Is the use of methylphenidate compatible with breast feeding? This is a general question.
Methylphenidate is a central stimulant used for treatment of ADHD. The exact pharmacodynamic effect of methylphenidate is not known but is probably inhibition of dopamine and noradrenaline reuptake (1).
Two reports of the transfer of methylphenidate into breast milk has been found (2,3).
The milk concentration of methylphenidate was measured in the milk of a mother to a 6.4 month old child. The woman had taken methylphenidate 40 mgx2 for 5.5 weeks, usually 5 days/week but before the samples were taken she had taken methylphenidate continuously during one week. Samples were taken immediately before the morning dose and 2.2, 4, 6.2 and 24 hours thereafter. The mean concentration was 15.4 ug/l in milk and 5.8 ug/l in plasma. The hind- to fore-milk concentration ratio varied from 0.8 to 1. The absolute infant dose was 2.3 ug/kg/day and the relative infant dose was 0.2% of the weight adjusted maternal dose. The maximum milk concentration, measured 2 hours after dose intake, was approximately 43 ug/l and in that case the infant dose would be 0.52% of the weight adjusted maternal dose. Methylphenidate could not be detected in infant plasma and no adverse effects were observed. The infant also ate solid food (2).
A woman treated with methylphenidate 5 mg in the morning and 10 mg at noon was sporadically breast feeding her 11 month old infant. Plasma and milk concentration were measured and the mean milk concentration was 2.5 ng/ml. The absolute dose for the infant would be 0.38 ug/kg/day and the relative dose would be 0.16% of the weight adjusted maternal dose. The maximal milk concentration was 5.9 ng/ml which would give a relative infant dose of 0.38% of the weight adjusted maternal dose. No adverse effects were observed (3).
Data on methylphenidate and breast feeding is sparse and breast feeding during methylphenidate treatment can therefore not generally be recommended. If a methylphenidate treated mother decides to breast feed, the infant exposition for methylphenidate and the risk of adverse effects is probably low.
Senast ändrad 2018-09-20