Is Methylphenidate compatible with breastfeeding? Do we have alternatives for Methylphenidate?

Methylphenidate

July 6, 2018 (Very Low Risk)

A central nervous system stimulant and indirect sympathomimetic with actions and indications similar to dexamfetamine.
Indicated in attention-deficit hyperactivity disorder (ADHD) and in narcolepsy.
Oral administration 1 to 3 times a day.

It is excreted in breastmilk in clinically insignificant amounts or not at all (Collin 2018, Bolea 2014, Spigset 2007, Hackett 2006) and no short or long term problems have been observed in infants whose mothers were taking it (Collin 2018, Rowe 2013, Bolea 2014, Spigset 2007, Hackett 2006).
The plasma levels of these infants were undetectable or very low (Bolea 2014, Hackett 2006).

Several medical associations and experts consider the use of this medication to be safe during breastfeeding (Calvo 2018, Collin 2018, Ornoy 2018, Marchese 2015, Rowe 2013).

Some authors suggest clinically monitoring weight gain and possible irritability in the infant (Marchese 2015, Rowe 2013).

Methylphenidate does not influence prolactin levels on a regular basis (Janowsky 1978).

Alternatives

We do not have alternatives for Methylphenidate since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Dexmethylphenidate Hydrochloride
  • Methylphenidate Hydrochloride

Writings

  • Μεθυλφαινιδάτη (Greek)
  • ميثيلفينيدات (Arabic)
  • Метилфенидат (Cyrillic)
  • 哌甲酯 (Chinese)
  • メチルフェニデート (Japanese)
  • C14 H19 NO2 (Molecular formula)
  • Methyl α-phenyl-2-piperidylacetate (Chemical name)
  • MPH (Abbreviation)
  • N06BA04 (ATC Code/s)

References

  1. Ornoy A. Pharmacological Treatment of Attention Deficit Hyperactivity Disorder During Pregnancy and Lactation. Pharm Res. 2018Abstract
  2. Calvo-Ferrandiz E, Peraita-Adrados R. Narcolepsy with cataplexy and pregnancy: a case-control study. J Sleep Res. 2018Abstract
  3. Collin-Lévesque L, El-Ghaddaf Y, Genest M, Jutras M, Leclair G, Weisskopf E, Panchaud A, Ferreira E. Infant Exposure to Methylphenidate and Duloxetine During Lactation. Breastfeed Med. 2018Abstract
  4. Marchese M, Koren G, Bozzo P. Is it safe to breastfeed while taking methylphenidate? Can Fam Physician. 2015Abstract Full text (link to original source) Full text (in our servers)
  5. Bolea-Alamanac BM, Green A, Verma G, Maxwell P, Davies SJ. Methylphenidate use in pregnancy and lactation: a systematic review of evidence. Br J Clin Pharmacol. 2014Abstract Full text (link to original source) Full text (in our servers)
  6. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  7. Spigset O, Brede WR, Zahlsen K. Excretion of methylphenidate in breast milk. Am J Psychiatry. 2007Abstract Full text (link to original source) Full text (in our servers)
  8. Hackett LP, Kristensen JH, Hale TW, Paterson R, Ilett KF. Methylphenidate and breast-feeding. Ann Pharmacother. 2006Abstract Full text (link to original source) Full text (in our servers)
  9. Janowsky DS, Leichner P, Parker D, Judd L, Huey L, Clopton P. Methylphenidate and serum prolactin in man. Psychopharmacology (Berl). 1978Abstract