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Focalin XR (Dexmethylphenidati hydrochloridum) for ADHD while breastfeeding

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  • Focalin XR (Dexmethylphenidati hydrochloridum) for ADHD while breastfeeding

    I’ve been taking 10-20mg focalin XR daily for years as needed to treat ADHD. When i got pregnant i stopped taking it. My son is now 7 months old. I breastfed exlusively for 6 months, now he is starting to eat some baby food at lunch but still breastfeeds mostly. It has been very challenging for me without the medication and now that i start work again i need to start taking 10mg daily in the morning.

    - Is it safe to continue breastfeeding while taking focalin XR?
    - Is it a problem that it is slow release?
    - Should i try to breastfeed him only in the morning before taking the medication and at night and switch to formula during the day?

    I would love to continue breastfeeding if possible but if there is any disadvantage for my son if i continue while taking focalin XR i would of course switch to formula.

    Thanks in advance for your time!

  • #2
    Sun_waves,

    Focalin is rated an L3-no data-probably compatible. "Dexmethylphenidate is the more pharmacologically active d-enantiomer of racemic methylphenidate. It is available in extended release formulations which would extend its biological half-life. We do have a few studies with methylphenidate. These studies show the transfer of methylphenidate into milk is low with relative infant doses ranging from 0.27% - 0.4% of the maternal dose. These levels are probably too low to be clinically relevant. No adverse effects were noted in any of the infants exposed to methylphenidate. While we do not have individual studies with dexmethylphenidate, one should assume they will be similar to the above studies with methylphenidate. Infants should be observed for agitation, and reduced weight gain although these are quite unlikely at these levels." (Medications and Mothers' Milk database, Dr Thomas Hale PhD). Take the medication after nursing and wait a few hours to nurse. Monitor for agitation, hyperactivity, insomnia, decreased appetite, weight gain, tremor.

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

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