Whats the web site

[frannie]

that I can go to to look up if a drug is safe to take while breastfeeding?

[JudyJudyJudy]

Medications:

http://www.kellymom.com/health/meds/aap-approved-meds.html

Herbs:

http://www.kellymom.com/herbal/ref/herbs_a.html

Pregnancy and breastfeeding:

http://safefetus.com/Search.asp

I usually google to find more info to make sure these sites are updated.

[frannie]

Thanks Judy

So if it says:
Unknown excretion into human breast milk.
Problems have not been documented in humans

Would this mean its okay to take it?

[JudyJudyJudy]

Try googling the med along with lactation risk category and see what it says. This is what the lactation categories mean:

http://www.kellymom.com/health/meds/lactation_risk_cat.html

I personally wouldn't go beyond L2, but some people feel comfortable going beyond that.

[pawprint]

Try googling the med along with lactation risk category and see what it says. This is what the lactation categories mean:

http://www.kellymom.com/health/meds/lactation_risk_cat.html

I personally wouldn't go beyond L2, but some people feel comfortable going beyond that.
Depends on the age of the baby and the frequency of nursing for me. There's a big difference between a newborn and a 10 month old to me, wrt to meds.

[Amy_G_]

what's the med and I'll look it up.
I usually look here
http://neonatal.ama.ttuhsc.edu/cgi-bin/discus/discus.cgi?pg=topics
but it's a bit hard to navigate and you can't always find the info you need. but I use it in conjunction with my Dr. Hales medication and mother's milk book.

[JudyJudyJudy]

You'll find that people view meds and breastfeeding differently. I personally think that Hale is far too liberal when it comes to meds and breastfeeding, but I know that others don't see it that way.

[frannie]

Its flexeril. From what I have been able to find its unknown if its safe.

[Amy_G_]

from here:
http://66.230.33.248/discus/messages/39/3701.html

"We unfortunately don't have any data on Flexeril (cyclobenzaprine) in breastfeeding women although I know it has been used.

It belongs to the tricyclic antidepressant family and is a commonly used muscle relaxant. It is not used as an antidepressant.

Since it is a tricyclic, and virtually none of the tricyclics are a problem in breastfeeding mothers, I really doubt this one would be a problem for a breastfeeding infant...but I don't have any data to confirm this as yet.

Tom Hale Ph.D."

It is rated L3 because there are not controlled studies on the med in breastfeeding mothers.

Depending also on how old baby is,
and how often mom is using the med and for what reason.
I find that muscle relaxants don't work as well as rest, stretching exercise, and a visit to a chiropractor if it's back pain.

[JudyJudyJudy]

Frannie, that's what I keep finding, too. I found this on Drugs.com:

It is not known whether this drug is excreted in human milk. Because cyclobenzaprine is closely related to the tricyclic antidepressants, some of which are known to be excreted in human milk, caution should be exercised when FLEXERIL is administered to a nursing woman.


I wouldn't be comfortable taking it while breastfeeding, but you have to make the decision for yourself and your child.

[Amy_G_]

You'll find that people view meds and breastfeeding differently. I personally think that Hale is far too liberal when it comes to meds and breastfeeding, but I know that others don't see it that way.

I'd like to see an example of what advice Dr. Hale gives that is too "liberal". He lists in his books all studies for the given medication, all complications, theoretic infant dose if that info is available, and then rates the drugs based on the information available. do you think his rating system is too liberal?

[JudyJudyJudy]

Yes, I think his rating system is too liberal. Medications that are thought to be safe today based on studies are often found NOT to be safe at a later date. Also, when he says something like, "I really doubt this one would be a problem for a breastfeeding infant...," when he really doesn't know, many are too quick to act as though God has spoken rather than thinking about what this really means: "but I don't have any data to confirm this as yet."

Based on what Drugs.com says, some tricyclic antidepressants are known to be excreted into milk, but Hale is saying otherwise.

[frannie]

Well I guess I'm not going to take it. Id just be to nerves during his next feeding.
Thanks for the help

[Amy_G_]

No, he actually says that the drugs are not a problem for breastfeeding.
If I look up the other drugs he mentions,
Amitriptyline is rated L2.
It is excreted in breastmilk in such tiny amounts (micrograms) and is undetectible in the infant's system.

Desipramine is also rated L2 but the drug is detected at a bit higher rate in breastmilk.

Just because a drug passes into breastmilk doesn't mean that is dangerous for baby.

Ibuprofen also shows up in small amounts in breastmilk but is rated L1, because it's a drug with minimal side effects and is commonly given to infants.

[Amy_G_]

I trust that he knows more about drugs than I do. He understands the chemical makeup of the drugs, the variables that determine if the drug passes into breastmilk including the molecular weight, whether it is binded to protein or free floating in the blood-which is where milk is made from, etc. He's an associate professor of pediatrics and an associate professor of pharmacology at the Texas Tech School of Medicine.

Drugs.com takes their information directly from the Physician's Desk reference (I have one of those as well). the Physician's Desk reference gets their information from the drug manufacturers, who do not want to take the liability for saying that ANY drug is safe in breastfeeding. I've never found a drug in the PDR that says it's safe in breastfeeding.

[Amy_G_]

frannie,
what are you taking the flexeril for?
Maybe there is something that is similar but is safer that you could take?

[Amy_G_]

Judy, think you could copy the "DR Hale is too liberal" thing to a new post for discussion?

[frannie]

frannie,
what are you taking the flexeril for?
Maybe there is something that is similar but is safer that you could take?


My back has been hurting a bit. Its Dh's prescription, I used to take it every once in a while before Ds came along and it helped. It was also relaxing and that would be nice right now to , but I will just take some Tylenol for the pain.

[Amy_G_]

Take Ibuprofen. it helps with pain and inflammation, and lasts longer. a warm bath for relaxation. definitely don't take it if it's not your prescription, the doseage for you may be totally different than the doseage for your dh based on weight and size.

[JudyJudyJudy]

Judy, think you could copy the "DR Hale is too liberal" thing to a new post for discussion?
Feel free if you want. Most people here will agree with you. The last time we had such a discussion, only a few people agreed with me, lol.

I'm one who is leery of meds even for adults. What's "safe" today is frequently found to be not safe tomorrow. It's bad enough to take that chance with an adult; it's often not worth taking the chance with a baby.

[MiMi_of_4]

Feel free if you want. Most people here will agree with you. The last time we had such a discussion, only a few people agreed with me, lol.

I'm one who is leery of meds even for adults. What's "safe" today is frequently found to be not safe tomorrow. It's bad enough to take that chance with an adult; it's often not worth taking the chance with a baby.

Thalidomide always comes to mind for me, Judy ~ and I know there are others, but that one will always be firmly etched in my mind.

[KerryS]

My back has been hurting a bit. Its Dh's prescription, I used to take it every once in a while before Ds came along and it helped. It was also relaxing and that would be nice right now to , but I will just take some Tylenol for the pain.

You sould NEVER take someone else's prescription, especially for something like Flexeril, which has a higher potential for abuse! Not only is it unsafe, but it's also illegal.

[JudyJudyJudy]

Thalidomide always comes to mind for me, Judy ~ and I know there are others, but that one will always be firmly etched in my mind.
Mine, too. Also, many of the meds that my mother was given were eventually taken off the market—unfortunately, not before she had long-term negative effects.


You sould NEVER take someone else's prescription, especially for something like Flexeril, which has a higher potential for abuse! Not only is it unsafe, but it's also illegal.
I totally agree, and I'll make a confession. I'm not one who takes many meds. In fact, when I have been prescribed them, I either don't fill them or end up throwing them away after they've expired. However, one night my neck, shoulders, and back were killing me and making my head feel like it was going to blow off, so I reluctantly decided to take one of dh's muscle relaxers (like me, he rarely takes meds, which is why only about two were gone out of the bottle). I ended up having a pretty bad allergic reaction, bad enough that I probably should have gone to the ER. However, I didn't go because I didn't want to have to explain why I had taken a med that had not been prescribed for me. It could have turned out very badly either way.