If this drug is unlikely to get into the milk in any significant amounts
after oral administration, it is likely to get into the milk in even smaller
amounts after intranasal administration.
Never assume a drug is contraindicated until proved otherwise. Assume it is
okay until proved otherwise. The risks of not breastfeeding are too great.
In this case we have a drug which is 99% protein bound. This is a good
theoretical basis on which to say it's okay for breastfeeding mothers, and
this does not change if the drug is given intranasally, IV or into the left
ventricle of the heart.
Jack Newman, MD, FRCPC
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