iritis, prednisone, and breastfeeding

[Christine__0__0]

  I am a new mother who is currently fighting my second bout of iritis.  I am hla-b27 positive with ankylosing spondylitis.  The iritis has not responded to 4 weeks treatment with Pred Forte, Voltaren, and cyclogyl.  My ophthalmalogist gave me a choice of an injection of steroids into the lower lid of my eye, or oral prednisone, 40 mg per day.  I chose the injection, because I am breastfeeding my child.  The injection has had very little effect during the last week, and my ophthalmalogist wants to discuss the possibility of the oral prednisone.  
  My question is this; what is considered a safe level of oral steroids for a lactating mother to take, and how long a course of treatment is considered safe?
  Thanks.

[HFHS MD JL]

_

Well, as you probably know, there are not many studies with any drugs in pregnant or lactating mothers.  It is likely that some of the drug will pass through the breast milk.  Although iritis associated with ankylosing spondylitis can be difficult to treat it usually responds to topical or injected steroids.  My first advice would be to see a uveitis specialist because they specialize in this area.  They would be more familiarwith treating difficult cases of iritis.  In general, I would consider repeating the injection one more time before considering oral steroids.  
Good luck!  This information was provided for medical educational purposes only.
Sincerely,
HFHS M.D.-JL