Nursing Research Today is a free monthly online journal that collates and summarizes the latest research about Nursing, including details on health care, hospital staff, professional care.

Therapy insight: the use of antirheumatic drugs during nursing.

Østensen M, Motta M

Center for Women with Rheumatic Disease, Department of Rheumatology, University Hospital of Bern, Bern, Switzerland. monika.oestensen@insel.ch

In 90% of cases, women with rheumatoid arthritis suffer a disease flare within 3 months of delivery of their baby. Drug treatment is, therefore, required; however, such therapies have implications for mothers who decide to nurse their infants. Unfortunately, because of a paucity of data, little is known about the transfer of antirheumatic drugs into breast milk, and even less is known about whether small amounts of these agents ingested during nursing could harm the infant. Our review of the literature indicates that paracetamol, prednisone, antimalarial agents, sulfasalazine and most NSAIDs can safely be used by lactating mothers. Expert opinions differ regarding the use of azathioprine, ciclosporin, and methotrexate during lactation because of varying views on the potential for short-term and long-term adverse effects. Evidence regarding the transfer of leflunomide and biologic drugs into breast milk is insufficient; therefore, until more studies are conducted, the use of these drugs in breastfeeding mothers should be restricted. At present, many patients feel they have to choose between postpartum disease control and lactation. Extended studies of the transfer of antirheumatic drugs into breast milk and the resulting consequences are, therefore, urgently needed.

Published 29 June 2007 in Nat Clin Pract Rheumatol, 3(7): 400-6.
Full-text of this article is available online (may require subscription).

© 2005-2008 Nursing Research Today. All Rights Reserved.