Among the myotonolytics, in the broadest sense, there are very different agents, such as baclofen, carisoprodol, quinine ethyl carbon-ate, chlormezanone, Clostridium botulinum toxin, dantrolene, fenyramidol, mephenesin, methocarbamol, orphenadrine, pridinol, tetrazepam, tizanidine, and tolperisone. For antiepileptics used for the treatment of neuropathic pain, see Chapter 4.8.
There is one case report on baclofen in which a maximum of 0.13 mg/1 was measured in the mother's milk following a single dose of 20 mg (Erikssons 1981). In one breastfeed, this would be 1.2% of the weight-related dosage for the child.
At steady-state conditions in one woman using carisoprodol 2100mg/d, on average 0.9 mg/1 was found in her milk plus 11.6 mg/1 of the active metabolite meprobamate. The relative dose would be 4%. The child was unremarkable, but was only partly breastfed
4.1.12 Gout therapy
(Nordeng 2001). No general conclusions for tolerance could be drawn from this.
There is also insufficient experience on the use of the other drugs while breastfeeding - some of them are therapeutically out of date, and a mild sedation of the breastfed child is conceivable.
Recommendation. Apart from emergency treatment with dantrolene for malignant hyperthermia, the indications for using a myotonoiytic should be considered very critically. Physiotherapeutic measures and antiphlogistics/ antirheumatics are preferable. In individual cases, the relaxant effect of low doses of the better-studied diazepam should be used in the short term.
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