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Client was prescribed Mucinex D. She is only breastfeeding her 2 yr. old once a day. Can she take it? Thank ou!
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Dear Shomoru,
Mucinex D is a combination of guaifenesin (expectorant) and pseudoephedrine (decongestant). We do not have data on how much guaifenesin enters breastmilk, but we know minimal amounts of pseudoephedrine does. The main risk with this combination medication is a decrease in milk supply due to the pseudoephedrine. Since she has an older child who is not dependent on breastmilk for nutrition, the risk would be minimal. Observe child for sedation (guaifenesin) and agitation (pseudoephedrine) although not likely since the child receives small amounts of breastmilk and can process medications well by now. The time the medication would be highest is the first 3 hours after the dose so she may want to avoid that time to decrease risk. Oxymetazoline (Afrin) nasal spray is a topical decongestant that is unlikely to enter plasma in clinically significant amounts; and therefore, unlikely to cause a decrease in milk supply. She could use oxymetazoline along with plain guaifenesin if she needed to protect her milk supply. Oxymetazoline may be used no more than 3 days. The child should be observed for nervousness and should not be used if the child has hypertension or cardiac symptoms.
Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center
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