Can you take ziprasidone while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Because there is little published experience with ziprasidone during breastfeeding, other antipsychotic agents may be preferred, especially while nursing a newborn or preterm infant. A safety scoring system finds ziprasidone possible to use cautiously during breastfeeding. Infants breastfed during maternal use of ziprasidone should be monitored for excess sedation, irritability, poor feeding, and extrapyramidal symptoms, such as tremors and abnormal muscle movements.
Quoted from Ziprasidone — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised March 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of ziprasidone. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much ziprasidone gets into breastmilk
Maternal Levels. In one woman, ziprasidone was started at 9 days postpartum (dosage not stated, but presumably at a low dose and titrated upward). Serum and milk concentrations were obtained 10 minutes before the morning dose every day for 16 days. By day 7 of therapy, the patient was taking 80 mg of ziprasidone twice daily. Ziprasidone was not detectable in milk until day 10 of therapy when the milk concentration was 11 mcg/L; thereafter, the milk concentrations were not quantifiable (<10 mcg/L).
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A woman took ziprasidone 40 mg and citalopram 60 mg daily throughout pregnancy and postpartum. She breastfed extensively, except for occasional formula feedings by others. At 6 months of age, a pediatrician found the infant to be healthy with normal growth and development.
Patients enlisted in the National Pregnancy Registry for Atypical Antipsychotics who were taking a second-generation antipsychotic drug while breastfeeding (n = 576) were compared to control breastfeeding patients who were not treated with a second-generation antipsychotic (n = 818). Of the patients who were taking a second-generation antipsychotic drug, 60.4% were on more than one psychotropic. A review of the pediatric medical records, no adverse effects were noted among infants exposed or not exposed to second-generation antipsychotic monotherapy or to polytherapy. The number of women taking ziprasidone was not reported.
Effects on milk supply
Prolactin elevation has occurred during ziprasidone treatment, and galactorrhea has been reported, often in adolescents. However, prolactin elevation might be more transient and less severe than with phenothiazines. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Patients enlisted in the National Pregnancy Registry for Atypical Antipsychotics who were taking a second-generation antipsychotic drug while breastfeeding (n = 576) were compared to control breastfeeding patients who had primarily diagnoses of major depressive disorder and anxiety disorders, most often treated with SSRI or SNRI antidepressants, but not with a second-generation antipsychotic (n = 818). Among women on a second-generation antipsychotic, 60.4% were on more than one psychotropic compared with 24.4% among women in the control group. Of the women on a second-generation antipsychotic, 59.3% reported “ever breastfeeding” compared to 88.2% of women in the control group. At 3 months postpartum, 23% of women on a second-generation antipsychotic were exclusively breastfeeding compared to 47% of women in the control group. The number of women taking ziprasidone was not reported.
Frequently asked questions
Can you take ziprasidone while breastfeeding?
What the NIH's Drugs and Lactation Database says about Ziprasidone while breastfeeding — quoted in full. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of ziprasidone while breastfeeding?
LactMed lists Haloperidol, Olanzapine, Quetiapine, Risperidone as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does ziprasidone pass into breastmilk?
LactMed's measured drug levels for ziprasidone are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking ziprasidone?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on ziprasidone
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.