Provigil and breastfeeding

[Weezie]

I have narcolepsy and have been off my medication, provigil since I got pregnant. I am very tired all the time and my husband is about to be deployed so I need something to help me stay awake. Everything I read says not to use provigil. Has anyone used this while nursing and seen any effects. Or has anyone used a different med as treatment for narcolepsy while nursing. I am very tired all the time, brain feels slower, have a hard time keeping up with help and now I will be without help for an entire month with a 7, 4 and 5 month old boys. Please help! I don't want to stop nursing until my little man is at least 1 year old.

[cpride]

Dear Weezie,

Modafinil (Provigil) has the potential to decrease your breastmilk supply, and we do not have studies on how much enters breastmilk. The structure of the drug suggests it may enter breastmilk readily; therefore, its use during breastfeeding could possibly be hazardous. There is another medication called methylphenidate (Concerta, Ritalin) that is also used for narcolepsy. We know that minimal amounts of the medication enters breastmilk. The time the methylphenidate would be highest in your milk would be one to three hours after your dose so avoid breastfeeding during that time if possible. Observe your infant for nervousness, insomnia, and poor appetite. If you have further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday through Friday, 8 to 5 CT.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[mytripleplay]

I am currently nursing a 2 year old and in the process of weaning. He currenly only nurses at night to go to sleep and then wakes up in the middle of the night to nurse. My concern is that my doctor and I are talking about medication for narcolepsy and I wondered what the studies were for toddlers who only nurse at night. Does anyone have experience with modafanil or other meds for excessive fatigue while nursing a two year old child?

[admin]

mytripleplay:

I doubt your infant would receive enough modafinil following only two feeds per day, particularly after morning administration of this drug. But just observe for insomnia in the infant. If you see it, you know what's going on.

Tom Hale Ph.D.