Is Ergotamine safe while breastfeeding?

Summary of use during breastfeeding

There is limited published experience with ergotamine during breastfeeding and it might cause adverse effects in the infant and decrease milk supply. Most authorities consider ergotamine to be contraindicated during nursing.[1-5]

Effects on the breastfed infant

A study in which ergotamine was administered to mothers of newborns immediately postpartum in a dose of 1 mg 3 times daily for 6 days found no effect on weight gain in the breastfed infants.[6] Milk intake, and therefore infant dosage, might have been minimal during the first few days before the mothers' milk came in fully.

Effects on milk supply

Thirty women who delivered fullterm infants received a single intramuscular dose of methylergonovine 0.2 mg after delivery, followed by oral ergotamine 1 mg 3 times daily for 6 days. Compared to 28 women who delivered fullterm infants and received no ergot derivatives, there was no difference in the milk production, as measured by weight differences before and after nursing, between the 2 groups during the first 6 days postpartum.[6]

A woman who was given ergotamine postpartum for lochia retention experienced severe nipple pain consistent with vasospasm of the nipple or Raynaud syndrome. She was unable to nurse her infant directly, but pumped and fed expressed milk by bottle. The drug had no apparent adverse effect on the milk supply or the infant.[7]

Levels in milk

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Alternatives LactMed lists

• Eletriptan
• Rizatriptan
• Sumatriptan
• Zolmitriptan