Question

I am a breastfeeding mother and i want to know if it is safe to use N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid? Is N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid safe for nursing mother and child? Does N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid extracts into breast milk? Does N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid has any long term or short term side effects on infants? Can N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid influence milk supply or can N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid decrease milk supply in lactating mothers?

N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid lactation summary

N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid usage has low risk in breastfeeding
  • DrLact safety Score for N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to 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 N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid usage in lactation

After a single dose of 65 mg (50 mg/square meter of body surface) as used for abortion no trace has been found in mother’s milk. For this reason it is considered to be safe for the infant while nursing under such an instance. Some authors considered it also to be safe when used on a weekly basis for the long-term treatment of Rheumatoid Arthritis and other Auto-immune diseases since few or nil presence in mother’s milk has been shown, although blood level testing in the infant is recommended. It can minimize exposure interrupting breastfeeding 24 hours after taking the drug, removing and discarding the milk. It is not recommended to nurse when used for treatment of cancer. Drug is cleared from the body after 6 elimination half-lives. Resuming breastfeeding after 4 days of breast milk pump and dump is likely safe .

Answer by DrLact: About N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid usage in lactation

Most sources consider breastfeeding to be contraindicated during maternal high-dose antineoplastic drug therapy with N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid. An abstinence period of at least 1 week after chemotherapy doses of N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid has been suggested.[1] Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[2] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.[3] Limited information indicates that a maternal dose of N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid up to 92 mg (1.12 mg/kg) produces low levels in milk, leading some authors to state that low single or weekly doses, such as those used for ectopic pregnancy or rheumatoid arthritis, are of low risk to the breastfed infant,[4][5][6][7][8] although some expert opinion warns against this use.[9][10][11][12][13] Withholding breastfeeding for 24 hours after a weekly low lose of N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid may decrease the infant's dose by 40%.[14][15] If breastfeeding during long-term, low-dose N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid use is undertaken, monitoring of the infant's complete blood count and differential could be considered.

N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid Side Effects in Breastfeeding

On day 151 postpartum, weekly N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid 25 mg subcutaneously begun a nursing mother. The estimated intake of the infant at that time was 3.4 mcg/kg in the first 24 hours after administration. The mother continued to breastfeed (extent not stated) for an additional 9 months while receiving subcutaneous N-(p-(((2,4-Diamino-6-pteridyl)methyl)methylamino)benzoyl)glutamic acid 25 mg weekly. No adverse effects were noted in the infant.[8]
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