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Mercaptopurine & pentasa

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  • Mercaptopurine & pentasa

    Hello,
    I currently take 50mg of mercaptopurine once daily and 1000mg of pentasa 4 times daily. My doctors agree that the pentasa is safe during breast feeding, but disagree about the mercaptopurine. The national institute of health's lactmed website says it is "probably accepable". I would really like to continue breast feeding and am looking for some clarification.
    Thank you.

  • #2
    Hello,

    You did not mention the age of the infant. The information I am providing you is under the assumption that the infant is full term and has no health issues. If the infant is a preemie, or has some kind of health concerns, please call us at the InfantRisk Center at 806-352-2519 (Mon-Fri, 8am-5pm, CDT) so we can discuss this with you on an individual basis.

    Dr. Hale rates the medications by risk. L1 medications are the most compatible with breastfeeding. The scale goes to L5, which are the medications that should be avoided while breastfeeding.

    Mercaptopurine is rated an L3. The time the medication is most concentrated in your system is about 2 hours after you take it. The transfer of the active metabolite (6-MP) into milk is quite low. However, this is a strong immunosuppressant and some caution is still recommended. The infant should be monitored closely for signs of immunosuppression, leukopenia, thrombocytopenia, hepatotoxicity, and pancreatitis. The risks to the infant are probably low. Recent long-term data suggest that the rate of infections in treated groups is not different from non-treated groups.

    The reason we say a medication is “probably compatible” with breastfeeding is because there is no way to know if any one infant may have a particular sensitivity to any medication.

    I would encourage you to discuss this medication with the infant’s pediatrician, so together you can make a final decision about breastfeeding while taking this medication. Please feel free to call us if you have any further questions.

    Colleen

    Colleen Peace, BSN, RN
    TTUHSC, InfantRisk Center

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