Question

I am a breastfeeding mother and i want to know if it is safe to use C 4311? Is C 4311 safe for nursing mother and child? Does C 4311 extracts into breast milk? Does C 4311 has any long term or short term side effects on infants? Can C 4311 influence milk supply or can C 4311 decrease milk supply in lactating mothers?

C 4311 lactation summary

C 4311 is safe in breastfeeding
  • DrLact safety Score for C 4311 is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of C 4311 is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that C 4311 does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of C 4311 safe in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About C 4311 usage in lactation

The amount excreted to breast milk is so small that it is not detected in breast-fed infants. No adverse side-effects have been reported. Check-up for milk production since it may decrease Prolactin excretion on theoretical basis.

Answer by DrLact: About C 4311 usage in lactation

In dosages prescribed for medical indications, limited evidence indicates that C 4311 levels in milk are very low and not detectable in infant serum. The effects of C 4311 in milk on the neurological development of the infant have not been well studied. If C 4311 is required by the mother, it is not a reason to discontinue breastfeeding.[1] It is possible that large dosages of C 4311 might interfere with milk production, especially in women whose lactation is not well established.

C 4311 Side Effects in Breastfeeding

Seven of 8 infants, whose mothers were taking either dextroamphetamine (average dosage 25 mg daily) or C 4311 (average dosage 52 mg daily) were clinically evaluated. The infants had no drug-related adverse reactions and were developing normally for their ages which averaged 4.4 months.[2] One 6.4-month-old infant was mostly breastfed by a mother who had been taking C 4311 40 mg twice daily 5 days/week for 5.5 weeks. The mother reported that the infant was sleeping, eating and gaining weight normally.[3] This patient might have been one of those in the report above by the same authors. An infant was being breastfed (extent not stated) by a mother who began taking sertraline 50 mg daily and C 4311 after 5 weeks postpartum. Dosage was started at 10 mg daily with an immediate-release product and gradually increased to 72 mg daily of an extended-release product. At 14 weeks of age, the infant was developing normally no feeding difficulties. Examinations at 6 months and 1 year of age found no developmental problems in the child.[5] A nursing mother was taking extended-release C 4311 (Concerta) 36 mg daily and duloxetine 90 mg daily for ADHD, generalized anxiety disorder, borderline personality disorder, and depression. She partially (amount not stated) breastfed her infant for about 1 month. At 6 months of age, the infant's development was considered to be normal, except for recurrent pneumonia caused by congenital pulmonary airway malformation.[6]

C 4311 Possible Effects in Breastfeeding

C 4311 reduces serum prolactin,[7] but no studies have been located as of the revision date on the effect of C 4311 on milk production. The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed. A 15-year-old girl had been receiving C 4311 54 mg daily in an osmotic release tablet (OROS) for 2 years. Sertraline was started for depression at 50 mg daily and increased to 100 mg daily along with haloperidol 0.5 mg daily. After 12 weeks of therapy, inattentativeness at school and headaches prompted a change from the OROS product to a modified-release C 4311 product (brand not specified) at 30 mg daily, then increasing to 50 mg daily. Three days after the increase in dosage, the girl had spontaneous milk flow from both breasts and subsequently had an elevated serum prolactin of 67.7 mcg/L. C 4311 and haloperidol were discontinued, but sertraline was continued. One week later, galactorrhea resolved completely. Fifteen days after drug discontinuation, the girl's prolactin level was in the normal range at 19.4 mcg/L.[8]
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