Is Pyridostigmine Safe in Breastfeeding
Question
I am a breastfeeding mother and i want to know if it is safe to use Pyridostigmine? Is Pyridostigmine safe for nursing mother and child? Does Pyridostigmine extracts into breast milk? Does Pyridostigmine has any long term or short term side effects on infants? Can Pyridostigmine influence milk supply or can Pyridostigmine decrease milk supply in lactating mothers?
Pyridostigmine lactation summary
- DrLact safety Score for Pyridostigmine is 1 out of 8 which is considered Safe as per our analyses.
- A safety Score of 1 indicates that usage of Pyridostigmine is mostly safe during lactation for breastfed baby.
- Our study of different scientific research also indicates that Pyridostigmine does not cause any serious side effects in breastfeeding mothers.
- Most of scientific studies and research papers declaring usage of Pyridostigmine 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 Pyridostigmine usage in lactation
Reversible cholinesterase inhibitor used for treatment of Myasthenia Gravis (see specific info). It is excreted into breast milk at undetectable levels (Skoglund 1978) or clinically non-significant (Hardell 1982, Djelmis 2002) without harmful effects having been observed in infants whose mothers were treated (Skoglund 1978, Hardell 1982). Plasma levels in such infants were undetectable (Hardell 1982). Because of a low oral bioavailability it seems even more unlikely the pass to the infant’s plasma through ingested breastmilk, except in preterm infants and immediate neonatal period, when there may be an increased intestinal permeability. American Academy of Pediatrics: medication usually compatible with breastfeeding.WHO 2002 List of Essential Medicines: compatible with breastfeeding.
Answer by DrLact: About Pyridostigmine usage in lactation
Because of the low levels of pyridostigmine in breastmilk, amounts ingested by the infant are small and infant serum levels are very low. Pyridostigmine is not be expected to cause any adverse effects in breastfed infants. Most mothers with myasthenia gravis are able to nurse successfully with pyridostigmine treatment, but occasionally breastfeeding must be discontinued to avoid excessive fatigue in the mother.
Pyridostigmine Side Effects in Breastfeeding
A woman was taking pyridostigmine 120 mg every 4 to 5 hours for myasthenia gravis. Her breastfed (extent not stated) infant reportedly thrived and had no cholinergic side effects.[1] Two infants whose mothers were taking pyridostigmine 3 and 5 mg/kg daily during pregnancy and lactation were exclusively breastfed. Both infants gained weight and developed normally and had no signs of cholinergic side effects.[2]
Pyridostigmine Possible Effects in Breastfeeding
Relevant published information in nursing mothers was not found as of the revision date. In animals, cholinergic drugs increase oxytocin release,[3] and have variable effects on serum prolactin.[4] The prolactin level in a mother with established lactation may not affect her ability to breastfeed. In a case series of 69 pregnancies in 65 women with myasthenia gravis over 27 years, 49 patients received pyridostigmine during pregnancy and lactation. Lactation data were available for 33 patients, and 25 of them nursed successfully, although the number of these mothers who were taking pyridostigmine was not given. Nursing was sometimes disrupted to avoid exhaustion in the mother.[5]