hormones and cortisol in healthy volunteers.
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Br J Clin Pharmacol
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1989;27:243-55.
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[<a href="/pmc/articles/PMC1379786/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1379786</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/2469451" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2469451</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="LM857.REF.5">Juruena
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MF, Pires
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ML, Calil
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HM. Moclobemide effects on prolactin plasma levels in healthy individuals: the hormonal increase induced by a single dose is maintained during a 4-week period of drug intake.
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Int Clin Psychopharmacol
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1997;12:317-21.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/9547133" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9547133</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="LM857.REF.6">Scheinin
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M, Koulu
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M, Karhuvaara
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S, et al.
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Evidence that the reversible MAO-A inhibitor moclobemide increases prolactin secretion by a serotonergic mechanism in healthy male volunteers.
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Life Sci
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1990;47:1491-9.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/2250565" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2250565</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="LM857.REF.7">Dunn
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NR, Freemantle
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SN, Pearce
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GL, et al.
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Galactorrhoea with moclobemide.
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Lancet
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1998;351:802.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/9519955" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9519955</span></a>]</div></dd></dl></div></div><div id="LM857.Substance_Identification"><h2 id="_LM857_Substance_Identification_">Substance Identification</h2><div id="LM857.Substance_Name"><h3>Substance Name</h3><p>Moclobemide</p></div><div id="LM857.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>71320-77-9</p></div><div id="LM857.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Antidepressive Agents</p><p>Monoamine Oxidase Inhibitors</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>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.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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