Sulfasalazine and breastfeeding

[RachelR]

Hi ,

I am 36 years old and have Psoriatic arthritis. I have a four month old son who I am breastfeeding. Currently, I am on prednisone 5-10 mgs and sulfasalazine (Pyraline-EN) which I am needing to increase to 3 grams a day very soon. I am a slightly nervous about the high dose of sulfasazine and breastfeeding my baby. I have done some of my own research and opinion seems to be divided. I would greatly appreciate some expert advice regarding this.

Many thanks,

[admin]

Rachel:

Sulfasalazine is not an ideal product to use in a breastfeeding mothers. More than 5 cases of bloody diarrhea have been reported in breastfeeding infants, so it is not an ideal candidate, particularly at higher doses. This is a difficult syndrome, and the only products that we consider relatively safe are the anti-TNF products such as infliximab and etanercept. These are large molecular weight products that do not enter milk readily, and are not absorbed orally by the infant.

I cannot reassure you that this higher dose of sulfasalazine will set well with your infant.

Tom Hale Ph.d.