To      : Katharine West
Re      : Flexeril(cyclobenzaprine)

I'm leaving of ILCA today but thought I would try to answer your question re
using Flexeril in a BFing mom.

First,  we have absolutely no data on its transfer into breastmilk.  It belongs
to the Tricyclic antidepressant family (at least structurally),  and it
probably produces muscle relaxation via a central mechanism.  There are big
questions as to whether this product is really effective, and this would be my
first question to the mom,  does she think this product is really helping her.
 If she is doubtful,  then I would suggest that she talk to her doctor about
discontinuing the product.

But if she thinks it is really helping her,  then she could probably still
breastfeed ok if she monitored her infant closely.  One would need to know how
old the infant is, how stable, Apnea?,  etc.  Remember, almost all tricyclic
antidepressants have been studied as far as breastmilk is concerned and few of
them really pose a problem,  primarily due to low milk levels.  This baby would
need to be assessed over weeks of time,  due to the "potential" slow buildup of
this product with time.

So this case calls for a risk-vs-benefit assessment.  I would first try to
assess whether the med really is helping. If not,  suggest she discontinue it.

Due to the long half-life, it would be largely unreasonable to attempt to avoid
the plasma peaks.

See everyone at ILCA................


Regards

Tom Hale