Several medications

[Brittanydominick]

I have recently been prescribed several meds. Batrim 500 2x a day, cephalexin 500 4x a day, hydrocodone 7.25 4x a day or as needed, fioricet not sure of mg, as needed, and pred taper 5mg starting with 4 times a day.
I nurse my 26 month old for naps and 3x a night.
will it be ok to continue nursing or do I need to wean him completely?

[admin]

Brittanydominick,

Bactrim is rated an L3-limited data-probably compatible. The amount that transfers into breast milk is 2-3% of the sulfamethoxazole and 4-9% of the trimethoprim. This is ok for older infants just monitor for vomiting, diarrhea, rash and thrush.

Cephalexin is rated an L1- limited data-probably compatible. The amount that transfers into breast milk is 0.39-1.47% of your dose. This one is also ok just monitor for the same side effects as the Bactrim.

Hydrocodone is rated an L3-limited data-probably compatible. The amount that transfers into breast milk is 2.2-3.7% of your dose. We do recommend taking this after you nurse and avoid nursing for about 3 hours. Do not exceed 40mg in 24 hours. Monitor for sedation, slowed breathing rate, apnea, pallor, constipation and appropriate weight gain.

Fioricet is an combination of acetaminophen, caffeine and butalbital. Fioricet is rated an L3-no data (for the butalbital portion), caffeine transfers 6-25.9% and the acetaminophen transfers 6.41-24.23%. The caffeine and tylenol are probably ok at low doses. Butalbital however has a long half-life of 35 hours. We say it is ok to use on occasion, but we do not recommend this on a daily basis because of the long half-life and sedating effects. We recommend to wait about 3-4 hours to nurse after a dose and monitor your infant for sedation, slowed breathing rate/apnea, pallor, not waking to feed at regular intervals.

Prednisone is rated an L2-limited data-probably compatible. The amount that transfers is 1.8-5.3% of your dose. We recommend to wait 4 hours for doses greater than 40mg. Since you are starting at 20mg and tapering down so this should not be a problem.

Sandra Lovato R.N.
InfantRisk Center
806-352-2519

[Burnest]

How long you taking cephalexin for?