Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Drugline nr 12180

Publicerat 1995-08-22

Query Text

A woman who gave birth two weeks ago is breast feeding her child. Treatment with Methergin (methylergometrine) has started and is planned to continue for five days. In the Swedish Physicians Desk Reference it is stated that treatment with methylergometrine to a nursing mother should not proceed three days.

Answer Text

Methylergometrine passes over to the milk in small amounts (1) and effects on the breast fed child have not been reported in the literature. In the Swedish PDR it is recommended not to exceed three days of treatment while nursing (2). In the American PDR it is stated that methylergometrine may be administered orally for a maximum of 1 week postpartum in a recommended dose of 0.2 mg times 3 or 4. Adverse effects have not been described, but caution should be exercised when methylergometrine is given to a nursing mother (3). In one of our handbooks it is stated that breast feeding may be regarded as safe when the mother is treated with methylergometrine (4). According to the manufacturer, unpublished single cases have shown infants with effects such as increased blood pressure, bradycardia, tachycardia, vomiting, diarrhea, and clonic seizures when the mother has been taking methylergometrine for several days (5). The symptoms disappeared when the drug was withdrawn. The recommendation from the manufacturer is not to exceed three days of treatment. There are discussions to change the American PDR-text to be more like the Swedish PDR-text.

Conclusion

Methylergometrine can be found in small amounts in the breast milk. The recommendation is not to exceed three days of treatment while nursing. However, the risk for negative effects on the child seem small if the breast feeding continues for up to a week.

Törnqvist E
Alván G

References

  1. Drugline nr 03213 (year 1982)
  2. Fass, 1995
  3. Physicians Desk Reference. 1994; 48:th ed: 2063
  4. Bennet. Drugs and human lactation. 1988; page 158
  5. Personal communication. Bjarne Sandberg, Sandoz AB

Senast ändrad 2018-09-20