Is Colchicine safe for breastfeeding mothers?
I have been prescribed Colchicine for treatment of my oral lichen planus condition. However, I am still nursing / breastfeeding my one year old child. I am wondering if the medication is safe to consume given that I am still nursing my child?
If not, is there any alternative treatment / medication that I can suggest to my oral medicine specialist?
Also, can I practise “Pump and Dump” if I want to continue nursing and yet continue with the medication? Assuming the dosage frequency is once a day, I will nurse my child in the morning first before I consume Colchicine, then I express my milk and dump them through the day, and only continue nursing my child 6 – 8 hours after the last dosage in the morning. Is this do-able?
I do agree with what Dr Ethan and Dr Jasmine have written about the risk of colchicine in breastfeeding.
For treatment of oral lichen planus, there are many other treatment options available apart from colchicine and you should speak to your doctor and raise your concerns about the use of colchicine while you are breast-feeding and explore if alternative options are available for you.
There is very little literature available re the use of colchicine and safety in breastfeeding. I would suggest to discuss with your specialist re an alternative drug if you are keen to continue breastfeeding. I am unable to comment re safety of pump and dump as it would depend on the exact pharmacokinetics of the drug ( how it is metabolised in the body, your body weight, peripheral binding , half life, what dosage you are on etc).
Sorry not terribly useful answer but colchicine is not one of the those very common drugs breastfeeding Mums take!
As Dr Jasmine mentioned, there’s not much literature available regarding the use of colchicine in breastfeeding.
The most recent, albeit small scale study done in 2015 with 37 women who breastfed while on colchicine showed that there was no increase in harmful long-term outcomes.
Other studies have shown that even though colchicine is secreted into breastmilk (with the highest milk levels occurring 2 to 4 hours after taking your medication), there has not been any published literature (to my knowledge) about harmful effects on infants who were breastfed while their moms were on colchicine.
The general guideline with the use of colchicine in breastfeeding women is that you and your specialist should continue to observe your infant for adverse effects.
Moving forward, you should definitely take up these concerns regarding the use of colchicine and breastfeeding with the specialist managing your oral lichen planus, as he will be able to advise you on the best course of action regarding continuing, or switching the medication.
At the end of the day, the use of any medication is always a matter of risks (harmful side effects) versus benefits. Your specialist may have chosen to continue you on colchicine as your oral lichen planus may have responded best to this medication, as opposed to others.
It would be remiss for doctors on DxD to suggest to you an alternative medication for your specialist to switch you on to, as we will not know what medications he may have already tried you on previously, or how severe your lichen planus is, etc. etc.