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Subject:
From:
Diane Wiessinger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 31 Mar 2005 14:47:46 -0500
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The mother of a 15 month old with a suspected ectopic pregnancy has been prescribed a 50-100 mg dose of methotrexate.  Hale gives figures following a 20 mg dose (as in for arthritis), and suggests that weaning for 2-4 half-lives should be sufficient.  Would those guidelines follow for the larger dose as well?

I've also suggested (pending more info; this won't happen before tomorrow or the next day) possible wiggle-room in the form of pumping before nursing and other milk-diminishing tactics instead of an outright weaning, at least after the first 1 to 2 half-lives (7.2 hr).

I'm puzzled by the combination of short half-life and possibility that the drug can linger, so that new pregnancies aren't recommended for several *months*.  What's the pharmacology there?  Is it a lingering metabolite that's the concern?

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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