Metoclopramide Injection while Breastfeeding

What is Metoclopramide Injection used for?

Is Metoclopramide Injection usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?

Metoclopramide while Breastfeeding

CAS Number: 364-62-5

Low excreted into breast milk. Not harmful effect on the infant but rare mild intestinal complaints has been reported. At dose of 10 mg three-times-a-day for 2 to 4 weeks an increase of milk production by enhancing Prolactin release has been shown only on low producing Prolactin women. Other well-designed studies have failed to show that effect. Neurological side effect mostly at high dose or long-term use (longer than one month) may occur specially if combined with antidepressant medication. Domperidone has less neurological side effects. The best kind of galactogogue is a breastfeeding on demand with an appropriate nursing technique. Do not use galactogogue substances without a medical supervision.

Metoclopramide while Breastfeeding

CAS Number: 364-62-5

Metoclopramide is excreted in variable amounts in breastmilk. Most infants would receive less than 10% of the maternal weight-adjusted dosage, but some receive doses that achieve pharmacologically active serum levels, elevated serum prolactin and possible gastrointestinal side effects. Although most studies have found no adverse effects in breastfed infants during maternal metoclopramide use, many did not adequately observe for side effects. Metoclopramide is used as a galactogogue.[1] Metoclopramide increases serum prolactin. A meta-analysis of 5 placebo-controlled studies concluded that 2 weeks of metoclopramide caused no increase of serum prolactin over placebo, but 3 weeks of treatment did.[2] The clinical value of metoclopramide in increasing milk supply is questionable. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[3] In well-designed studies that evaluated the effectiveness of metoclopramide as a galactogogue in women who continue to have difficulty producing milk after nursing techniques have been optimized, it was of no additional benefit. Prophylactic use in the mothers of preterm infants has also shown little or no benefit. Metoclopramide has no officially established dosage for increasing milk supply. Most studies have used metoclopramide in a dosage of 10 mg 2 or 3 times daily for 7 to 14 days. Some studies used a tapering dosage for the last days few of the regimen to avoid an abrupt drop in milk supply after drug discontinuation. No published literature supports the efficacy or safety of higher dosages, longer treatment periods or repeated courses of therapy. Postpartum mothers are at a relatively high risk for postpartum depression and metoclopramide can cause depression as a side effect. Therefore, metoclopramide should probably be avoided in women with a history of major depression and not used for prolonged periods in any mothers during this time of high susceptibility.[4][5] Long-term uses of metoclopramide also increases the risk of tardive dyskinesia.[6] Other reported side effects in nursing mothers include tiredness, nausea, headache, diarrhea, dry mouth, breast discomfort, vertigo, restless legs, intestinal gas, hair loss and anxiety.[5][7][8] In a survey of nursing mothers in the United States, 32 had used metoclopramide as a galactogogue and all reported having experienced an adverse reaction from the drug.[9] A larger survey of women taking metoclopramide for lactation enhancement found that 4.8% of women had either palpitations or racing heart rate, 12% reported depression, and 1 to 7% reported other central nervous system side effects ranging from dizziness and headache to involuntary grimacing and tremors. Diarrhea, irritability and fatigue were also relatively common.[10]

What should I do if I am breastfeeding mother and I am already exposed to Metoclopramide Injection?

I am nursing mother and my doctor has suggested me to use Metoclopramide Injection, is it safe?

If I am using Metoclopramide Injection, will my baby need extra monitoring?

Who can I talk to if I have questions about usage of Metoclopramide Injection in breastfeeding?