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Caffeine / ergotamine Pregnancy and Breastfeeding Warnings

Caffeine / ergotamine is also known as: Cafatine, Cafergot, Cafetrate, Ercaf, Migergot, Wigraine

Caffeine / ergotamine Pregnancy Warnings

Caffeine-ergotamine has been assigned to pregnancy category X by the FDA. There are no studies on the placental transfer or teratogenicity of the combined product caffeine-ergotamine. Caffeine has been reported to cross the placenta and to be teratogenic in animals. Ergotamine crosses the placenta in small amounts but has not appeared to be embryotoxic in this quantity. However, prolonged vasoconstriction of the uterine vessels and/or increased myocardial tone leading to reduced myometrial and placental blood flow may have contributed to fetal growth retardation observed in animals. There are no controlled data in human pregnancy. Caffeine-ergotamine use is considered contraindicated during pregnancy.

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Caffeine / ergotamine Breastfeeding Warnings

Ergotamine is excreted into human milk. Vomiting, diarrhea and convulsions have been reported in nursing infants. Ergotamine is considered contraindicated during breast-feeding by the American Academy of Pediatrics. Caffeine is excreted into human milk in small amounts. Adverse effects in the nursing infant are unlikely. However, irritability and poor sleep patterns have been reported in nursing infants. The amount of caffeine generally found in caffeinated beverages is considered to usually be compatible with breast-feeding by the American Academy of Pediatrics. Because caffeine is excreted into human milk and because caffeine is metabolized slowly by nursing infants, consumption of more than moderate levels of caffeine by nursing mothers is not recommended.

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References for pregnancy information

  1. Verloes A, Emonts P, Dubois M, Rigo J, Senterre J "Paraplegia and arthrogryposis multiplex of the lower extremities after intrauterine exposure to ergotamine." J Med Genet 27 (1990): 213-4
  2. Eskenazi B "Caffeine during pregnancy: grounds for concern? [editorial; comment]." JAMA 270 (1993): 2973-4
  3. Mills JL, Holmes LB, Aarons JH, Simpson JL, Brown ZA, Jovanovic-Peterson LG, Conley MR, Graubard BI, Knopp RH, Metzger BE "Moderate caffeine use and the risk of spontaneous abortion and intrauterine growth retardation [see comments." JAMA 269 (1993): 593-7
  4. "Product Information. Cafergot (ergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  5. "Product Information. Bellergal-S (ergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  6. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
  7. Joesoef MR, Beral V, Rolfs RT, Aral SO, Cramer DW "Are caffeinated beverages risk factors for delayed conception? [see comments." Lancet 335 (1990): 136-7

References for breastfeeding information

  1. Committee on Drugs, 1992 to 1993 "The transfer of drugs and other chemicals into human milk." Pediatrics 93 (1994): 137-50
  2. Roberts RJ, Blumer JL, Gorman RL, et al "American Academy of Pediatrics Committee on Drugs: Transfer of drugs and other chemicals into human milk." Pediatrics 84 (1989): 924-36
  3. "Product Information. Bellergal-S (ergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  4. "Product Information. Cafergot (ergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  5. Rose JE, Behm FM "Psychophysiological interactions between caffeine and nicotine." Pharmacol Biochem Behav 38 (1991): 333-7
  6. Berlin CM Jr, Denson HM, Daniel CH, Ward RM "Disposition of dietary caffeine in milk, saliva, and plasma of lactating women." Pediatrics 73 (1984): 59-63

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