From the Guidelines
Indomethacin is considered compatible with breastfeeding, as stated by the American Academy of Pediatrics, with trace amounts found in breast milk 1. When considering the use of indomethacin in breastfeeding mothers, it's essential to weigh the benefits against the potential risks. The amount of indomethacin that passes into breast milk is relatively low, with infants receiving approximately 0.1-0.5% of the maternal dose. For breastfeeding mothers who require NSAID therapy, indomethacin can be used, particularly for short-term treatment. The typical adult dose ranges from 25-50 mg taken 2-3 times daily, with a maximum daily dose of 200 mg. Some key points to consider when using indomethacin during breastfeeding include:
- Taking the medication immediately after breastfeeding to minimize infant exposure
- Monitoring infants for potential side effects, including gastrointestinal disturbances, although these are rare at the low exposure levels
- Exercising extra caution in premature infants or those with kidney problems, as they may be more sensitive to even small amounts of the medication
- Considering alternative NSAIDs like ibuprofen for long-term use in breastfeeding mothers due to their shorter half-life and established safety profile, as noted in the guideline on anaesthesia and sedation in breastfeeding women 2020 1. It's also important to note that indomethacin works by inhibiting prostaglandin synthesis, which reduces inflammation and pain, but this same mechanism accounts for its potential side effects. Overall, the use of indomethacin during breastfeeding should be approached with caution, and mothers should consult their healthcare provider to determine the best course of treatment.
From the FDA Drug Label
Indomethacin is excreted in the milk of lactating mothers. Indomethacin is not recommended for use in nursing mothers. The FDA drug label states that indomethacin is not recommended for use in nursing mothers because it is excreted in breast milk. Therefore, indomethacin is not compatible with breastfeeding 2.
From the Research
Indomethacin and Breastfeeding
- Indomethacin is a Nonsteroidal Anti-Inflammatory Drug (NSAID) that has been used for various medical conditions, including pain and inflammation.
- According to the study 3, short-term treatment with NSAIDs, including indomethacin, is considered compatible with breastfeeding.
- However, it is essential to note that the study 3 recommends considering safer alternatives and weighing the benefits and risks of using any medication during breastfeeding.
- Another study 4 provides general guidelines for the use of medicines during breastfeeding, stating that most medicines can be used safely during breastfeeding at the recommended dose, but there are exceptions that necessitate caution.
- There is limited information available on the specific use of indomethacin during breastfeeding, but the general consensus is that short-term use of NSAIDs is considered compatible with breastfeeding 3.
- It is crucial to consult with a healthcare professional before taking any medication, including indomethacin, during breastfeeding to discuss the potential risks and benefits and determine the best course of treatment.
Key Considerations
- The American Academy of Pediatrics and other medical organizations recommend that breastfeeding mothers consult with their healthcare provider before taking any medication, including NSAIDs like indomethacin.
- Studies 5 and 6 discuss the use of indomethacin in pregnancy and the neonatal intensive care unit, but do not provide specific information on its use during breastfeeding.
- A study 7 reviews the pharmacology of indomethacin, including its use in pregnant and lactating women, but does not provide conclusive evidence on its compatibility with breastfeeding.