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12-23-2012 at 4:04 PM
sthomas122...
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Joined on 06-10-2012
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sthomas1222 is not online. Last active: 04-07-2013, 6:30 PMBronze

Mirapex and BF

Hi everyone. Before I get bombarded, yes I know Mirapex is a Cat. C but it wasn't an option for me to go off of it during pregnancy. My RLS was extreme before pregnancy. Thankfully just in the past 2 weeks has it gotten worse. But now we're getting to the point where after baby comes I'm thinking about trying to go off of it again. Since I'll be sleeping in short spurts since I'm hoping to EBF baby I'm willing to try again. But if I need to go back on it does anyone have any experience with taking Mirapex while breastfeeding? All my online research basically says "we don't know crap about it so don't take it" which is basically what it said for using while pregnant. 

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03-30-2013 at 10:05 AM
lauretta1
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Joined on 02-03-2009
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lauretta1 is not online. Last active: 04-26-2013, 9:58 AMNewbie

Hi,I am trying to get pregnant and have been on Mirapex for several years now for severe RLS. I would really love to hear about your experience with Mirapex while you were pregnant.I have been to numerous doctors, obgyn's, etc and no one can give me an answer - I know it is a class C, but I will need to continue it while pregnant and am obviously concerned about the side effects to the baby. Any advice or help you could offer would be wonderful and so much appreciated! 

 
03-30-2013 at 11:40 AM
AmyG*
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AmyG* is not online. Last active: 05-23-2013, 12:03 AMGold

You can call Infant risk to get all the info on the drug directly and their opinion on it's safety in pregnancy and lactation.  They may have a suggestion of another drug to try for your condition  that would be safer in lactation

Dr Hale's book Medications and Mother's milk says (I will try to type it all out for you, ignore typos I'm typing with a cat in my lap)

Pramipexole, Mirapex.

Pramipexole is a nonergot dopamine agonist for use in treating the symptoms of Parkinson's disease and restless leg syndrome.  While rodent studies showed rather high level sin milk, rat studies simply don't correlate with humans.  No human studies are available concerning levels i milk.

Regardless, Pramipexole is known to reduce the secretion of Prolactin(the breastfeeding hormone) and it is possible that it could significantly reduce milk synthesis. This product should probably not be used in breastfeeding mothers.

Pregnancy risk C

Lactation risk L4(possibly hazardous)

 

the half life is 8 hours. [which means in 8 hours 1/2 of it remains in your system, in 16 hours 1/4 remains, in 24 hours 1/8 remains but then it's time for another dose.]

it peaks in 2 hours [so you would definitely avoid nursing for 2 hours or so after a dose.]

it is protein bound at 15% [you are lookig for drug with protein binding above  90%] 

it is orally absorbed at 90% [so whatever enters breastmilk will be passed to baby orally]

its volume of distribution is 7.14 [the higher the volume of distribution, means the drug is stored around your body and takes longer to actually exit your system, not just it's blood half life above.  you are looking for a volume of distribution <1]

the Molecular weight is 302 [the higher the molecular weight, the harder it is to enter breastmilk directly, if over 200 the drug has to dissolve the lipid bilayers in the mammary epithelium  to enter milk.  drugs that do not enter breastmilk at all have huge molecular weights like insulin with a MW >6000]

 

from the above info, I would recommend not taking the med and breastfeeding because even if the drug is safe for infant in the amounts that could enter breastmilk, the lowering of prolactin could mean an end to breastfeeding due to low/no milk supply. 

so from the above chemical info about the dru


AmyG 
03-30-2013 at 12:05 PM
AmyG*
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AmyG* is not online. Last active: 05-23-2013, 12:03 AMGold

ok a google search tells me that other drugs for RLS are

ropinirole,  carbidopa and levodopa

all have sane L4 rating and known to seriously impact prolactin levels and decrease milk supply.

the only druf I see listed that may be an option safer in breastfeeding, aside from pain meds or sleeping pills would be neurontin which has some success with RLS, it is rated L2 for safety (safer drug list)

 


AmyG 
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