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Methylprednisolone combined with other medications

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  • Methylprednisolone combined with other medications

    I am on Prednisolone (4 mg, tapered off and up to 24 MG on the first dose) for some back issues. They also put me on Cyclobenzaprine (10 MG used at bedtime), and Hydrocodone - Acetaminophen (5-325 TB). My Nurse Practitioner told me not to breastfeed while on this, but I know individually most of these are okay. I don't know if they are okay when combined, though. Are these not good to mix together and breastfeed, or am I still okay to breastfeed while taking these medications?

  • #2

    Methylprednisolone is rated an L2-limited data-probably compatible. The amount transferred into breast milk is 0.46-3.15% of your dose. [COLOR=#333333][FONT=lucida grande]Methylprednisonolone is probably suitable to use during breastfeeding as long as it is taken in low-moderate doses (doses do not exceed 80 mg daily). The problem with steroids is using high doses for prolonged periods of time could decrease the infants growth. You are on a low dose and tapering down, so should be ok.

    Hydrocodone/acetaminophen is rated an L3-limited data-probably compatible. The amount transferred is 2.2-3.7% of your dose. We do recommend waiting 2 hours after a dose to breastfeed as this is when it is most concentrated in the breast milk. In neonates, hydrocodone dosages should be limited to no more than 30 mg per day. If higher doses are required, then the infant should be closely monitored for possible untoward effects such as sedation and apnea. Doses more than 40 mg/day should be avoided, if your infant is older than 2 months you should not exceed 40mg in 24 hours. Monitor the infant for sedation, slowed breathing rate, pallor, apnea, constipation and appropriate weight gain.

    Cyclobenzapine is rated an L3-no data-probably compatible. We do not know how much transfers into breast milk. It has a long half life of 8-37 hours with the average being 18 hours. According to the product monograph up to 40% of adults reported drowsiness with the use of this product. You are taking a low dose, and if your infant is older and sleeping during the night after you take a dose this will reduce how much they receive. Monitor the infant for drowsiness/sedation, dry mouth, poor feeding, and vomiting.[/FONT][/COLOR]

    [COLOR=#333333][FONT=lucida grande]As long as your infant is not symptomatic the use of these medications together is probably ok. If the infant is too sedated try half breast milk and half formula or stored milk.

    I hope this helps.

    Sandra Lovato R.N.
    InfantRisk Center


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