Medications to curb alcohol abuse

[Msrara]

Hi,
I have a drinking problem & have researched medications to stop or limit the abuse of alcohol. I might add I do not breastfeed when I drink & I drink one to two nights a week. My child is 15 months old & only nurses at night. These drugs I found on the internet: naltrexone, nalmefene, topiramate. Are any of these safe while nursing or should I quit nursing all together?
Thanks for your help with this matter. I want to make the best educated decision.

[admin-james]

Hi, thanks for your post.

Naltrexone is very safe to use in breastfeeding. Only about 1% of your dose transfers to the milk and even infants are very tolerant to it. Topiramate transfers into milk to a significant degree, up to 25%, but the plasma levels in the babies end up being fairly low. In your situation with an older child, this is probably a safe choice to use. No studies on nalmefene in breastfeeding have been published and this product has not been FDA approved for use in the United States. It is similar to naltrexone in many ways, so it is likely to be safe for you to use, but it should be your last choice.

Good job getting yourself some help. It may be a hard road, but you won't regret it.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD

[Msrara]

Naltrexone 50 mg

I have been told to take my Naltrexone at night before bed. 50 mg. My 16 month old has been waking up frequently and nursing during the night. Originally i thought i would be taking this med in the morning and nursing hours after during the evening. Is it still safe to use even close to having just taken it?

[admin-james]

Yes. We give naltrexone our very best safety rating under normal circumstances. You have the added safety benefit of being on a low dose and having an older child. Toddlers get much less milk relative to their body weights than infants. These factors reduce the risks down even further.