From the Guidelines
Meloxicam is considered compatible with breastfeeding, as it is classified as a conditional recommendation by the American College of Rheumatology 1. When considering the use of meloxicam during lactation, it is essential to weigh the benefits and risks. The American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases recommends that disease control be maintained with lactation-compatible medications, and individualized risks and benefits be reviewed with each patient 1.
Key Considerations
- Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that can be used during breastfeeding, but with caution.
- The American Academy of Pediatrics considers some NSAIDs, such as ibuprofen, indomethacin, and naproxen, safe for use during breastfeeding, but meloxicam is not explicitly mentioned in this context 1.
- However, the American College of Rheumatology guideline provides more recent and relevant guidance, classifying meloxicam as a conditional recommendation for use during breastfeeding 1.
Recommendations
- If meloxicam is necessary during breastfeeding, use the lowest effective dose for the shortest duration possible, typically 7.5-15 mg once daily.
- Monitor the baby for any unusual symptoms, such as changes in feeding patterns, unusual sleepiness, vomiting, or diarrhea.
- Consider alternative pain relievers, such as acetaminophen, which is generally considered the safest option during breastfeeding.
Important Notes
- The medication works by inhibiting cyclooxygenase enzymes to reduce inflammation and pain.
- Meloxicam has a longer half-life, allowing for once-daily dosing, which minimizes infant exposure.
- It is crucial to discuss the use of meloxicam during breastfeeding with a healthcare provider to determine the best course of action for individual patients.
From the Research
Safety of Meloxicam during Lactation
- The safety of meloxicam, a nonsteroidal anti-inflammatory drug (NSAID), during lactation is not directly addressed in the provided studies.
- However, studies suggest that short-term use of NSAIDs is generally considered compatible with breastfeeding 2, 3.
- It is recommended that the lowest effective maternal dose of an analgesic drug should be given to minimize infant exposure 2.
- Maternal administration of most NSAIDs results in low infant exposure via breastmilk, making them generally considered safe during breastfeeding 3.
- The benefits of breastfeeding should be weighed against the potential risks of adverse drug effects in the infant, and the decision to continue breastfeeding should be made on an individual basis 2, 4.
General Considerations for Drug Use during Lactation
- Most commonly used drugs are relatively safe for breastfed babies, with the dose received via milk generally being small 5.
- An understanding of the principles underlying the transfer of drugs into breast milk is important, as is an awareness of the potential adverse effects on the infant 5, 4.
- The advantages of breastfeeding for infant development outweigh the potential adverse consequences, and this physiologic process should be encouraged 4.