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I was recently diagnosed with Graves disease. I had already been on 50mg zoloft for treatment for postpartum depression which helped a lot but I am still on it. After I found out about the Graves, I had to start 25mg metoprolol 2x day for my heart. I still have a lot of other symptoms from the Graves disease so my doctor has prescribed 10 mg of methimazole. I haven't started it yet because I'm concerned with taking all these medications and breastfeeding. I want to wean off the zoloft and I should be able to stop the metoprolol soon but taking all of these at once worries me a lot. Especially the methimazole. My baby is almost 11 months and I really want to continue breastfeeding if I can but don't want to risk her health at all. Is this combination of meds safe or should I consider weaning?
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Ellen M,
These are 3 totally different types of medications. They are all rated L2's-probably compatible. You are on low doses of each so probably ok to nurse as long as your infant is not symptomatic.
Zoloft is an L2-probably compatible. A normal dose is 50-200mg a day. The amount that transfers into breast milk is 0.4-2.2% of your dose. Monitor for sedation or irritability, not waking to feed/poor feeding and weight gain.
Metoprolol is an L2-probably compatible. A normal dose is 100-450mg a day. The amount that transfers into breast milk is 1.4% of your dose. Monitor for Drowsiness, lethargy, pallor, poor feeding and weight gain.
Methimazole is an L2-probably compatible. A normal dose is 5-30mg a day. Most of the studies done were at doses of 20mg a day. In a study of 134 mother-child pairs with the mom taking 20mg a day, there were no changes in the infants TSH, T3, or T4 in a 12 month study. The amount that transfers into breast milk is 5.88-14.7% of your dose. Monitor for signs of hypothyroidism; and monitor your infants thyroid functions to be safe.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519
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