Dear Friends: I've been away and on return noted a large number of drug questions. So I have decided to provide my opinion on them as a group. Fluoxetine(Prozac)...while most of you know that I do not generally support the use of Prozac in newborns, particularly those born of mothers who have already received Prozac while pregnant...I am not absolutely adverse to the use of Prozac in older babies. How old ? I don't really know, but certainly infants 4-6 months and older could probably tolerate Prozac quite adequately assuming the dose is minimal (20 mg/day). Dostinex(cabergoline): As you all know, there are times when discontinuing breastfeeding is required. In the past we used a rather dangerous product called Parlodel. And today I noted someone using it in a mom for some reason. However, should this need arise again, I would suggest you review cabergoline (Dostinex) in my newest book. It is a cousin of Parlodel but is much, much safer. It very effectively (100%) inhibits lactation early postpartum by inhibiting Prolactin. Methylphenidate(Ritalin): As of now, we have no data on its transfer into human milk. I suspect small, but perhaps significant quantities might transfer. Ritalin is well absorbed, has a small molecular weight(233), and is lipophilic, which accounts for its entering the brain compartment. For these reasons alone, it is likely to enter milk. Now I don't really know if this is still enough to produce side effects in an infant, but I would be cautious. Observe for stimulation and anorexia. If your baby stays awake all night, then you know the reason. Ciprofloxacin(Cipro): The fluoroquinolones are generally contraindicated in pediatric patients, but only relatively. We still use them in emergency situations such as cystic fibrosis kids. The only problem with Cipro, is that its milk levels may be slightly higher than other members of this family. Herein, the only really dangerous condition, is the possible liklihood of overgrowth of c. difficle and induction of pseudomembranous colitis (a bloody diarrhea). So when needed in a breastfeeding mom, suitable choices are norfloxacin or ofloxacin, whose milk levels are quite low. Orlistat (Zenical): The so called 'fat burner' is actually just the opposite. It inhibits gastrointestinal lipoprotein lipase, thus inhibiting the absorption of triglycerides (fats). Only 5% of orlistat is bioavailable and the plasma levels are incredibly low (nanograms only). So I really doubt any would enter milk. This drug is kind of interesting. Seems it may be useful in helping individuals with high levels of PCBs and other lipophilic toxins rid their body of these toxins. ( The toxins exit the body dissolved in the unabsorbable fat in the gut). Regards Tom Hale, Ph.D. www.perinatalpub.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html