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Subject:	Re: Flexeril
From:	Phyllis Adamson IBCLC <[log in to unmask]>
Reply To:	Lactation Information and Discussion <[log in to unmask]>
Date:	Wed, 28 Dec 2011 15:43:03 -0700
Content-Type:	text/plain
Parts/Attachments:	text/plain (55 lines)

Yes it has a very long half-life, but the Volume of Distribution is HIGH - one reason it takes longer to clear from the body, and the rate of clearance is different for each area of the body it settles in. So it's much less in the blood and much more in remote areas of the doby.
And it's Protein Binding is 93%. Hale say to choose drugs that have PB of >90%. The higher the PB, the more difficult it is for the drug to enter the milk compartment.
No pediatric indications and caution urged. As an L3, Hale does not recommend suspension of breastfeeding.
Caution urged when baby is a preemie or newborn.

Here is what Lactmed / Toxnet has to say:
<http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~p2Y8FR:1>

Why does the doc want to interrupt breastfeeding when he could choose an alternative medication?
The named alternative is metaxalone.
Here is an alternative suggested by Lactmed / Toxnet:
<http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~qxxNaO:1>

Wonder if a muscle relaxant might in any way affect MER or nipple protractability?

Phyllis

---- Brenda Phipps <[log in to unmask]> wrote:

=============
Wondering the effects of Flexeril, a muscle relaxant given to a patient of mine for jaw spasms, and her 2 1/2 month old robust (15 lb) baby. This is an L3 in Hale's references, and it states it is "not necessarily a reason to wean" with its use.

The dentist told this mother that she needs to wean for up to 7 days after the last pill is taken due to its long half life. I don't believe this is correct, but would like to know from the others on the list if they have had patients take this with no problems in the baby.

Thank you ever so much,
Brenda Phipps, BS, IBCLC

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--
Phyllis Adamson, BA, IBCLC, RLC
Glendale, AZ.
[log in to unmask]

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