IMPORTANT : DRUGS AFFECTING LACTATION

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Drug Effects In Lactation 

 Most drugs have not been tested in
 • nursing women and their effect on infant is unknown. Maternal drug use during lactation should • be cautious. There is some degree of risk with any 
• systemic medication ingested by the mother. Drug Effects In Lactation (Cont,d) The dose reaching the infant is proportional 
• to the mother’s drug concentration. In many instances, the infant may not 
• receive sufficient drug to produce adverse effects. Most OTC and prescription drugs taken only 
• when needed, are thought to be safe. Drug Effects In Lactation (Cont,d) Safe Drugs In Lactation (NOT In Pregnancy): 
• Antibacterials (Penicillins And Cephalosporins) – Anticoagulants (Heparin Or Warfarin) – Antihypertensives (ACE Inhibitors, Ca – 2+ Blockers) Caffeine (In Moderate Amounts) – Corticosteroids (Prednisolone or Inhaled Products) – Decongestants (Nose Drops or Spray) – Acetaminophen – Cromolyn – Drug Effects In Lactation (Cont,d) Safe Drugs In Lactation (NOT In Pregnancy):
 • Digoxin – Famotidine – Ibuprofen – Insulin – Levothyroxine – Mini-pill OCPs – Antiepileptics – Antihistamines – Drug Effects In Lactation (Cont,d) Drugs to be used with caution in lactation:
 • Aspirin – Beta blockers (acebutolol, atenolol) – Corticosteroids (systemic drugs may suppress growth – and interfere with endogenous corticosteroid production) Diuretics – Dyslipidemics (cholestyramine [may cause severe – constipation in the infant],statins) Methadone – Metoclopramide – Theophylline – Drug Effects In Lactation (Cont,d) Drugs to be used with caution in lactation: • Alcohol (within 2 hours of breast-feeding) – Aluminum-containing antacids – Amantadine – Antianxiety agents (benzodiazepines) – Antibacterials (chloramphenicol, metronidazole, – nitrofurantoin, sulfonamides) Antidepressants (bupropion, tricyclics, and selective – serotonin receptor inhibitors) Antihistamine (clemastine) – Antipsychotics (older or typical agents) – Drug Effects In Lactation (Cont,d) Contraindicated drugs in lactation (if they • are required, breast feeding should be stopped): Amiodarone – Antibacterials (fluoroquinolones, tetracyclines, – trimethoprim [interfere with folic acid metabolism in the infant]) Antineoplastics – Bromocriptine (decreases milk production) – Drug Effects In Lactation (Cont,d) Contraindicated drugs in lactation (Cont,d) • Cyclosporine – Drugs of abuse (amphetamines, cocaine, heroin, – marijuana, phencyclidine, nicotine) Ergotamine – Isotretinoin – Lithium – Phenytoin – Caffeine (large amounts) 

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