Methylphenidate 
CASRN: 113-45-1  
For other data, click on the Table of Contents


Drug Levels and Effects:


Summary of Use during Lactation: 
In dosages prescribed for medical indications, limited evidence indicates 
that methylphenidate levels in milk are very low and might not affect nursing 
infants adversely. The effects of methylphenidate in milk on the neurological 
development of the infant have not been well studied. It is possible that large 
dosages of methylphenidate might interfere with milk production, especially in 
women whose lactation is not well established. 


Drug Levels: 
Maternal Levels. Three mothers were taking methylphenidate in an average 
dosage of 52 mg daily (range 35 to 80 mg daily) for attention deficit 
hyperactivity disorder. The average milk level was 19 mcg/L which resulted in an infant 
dosage of 2.9 mcg/kg daily or 0.7% of the maternal weight-adjusted dosage.[1]

The same authors reported a nursing mother who was taking methylphenidate, 
but it is unclear if this patient is one of those reported above. The mother was 
taking 40 mg twice daily, 5 days/week for 5.5 weeks prior to testing, but for 
7 consecutive days immediately before collecting blood and milk samples after 
a morning dose of 40 mg. The average milk level of methylphenidate over the 
24 hours after the dose was 15.4 mcg/L. The infant was calculated to receive 
2.3 mcg/kg daily which was 0.2% of the maternal weight-adjusted dosage.[2]

A woman who was 11 months postpartum was taking oral immediate-release 
methylphenidate 5 mg in the morning and 10 mg at noon. The drug was undetectable 
(<0.3 mcg/L) before the morning dose and 21 hours after the noon dose. Three 
other levels ranged from1.7 to 3.8 mcg/L. The authors estimated that a fully 
breastfed infant would receive a dose of 0.38 mcg/kg daily or 0.16% of the maternal 
weight-adjusted dosage.[3]

Infant Levels. Methylphenidate blood levels were measured in 2 breastfed 
infants. These were 2 of 3 infants whose mothers were taking an average of 52 mg 
daily of methylphenidate. The drug was undetectable (<1 mcg/L) in the infants' 
blood; however, the corresponding maternal dosages and times of blood 
collection were not stated in the abstract.[1]

A 6.4-month-old partially breastfed infant had been breastfed for 5.5 weeks 
by a mother taking methylphenidate 40 mg twice daily. The drug was undetectable 
(<1 mcg/L)in the infant's plasma 5.3 hours after the mother's dose and having 
been breastfed 4 times since the dose.[2] This patient might have been one of 
those in the report above by the same authors. 


Effects in Breastfed Infants: 
Seven of 8 infants whose mothers were taking either dextroamphetamine 
(average dosage 25 mg daily) or methylphenidate (average dosage 52 mg daily). The 
infants had no methylphenidate-related adverse reactions and were developing for 
their ages.[1]

One 6.4-month-old infant was mostly breastfed by a mother who had been taking 
methylphenidate 40 mg twice daily 5 days/week for 5.5 weeks. The mother 
reported that the infant was sleeping, eating and gaining weight normally.[2] This 
patient might have been one of those in the report above by the same authors. 


Possible Effects on Lactation: 
Methylphenidate reduces serum prolactin,[4] but no studies have been located 
as of the revision date on the effect of methylphenidate on milk production. 
The maternal prolactin level in a mother with established lactation may not 
affect her ability to breastfeed. 


AAP Category: 
Not listed. 


Alternate Drugs to Consider: 
_Amphetamine _ 
(http://toxnet.nlm.nih.gov/cgi-bin/sis/search/r?dbs+lact:@term+@na++Amphetamine++) 


References: 
1. Hackett LP, Ilett KF, Kristensen JH et al. Infant dose and safety of 
breastfeeding for dexamphetamine and methylphenidate in mothers with attention 
deficit hyperactivity disorder. Ther Drug Monit. 2005;27:220-1. Abstract. 
2. Hackett LP, Kristensen JH, Hale TW, Paterson R, Ilett KF. Methylphenidate 
and breast-feeding. Ann Pharmacother. 2006; 40:1890-1. PMID: _16940409_ 
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=16940
409&dopt=abstract)  
3. Spigset O, Brede WR, Zahlsen K. Excretion of methylphenidate in breast 
milk. Am J Psychiatry. 2007;164:348. PMID: _17267805_ 
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=17267805)  
4. Upadhyaya HP, Brady KT, Liao J et al. Neuroendocrine and behavioral 
responses to dopaminergic agonists in adolescents with alcohol abuse. 
Psychopharmacology (Berl). 2003;166:95-101. PMID: _12520313_ 
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=12520313&dopt=abstract)  



Substance Identification:


Substance Name: Methylphenidate 

CAS Registry Number: 113-45-1 

Drug Class: 
Adrenergic Agents 
Central Nervous System Stimulants 
Dopamine Agents 
Sympathomimetics 

Administrative Information:


LactMed Record Number: 
436


Last Revision Date: 
20070303 







Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
_http://www.breastfeedingalwaysbest.com/_ 
(http://www.breastfeedingalwaysbest.com/) 
www.myspace/AdonicaLee



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