Which medication for opioid use disorder is not recommended for breastfeeding mothers?

Naltrexone is not recommended for breastfeeding mothers primarily due to its pharmacological action as an opioid antagonist. While it is effective in treating opioid use disorder by blocking the effects of opioids, there is limited data on its safety during breastfeeding. Naltrexone can pass into breast milk and potentially lead to withdrawal symptoms or reduced effectiveness of opioid pain medications in nursing infants, which concerns its use in this population.

On the other hand, methadone, buprenorphine, and acamprosate have been shown to have relatively more established safety profiles during lactation. Methadone and buprenorphine are often preferred for managing opioid use disorder in breastfeeding women, as they can help stabilize the mother without posing significant risks to the infant. Acamprosate, though primarily used for alcohol use disorder, does not have known adverse effects for breastfeeding mothers.

Overall, when considering treatment options for opioid use disorder in breastfeeding mothers, the safety and potential effects on the infant are crucial in determining the appropriateness of a medication, which is why naltrexone is generally avoided in this scenario.