Medicines and breastfeeding
Whether a medicine is compatible with breastfeeding already has a good answer, and it is not ours: LactMed, the US National Library of Medicine’s Drugs and Lactation Database, is what clinicians consult. So we quote it rather than rewriting it — the verdict, the measured levels in milk, what has been seen in breastfed infants, and the drugs LactMed would consider instead, each one linked to its own record.
By the pharmaranks editorial teamReviewed against the NIH/NLM Drugs and Lactation Database (LactMed) sourcesUpdated Jul 27, 2026How we research
Pregnancy is a separate question with a separate evidence base — see drugs in pregnancy, which reads the FDA label’s own §8.1 risk summary. The two frequently differ for the same drug, so neither answer stands in for the other.
868drugs with a LactMed record, each showing that record’s opening line verbatim where it fits whole. Records frequently qualify their first sentence — atorvastatin opens with the consensus against statins and then sets out the argument against it — so open the drug before deciding anything.
A
- AbataceptAbatacept is a large fusion protein that interferes with T-cell activation.
- AbciximabNo information is available on the clinical use of abciximab during breastfeeding.
- AcarboseBecause less than 2% of a dose of acarbose is absorbed from the mother's gastrointestinal tract, it is unlikely that any drug reaches the infant through breastmilk.
- Acebutolol
- AcetaminophenAcetaminophen is a good choice for analgesia, and fever reduction in nursing mothers.
- AcetazolamideLimited information indicates that maternal doses of acetazolamide up to 1000 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants.
- AcetohexamideAcetohexamide is no longer marketed in the United States.
- AcitretinA maternal acitretin dose of 0.65 mg/kg daily produced low levels in milk in one woman.
- AclidiniumAlthough no published data exist on the use of aclidinium during breastfeeding, it produces low maternal serum levels because of rapid hydrolysis to inactive metabolites.
- AcyclovirEven with the highest maternal dosages, the dosage of acyclovir in milk is only about 1% of a typical infant dosage and would not be expected to cause any adverse effects in breastfed infants.
- AdalimumabMaternal adalimumab injections produce low levels in breastmilk.
- AdapaleneTopical adapalene has not been studied during breastfeeding.
- AfliberceptThis record refers to the use of intravitreal aflibercept.
- Agalsidase BetaNo information is available on the clinical use of agalsidase beta during breastfeeding.
- AlatrofloxacinAlatrofloxacin is no longer marketed in the US.
- AlbendazoleAlbendazole and its active metabolite are minimally excreted into breastmilk.
- Albuterol
- AlclometasoneAlclometasone has not been studied during breastfeeding.
- AlectinibNo information is available on the clinical use of alectinib during breastfeeding.
- AlemtuzumabNo information is available on the clinical use of alemtuzumab during breastfeeding.
- AlendronateLimited evidence indicates that breastfeeding after cessation of long-term bisphosphonate treatment appears to have no adverse effects on the infant.
- Alglucosidase AlfaA maternal dose of alglucosidase 20 mg/kg every 2 weeks produces low levels in milk and does not appear to increase alphaglucosidase activity in the bloodstream of infants.
- AlirocumabNo information is available on the clinical use of alirocumab during breastfeeding.
- AllopurinolLimited information indicates that a maternal dose of allopurinol of 300 mg daily provides near-therapeutic dose and plasma levels in an exclusively breastfed infant.
- AlmotriptanThere is minimal published experience with almotriptan during breastfeeding, although the dose in milk appears to be low.
- AlprazolamA safety scoring system finds alprazolam possible to use during breastfeeding.
- AlteplaseTissue plasminogen activator (tPA), which is identical to alteplase, is a normal component of human colostrum and breastmilk.
- AmantadineIt is probably best to avoid amantadine during breastfeeding because of its potential negative effect on lactation.
- AmcinonideAmcinonide has not been studied during breastfeeding.
- AmikacinAmikacin is poorly excreted into breastmilk.
- Amiloride
- AminophyllineAn expert panel considers use of aminophylline to be acceptable during breastfeeding.
- AmiodaroneBreastmilk and infant serum levels of amiodarone and its active metabolite are somewhat unpredictable, but can be high during breastfeeding.
- AmisulprideExcretion of amisulpride into breastmilk is higher than with other pharmacologically similar drugs.
- AmitriptylineMilk levels of amitriptyline and its metabolites are low.
- AmlodipineLimited information indicates that milk levels of amlodipine are usually low and plasma levels in breastfed infants are undetectable.
- AmoxapineBecause there is no published experience with amoxapine during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- AmoxicillinAmoxicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- AmphetamineIn dosages prescribed for medical indications, some evidence indicates that amphetamine does not affect nursing infants adversely.
- Amphotericin B
- AmpicillinSubstantial information indicates that ampicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- AnakinraAnakinra is the pharmaceutical name for recombinant human interleukin-1 receptor antagonist (IL-1Ra).
- ApixabanInformation from four mothers indicates that apixaban levels in milk are high, potentially resulting in infant anticoagulation and bleeding, which was confirmed with a pharmacokinetic model.
- ApomorphineNo information is available on the use of apomorphine during breastfeeding.
- ApraclonidineNo information is available on the use of apraclonidine during breastfeeding.
- ApremilastNo information is available on the clinical use of apremilast during breastfeeding.
- ArformoterolArformoterol is the R-enantiomer of the long-acting beta-2 adrenergic agonist, formoterol.
- ArgatrobanBecause argatroban is poorly absorbed orally, it might not adversely affect a breastfeeding infant.
- AripiprazoleLimited information indicates that maternal doses of aripiprazole up to 15 mg daily produce low levels in milk.
- ArmodafinilArmodafinil is the R-enantiomer of modafinil.
- Arsenic TrioxideMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- Artemether And LumefantrineArtemether and lumefantrine have not been studied in nursing mothers.
- ArticaineBased on the low excretion of articaine into breastmilk, a single dose of articaine injected during breastfeeding is unlikely to adversely affect the breastfed infant.
- AsenapineNo information is available on the use of asenapine during breastfeeding.
- AspirinAfter aspirin ingestion, salicylic acid is excreted into breastmilk, with higher doses resulting in disproportionately higher milk levels.
- AtazanavirAmounts of atazanavir in milk appear to be low based on limited data.
- Atenolol
- AtezolizumabNo information is available on the clinical use of atezolizumab during breastfeeding.
- AtomoxetineAmounts of atomoxetine in milk is very low after usual doses and reports from the manufacturer found no serious adverse effects in two breastfed infants.
- AtorvastatinThe consensus opinion is that women taking a statin should not breastfeed because of a concern with disruption of infant lipid metabolism.
- AtovaquoneNo information is available on the use of atovaquone during breastfeeding.
- AtropineNo information is available on the use of atropine during breastfeeding.
- AuranofinExcretion of gold into milk after auranofin has not been studied.
- AvelumabNo information is available on the clinical use of avelumab during breastfeeding.
- AxitinibNo information is available on the use of axitinib during breastfeeding.
- AzacitidineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- AzatadineAzatadine s no longer marketed in the United States.
- Azathioprine
- Azelaic AcidTopical azelaic acid has not been studied during breastfeeding.
- AzelastineSmall occasional doses of azelastine nasal spray would not be expected to cause any adverse effects in breastfed infants.
- AzithromycinBecause of the low levels of azithromycin in breastmilk and use in infants in higher doses, it would not be expected to cause adverse effects in breastfed infants.
- AztreonamLimited information indicates that aztreonam produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
B
- BacampicillinLimited information indicates that bacampicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- Baclofen
- BaricitinibNo information is available on the use of baricitinib during breastfeeding.
- BasiliximabNo information is available on the clinical use of basiliximab during breastfeeding.
- BeclomethasoneAlthough not measured, the amounts of inhaled corticosteroids absorbed into the maternal bloodstream and excreted into breastmilk are probably too small to affect a breastfed infant.
- BelimumabPreliminary information and a predictive model indicate that belimumab levels in milk are very low.
- BenazeprilBecause of the low levels of benazepril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- BendamustineNo information is available on the use of bendamustine during breastfeeding.
- BendroflumethiazideNo information is available on the amount of bendroflumethiazide in breastmilk.
- BenralizumabNo information is available on the clinical use of benralizumab during breastfeeding.
- Benzoyl PeroxideTopical benzoyl peroxide has not been studied during breastfeeding.
- BenzthiazideNo information is available on the amount of benzthiazide in breastmilk.
- BenztropineNo information is available on the use of benztropine during breastfeeding.
- BetamethasoneBetamethasone has not been well studied during breastfeeding.
- Betaxolol
- BetrixabanBetrixaban is no longer marketed in the United States.
- BevacizumabNo information is available on the intravenous use of bevacizumab during breastfeeding.
- BezlotoxumabNo information is available on the use of bezlotoxumab during breastfeeding.
- BimatoprostNo information is available on the use of bimatoprost during breastfeeding.
- BinimetinibNo information is available on the clinical use of binimetinib during breastfeeding.
- BisoprololLimited information indicates that a maternal dose of 5 mg daily produces low levels in milk, and some follow-up date indicate no adverse long-term effects on the breastfed infant.
- BitolterolBitolterol is no longer marketed in the US.
- BivalirudinNo information is available on the use of bivalirudin during breastfeeding.
- BleomycinMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- BlinatumomabNo information is available on the clinical use of blinatumomab during breastfeeding.
- BoceprevirBoceprevir has been removed from the US market.
- BosentanA study in one patient taking bosentan during breastfeeding found very low levels in milk.
- BosutinibNo information is available on the clinical use of bosutinib during breastfeeding.
- BremelanotideNo information is available on the clinical use of bremelanotide during breastfeeding.
- BrexpiprazolePreliminary information indicates that brexpiprazole in milk does not adversely affect infant growth and development, but that it might decrease the milk supply.
- BrimonidineLimited information indicates that maternal use of brimonidine 0.2% ophthalmic drops do not adversely affect their nursing infants.
- BrinzolamideNo information is available on the use of brinzolamide ophthalmic drops during breastfeeding.
- BrodalumabNo information is available on the clinical use of brodalumab during breastfeeding.
- BromfenacMilk levels of bromfenac are likely to be low with the usual oral dosage, but milk levels have not been measured after higher injectable dosages.
- BromocriptineBromocriptine is usually not used during breastfeeding because it suppresses lactation.
- BrompheniramineSmall, occasional doses of brompheniramine would not be expected to cause any adverse effects in breastfed infants.
- BudesonideThe amounts of inhaled budesonide excreted into breastmilk are minute and infant exposure is negligible.
- BumetanideIt is unknown if bumetanide is excreted into breastmilk.
- BupivacaineBecause of the low levels of bupivacaine in breastmilk, and it is not orally absorbed, amounts received by the infant are small and it has not caused any adverse effects in breastfed infants.
- Buprenorphine
- BupropionLimited information indicates that maternal bupropion doses of up to 300 mg daily produce low levels in breastmilk and would not be expected to cause any adverse effects in breastfed infants.
- BuspironeLimited information indicates that maternal doses of buspirone up to 45 mg daily produce low levels in milk.
- BusulfanMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- ButabarbitalBecause there is little published experience with butabarbital during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- ButenafineTopical butenafine has not been studied during breastfeeding.
- ButorphanolMaternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression.
C
- CabergolineCabergoline is usually not used during breastfeeding because it suppresses lactation.
- CaffeineCaffeine appears in breastmilk rapidly after maternal ingestion.
- CalcipotrieneNo information is available on the use of calcipotriene during breastfeeding.
- CalcitriolCalcitriol is the normal physiologically active form of vitamin D, 1,25-dihydroxyvitamin D.
- CanagliflozinNo information is available on the clinical use of canagliflozin during breastfeeding.
- CapecitabineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- Capreomycin
- CaptoprilBecause of the low levels of captopril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- CarbacholNo information is available on the use of carbachol ophthalmic drops during breastfeeding.
- Carbamazepine
- CarbinoxamineSmall occasional doses of carbinoxamine are probably acceptable during breastfeeding.
- CarboplatinAfter carboplatin administration to nursing mothers, excretion of platinum into milk occurs.
- CarfilzomibNo information is available on the clinical use of carfilzomib during breastfeeding.
- CariprazineAlthough amounts of cariprazine and its active metabolites in milk are relatively low, the metabolite half-lives are long.
- CarisoprodolIf carisoprodol is required by the mother, it is not necessarily a reason to discontinue breastfeeding.
- CarmustineNo information is available on the use of carmustine during breastfeeding.
- CarteololNo data are available for the use of carteolol during breastfeeding.
- CarvedilolNo published information is available on the use of carvedilol during breastfeeding.
- CaspofunginNo information is available on the use of caspofungin during breastfeeding.
- CefaclorCefaclor is no longer marketed in the United States.
- CefazolinLimited information indicates cefazolin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- Cefepime
- CefoperazoneCefoperazone is no longer marketed in the United States.
- CefotaximeCefotaxime is no longer marketed in the United States.
- CefoxitinSubstantial information indicates that cefoxitin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- CefprozilLimited information indicates that cefprozil produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- CeftazidimeLimited information indicates that ceftazidime produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- CeftibutenLimited information indicates that ceftibuten produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- CeftizoximeCeftizoxime is no longer marketed in the US.
- CeftriaxoneLimited information indicates that ceftriaxone produce low levels in milk, which are not expected to cause adverse effects in breastfed infants.
- CefuroximeLimited information indicates that cefuroxime produces low levels in milk that are not expected to cause severe adverse effects in breastfed infants.
- CelecoxibBecause of the low levels of celecoxib in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- CephalexinLimited information indicates that maternal cephalexin produces low levels in milk that are usually not expected to cause adverse effects in breastfed infants.
- CephradineLimited information indicates cephradine produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- CeritinibNo information is available on the clinical use of ceritinib during breastfeeding.
- Certolizumab PegolCertolizumab is excreted into breastmilk in some, but not all, women in small amounts.
- CetirizineSmall occasional doses of cetirizine are acceptable during breastfeeding.
- CetuximabNo information is available on the clinical use of cetuximab during breastfeeding.
- ChloramphenicolAdverse reactions such as vomiting, excessive intestinal gas and falling asleep at the breast have been reported in breastfed infants whose mothers were taking oral chloramphenicol.
- ChlordiazepoxideNo information is available on the use of chlordiazepoxide during breastfeeding.
- ChlorhexidineChlorhexidine has been used vaginally or topically on the abdomen or perineum prior to delivery to prevent infection.
- ChloroprocaineNo information is available on the use of chloroprocaine during breastfeeding.
- Chloroquine
- ChlorothiazideAmounts of chlorothiazide in milk are low, but high doses might suppress lactation.
- ChlorpheniramineSmall (2 to 4 mg), occasional doses of chlorpheniramine are acceptable during breastfeeding.
- ChlorpromazineChlorpromazine is detectable in the milk of some mothers during therapy, but levels appear not to correlate well with the maternal dose or serum level.
- ChlorpropamideChlorpropamide is no longer marketed in the United States.
- ChlorthalidoneAlthough amounts of chlorthalidone in milk are not great, its slow clearance may lead to accumulation in the infant, especially while nursing a newborn or preterm infant.
- CholestyramineCholestyramine is a nonabsorbable resin.
- ChondroitinChondroitin sulfate consists of a mixture of large glycosaminoglycans and disaccharide polymers, usually derived from shark or bovine cartilage.
- CiclesonideAlthough not measured, the amounts of inhaled corticosteroids absorbed into the maternal bloodstream and excreted into breastmilk are probably too small to affect a breastfed infant.
- CiclopiroxTopical ciclopirox has not been studied during breastfeeding.
- CimetidineMaternal cimetidine doses of 1000 to 1200 mg daily result in infant dosages that are much less than reported neonatal dosages of 5 to 10 mg/kg daily.
- CiprofloxacinAmounts of ciprofloxacin in breastmilk are low.
- CisatracuriumNo information is available on the use of cisatracurium during breastfeeding.
- CisplatinAfter cisplatin administration to nursing mothers, excretion of platinum into milk occurs.
- CitalopramInfants receive citalopram in breastmilk, and it is detectable in low levels in the serum of some.
- CladribineThe amount of cladribine in milk is low with oral doses of 10 to 20 mg daily used in multiple sclerosis.
- ClarithromycinBecause of the low levels of clarithromycin in breastmilk and safe administration directly to infants, it is acceptable in nursing mothers.
- ClemastineSmall occasional doses of clemastine are acceptable during breastfeeding.
- ClindamycinClindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora.
- ClobazamLimited information indicates that maternal doses of clobazam up to 30 mg daily produce low levels in milk.
- ClobetasolClobetasol has not been studied during breastfeeding.
- Clocortolone PivalateTopical clocortolone has not been studied during breastfeeding.
- ClofazimineLimited information indicates that clofazimine appears in milk in relatively large amounts.
- ClomipheneClomiphene appeared in low amounts in milk in one woman.
- ClomipramineLimited evidence indicates that use of clomipramine during breastfeeding is acceptable.
- ClonazepamMaternal clonazepam occasionally causes sedation in their breastfed infants, especially when given with other central nervous system depressants.
- Clonidine
- ClotrimazoleBecause has poor absorption from the skin and vagina and has poor oral bioavailability, it is unlikely to adversely affect the breastfed infant, including after topical application to the nipples.
- CloxacillinLimited information indicates that cloxacillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- ClozapineBecause there is little published experience with clozapine during breastfeeding, and sedation and adverse hematologic effects have been reported in breastfed infants, other agents are preferred.
- CobimetinibNo information is available on the clinical use of cobimetinib during breastfeeding.
- CocaineNo data are available on the medical use of cocaine in nursing mothers.
- Codeine
- Coenzyme Q10Coenzyme Q10 (ubiquinone) is a normal part of the diet, and is also endogenously synthesized.
- ColchicineLong-term prophylactic maternal doses of colchicine up to 1.5 mg daily produce levels in milk that result in the infant receiving less than 10% of the maternal weight-adjusted dosage.
- ColesevelamColesevelam is a nonabsorbable resin.
- ColestipolColestipol is a nonabsorbable resin.
- ColistimethateLimited data indicate that colistin is minimally excreted into breastmilk following intramuscular administration of colistimethate.
- CopanlisibCopanlisib has been removed from the US market.
- CorticotropinNo information is available on the clinical use of corticotropin during breastfeeding.
- Cortisone
- CreatineCreatine is used as a dietary supplement to increase muscle mass and improve exercise performance.
- Cromolyn
- CyclizineOccasional doses of cyclizine are probably acceptable during breastfeeding.
- CyclobenzaprineAmounts of cyclobenzaprine in milk appear to be very small and two infants apparently tolerated the drug in milk well.
- CyclopentolateNo information is available on the use of cyclopentolate during breastfeeding.
- CyclophosphamideCyclophosphamide appears in milk in potentially toxic amounts; additionally, highly toxic active metabolites could add to the risk to the infant.
- CyclosporineCyclosporine levels vary considerably in several case reports and series.
- Cyproheptadine
D
- DacarbazineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially alkylating agents such as dacarbazine.
- DaclatasvirDaclatasvir is no longer marketed in the United States.
- DaclizumabNo information is available on the clinical use of daclizumab during breastfeeding.
- DacomitinibNo information is available on the clinical use of dacomitinib during breastfeeding.
- DalbavancinNo information is available on the use of dalbavancin during breastfeeding.
- Dalteparin
- DantroleneBecause no information is available on the long-term use of dantrolene during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- DapagliflozinNo information is available on the clinical use of dapagliflozin during breastfeeding.
- DapsoneDapsone can be used during breastfeeding; however, hemolytic anemia might occur, especially in newborn infants and in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
- DaptomycinLimited and somewhat inconsistent information indicates that daptomycin produces very low levels in milk and it would not be expected to cause any adverse effects in breastfed infants.
- DaratumumabNo information is available on the clinical use of daratumumab during breastfeeding.
- Darunavir
- DasatinibAlthough one breastfed infant apparently experienced no adverse effects during maternal use of dasatinib, no long-term data are available.
- DeferasiroxDeferasirox appears to pass into milk very poorly.
- DeferiproneDeferiprone is likely actively transported into milk through binding with lactoferrin.
- DeferoxamineDeferoxamine is poorly absorbed orally, so it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants.
- DelavirdineDelavirdine is no longer marketed in the United States.
- DemeclocyclineA number of reviews have stated that tetracyclines are contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition.
- DesfluraneThere is no published experience with desflurane during breastfeeding.
- DesipramineMilk levels of desipramine and its metabolite are low and have not been detected in the serum of breastfed infants.
- DesloratadineBecause of its expected low milk levels and lack of sedation and anticholinergic effects, maternal use of desloratadine is unlikely to affect a breastfed infant or milk production.
- DesmopressinDesmopressin from a nasal spray is excreted in negligible amounts into milk and is poorly absorbed orally by the infant, so it appears acceptable to use during breastfeeding.
- DesonideDesonide has not been studied during breastfeeding.
- DesoximetasoneDesoximetasone has not been studied during breastfeeding.
- DesvenlafaxineModest doses of desvenlafaxine are excreted into breastmilk, but serum drug levels of breastfed infants are less than 10% of simultaneous maternal levels.
- DexamethasoneLittle information is available on the use of systemic dexamethasone during breastfeeding.
- DexlansoprazoleDexlansoprazole is the R-enantiomer of the proton-pump inhibitor, lansoprazole.
- DexmedetomidineLimited data indicate that very small amounts of dexmedetomidine are excreted into breastmilk for 4 to 6 hours after the end of an intravenous infusion.
- Dexmethylphenidate
- DexrazoxaneNo information is available on the use of dexrazoxane during breastfeeding.
- DextroamphetamineIn dosages prescribed for medical indications, some evidence indicates that dextroamphetamine might not affect nursing infants adversely.
- DiatrizoateLimited information indicates that maternal doses of diatrizoate up to 38 g (containing 18.5 grams of iodine) produce low levels in milk.
- DiazepamDiazepam is excreted into breastmilk and it and its active metabolite, nordiazepam, accumulate in the serum of breastfed infants with repeated doses.
- DibucaineTopical dibucaine has not been studied during breastfeeding, but is unlikely to affect her breastfed infant if it is applied away from the breast.
- DiclofenacData on excretion of diclofenac into milk are poor, but the drug has a short half-life and little glucuronide metabolite formation.
- DicloxacillinLimited information indicates that dicloxacillin levels in milk are very low and are not expected to cause adverse effects in breastfed infants.
- DicyclomineDicyclomine has not been well studied during breastfeeding.
- DidanosineDidanosine has been removed from the US market.
- DiflunisalThe small amounts of diflunisal in milk do not appear to pose a serious risk to breastfeeding infants.
- DigoxinBecause of the low levels of digoxin in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- DiltiazemBased on limited data, amounts of diltiazem ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- DimenhydrinateSmall, occasional doses of dimenhydrinate would not be expected to cause any adverse effects in breastfed infants.
- Dimethyl FumarateThe active form of both dimethyl fumarate and diroximel fumarate is monomethyl fumarate.
- Dinoprostone
- DinutuximabNo information is available on the clinical use of dinutuximab during breastfeeding.
- DiphenhydramineSmall (25 mg or less), occasional doses of diphenhydramine would not be expected to cause any adverse effects in breastfed infants.
- DipyridamoleNo published information is available on the use of dipyridamole during breastfeeding, although labeling states that the drug is excreted into human milk.
- DisopyramideDisopyramide is sometimes found in the plasma of nursing infants at levels of 7.5% to 12.5% of the mother's levels.
- DivalproexVery little information is available on the clinical use of divalproex during breastfeeding.
- DobutamineNo information is available on the use of dobutamine during breastfeeding.
- DocetaxelMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- DolutegravirDolutegravir is detectable in maternal milk in low amounts.
- DopamineNo information is available on the use of dopamine during breastfeeding.
- DoravirineNo information is available on the clinical use of doravirine during breastfeeding.
- DoripenemDoripenem is no longer marketed in the US.
- Dornase AlfaNo information is available on the clinical use of dornase alpha (hamster) during breastfeeding.
- DorzolamideLimited experience with the use of ophthalmic dorzolamide indicate that it is unlikely to adversely affect the breastfed infant.
- DoxazosinLimited information indicates that maternal doses of 4 mg daily produce low very levels in milk and would not be expected to cause any adverse effects in breastfed infants.
- Doxepin
- DoxorubicinMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially anthracyclines such as doxorubicin.
- DoxycyclineA number of reviews have stated that tetracyclines are contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines.
- DoxylamineSmall occasional doses of doxylamine would not be expected to cause any adverse effects in breastfed infants.
- DronabinolDronabinol is the synthetic form of delta-9-tetrahydrocannabinol (THC), the major active component of cannabis.
- DroperidolBecause little information is available on the long-term use of droperidol during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- DrospirenoneDrospirenone is a progestin that is an analogue of spironolactone.
- DulaglutideNo information is available on the clinical use of dulaglutide during breastfeeding.
- DuloxetineLittle published information is available on the use of duloxetine during breastfeeding; however, the dose in milk is low and serum levels were low in two breastfed infants.
- DupilumabEvidence indicates that dupilumab is acceptable to use during breastfeeding.
- DurvalumabNo information is available on the clinical use of durvalumab during breastfeeding.
- DuvelisibNo information is available on the clinical use of duvelisib during breastfeeding.
- DyphyllineDyphylline is no longer marketed in the US.
E
- Echinacea
- EconazoleTopical econazole has not been studied during breastfeeding.
- EculizumabMaternal dosages of eculizumab usually produce undetectable levels in breastmilk.
- EfavirenzEfavirenz is excreted into breastmilk and small amounts are found in the serum of some infants.
- EflornithineMaternal intravenous eflornithine 400 mg/kg daily for 7 days did not cause any adverse serious effects in breastfed infants.
- ElagolixNo information is available on the use of elagolix during breastfeeding.
- EletriptanLimited information indicates that a maternal dose of eletriptan up to 80 mg daily produces low levels in milk and would not be expected to cause any adverse effects in breastfed infants.
- ElotuzumabNo information is available on the clinical use of elotuzumab during breastfeeding.
- ElvitegravirNo published information is available on the use of elvitegravir during breastfeeding.
- EmicizumabA low level of emicizumab was found in the milk of 2 women.
- EmpagliflozinLittle information is available on the clinical use of empagliflozin during breastfeeding.
- EmtricitabineEmtricitabine has been studied relatively well during breastfeeding, and it is sometime used in treating HIV-positive mothers who are breastfeeding.
- EnalaprilBecause of the very low levels of enalapril in breastmilk, amounts ingested by the infant are small and have not been detected in infant serum or caused any adverse effects in a few breastfed infants.
- EnasidenibNo information is available on the clinical use of enasidenib during breastfeeding.
- EncorafenibNo information is available on the clinical use of encorafenib during breastfeeding.
- EnfluraneThere is no published experience with enflurane during breastfeeding.
- EnfuvirtideNo published information is available on the use of enfuvirtide during breastfeeding.
- EnoxacinFluoroquinolones have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints.
- EnoxaparinMaternal enoxaparin in doses up to 40 mg daily do not to cause any adverse effects in breastfed infants.
- EntecavirEntecavir has not been studied in nursing mothers being treated for hepatitis B infection.
- Epinastine
- EpinephrineNo information is available on the use of epinephrine during breastfeeding.
- Epoetin AlfaThe excretion of exogenous epoetin alfa (recombinant human erythropoietin; EPO) in breastmilk has not been studied.
- EprosartanEprosartan is no longer marketed in the US.
- EravacyclineNo information is available on the use of eravacycline during breastfeeding.
- ErgotamineThere is limited published experience with ergotamine during breastfeeding and it might cause adverse effects in the infant and decrease milk supply.
- ErtugliflozinNo information is available on the clinical use of ertugliflozin during breastfeeding.
- ErythromycinBecause of the low levels of erythromycin in breastmilk and safe administration directly to infants, it is acceptable in nursing mothers.
- EscitalopramEscitalopram is the active S-isomer of the antidepressant, citalopram.
- EsketamineEsketamine is the more potent S-isomer of the racemic drug, ketamine.
- EsmololNo published information is available on the use esmolol during breastfeeding.
- EsomeprazoleEsomeprazole is the S-enantiomer of the proton-pump inhibitor, omeprazole.
- EstradiolLimited information on the use of estradiol during breastfeeding indicates that the route of administration and dosage form have influences on the amount transferred into breastmilk.
- Estradiol CypionateEstradiol cypionate has not been studied during breastfeeding.
- Estradiol ValerateEstradiol valerate has not been studied during breastfeeding.
- EszopicloneNo data are available on the use of eszopiclone during breastfeeding.
- EtanerceptEtanercept is minimally excreted into breastmilk and poorly absorbed by the infant, which would be expected because of its high molecular weight of approximately 150,000 Da.
- Ethacrynic Acid
- Ethambutol
- Ethinyl EstradiolThis record contains information specific to ethinyl estradiol used alone.
- EthionamideMinimal information exists on the use of ethionamide during breastfeeding.
- EthosuximideAverage ethosuximide dosages of 50 to 60% of the maternal weight-adjusted dosage are excreted in human milk and infant plasma levels of 25 to 30% of maternal levels are common.
- EtodolacBecause no information is available on the use of etodolac during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- EtomidateAmounts of etomidate in milk are very small and decrease rapidly.
- Etonogestrel
- EtoposideMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- EtravirineEtravirine is excreted in breastmilk in concentrations exceeding the maternal plasma and appears to increase in concentration over time.
- EverolimusIn two women, everolimus was either undetectable or detectable in very small amounts in the colostrum.
- EvolocumabNo information is available on the clinical use of evolocumab during breastfeeding.
- Ezetimibe
- EzogabineEzogabine is no longer marketed in the US.
F
- FamciclovirBecause there is no published experience with famciclovir during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- FamotidineFamotidine doses in breastmilk result in infant dosages that are lower than those used in newborn infants.
- Felbamate
- FelodipineBecause no information is available on the use of felodipine during breastfeeding, an alternate drug may be preferred.
- FenofibrateNo relevant published information exists on the use of fenofibrate during breastfeeding.
- FenoldopamNo information is available on the use of fenoldopam during breastfeeding.
- FenoprofenSome reviewers consider fenoprofen to be acceptable during breastfeeding.
- Fentanyl
- Ferric CarboxymaltoseIntravenous iron carboxymaltose increases breastmilk iron in mothers with iron deficiency anemia.
- Ferric CitrateIron is a normal component of human milk.
- Ferric DerisomaltoseLimited data indicate that breastmilk iron is increased 3 days after an intravenous infusion of ferric derisomaltose (formerly called iron isomaltoside), but levels remain within the normal range.
- Ferric Pyrophosphate CitrateNo information is available on the use of ferric pyrophosphate citrate during breastfeeding and the manufacturer recommends that it not be used during breastfeeding.
- FerumoxytolNo information is available on the use of ferumoxytol during breastfeeding; however, the drug has been given safely to neonates intravenously as a magnetic resonance contrast agent.
- FexofenadineBecause of its lack of sedation and low milk levels, maternal use of fexofenadine would not be expected to cause any adverse effects in breastfed infants.
- FidaxomicinNo information is available on the use of fidaxomicin during breastfeeding.
- FilgrastimFilgrastim in the pharmaceutical name for granulocyte colony-stimulating factor (G-CSF).
- Fingolimod
- FlecainideMaternal doses of flecainide up to 200 mg daily produce low levels in milk and undetectable infant serum levels.
- FluconazoleFluconazole is acceptable in nursing mothers because amounts excreted into breastmilk are less than the neonatal fluconazole dosage.
- FlunisolideAlthough not measured, the amounts of inhaled corticosteroids absorbed into the maternal bloodstream and excreted into breastmilk are probably too small to affect a breastfed infant.
- FluocinonideFluocinonide has not been studied during breastfeeding.
- FluoresceinBecause absorption from the eye is limited, fluorescein would not be expected to cause any adverse effects in breastfed infants.
- FluorouracilMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- Fluoxetine
- FluphenazineThere is no published experience with fluphenazine during breastfeeding.
- FlurandrenolideFlurandrenolide has not been studied during breastfeeding.
- FlurazepamNo information is available on the excretion of flurazepam into breastmilk.
- FlurbiprofenBecause of the low levels of flurbiprofen in breastmilk and its short half-life it is unlikely to adversely affect the breastfed infant, especially if the infant is older than 2 months.
- FluvastatinNo relevant published information exists on the use of fluvastatin during breastfeeding.
- Formoterol
- FosamprenavirNo published information is available on the use of fosamprenavir during breastfeeding.
- FosinoprilBecause no information is available on the use of fosinopril during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- FosphenytoinNo information is available on the clinical use of fosphenytoin during breastfeeding.
- Furosemide
G
- GabapentinLimited information indicates that maternal doses of gabapentin up to 2.1 grams daily produce relatively low levels in infant serum.
- GadobutrolGadobutrol is one of the most stable gadolinium agents, theoretically making it one of the safer drugs to use during breastfeeding.
- GadodiamideGadodiamide releases more free gadolinium than some other gadolinium-containing contrast agents and has been removed from the market in several countries.
- Gadoteridol
- GadoversetamideGadoversetamide has been withdrawn from the market in the US and several other countries.
- GanciclovirSeveral factors might affect the decision to use ganciclovir in a nursing mother.
- GatifloxacinNo information is available on the clinical use of gatifloxacin during breastfeeding.
- GemcitabineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- GemfibrozilNo relevant published information exists on the use of gemfibrozil during breastfeeding.
- GemifloxacinNo information is available on the clinical use of gemifloxacin during breastfeeding; however, amounts in breastmilk appear to be low.
- GentamicinGentamicin is poorly excreted into breastmilk.
- Gentian VioletGentian violet (crystal violet) was used in the past to treat oral and nipple thrush during breastfeeding.
- GilteritinibNo information is available on gilteritinib during breastfeeding.
- GlasdegibNo information is available on glasdegib during breastfeeding.
- GlimepirideBecause no information is available on the use of glimepiride during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- GlipizideLimited data indicate that the levels of glipizide in milk are low.
- GlucomannanGlucomannan is a soluble, highly viscous fiber commonly derived from Amorphophallus konjac root.
- GlucosamineGlucosamine is an amino-monosaccharide that is either derived from shellfish or synthetically produced.
- GlyburideLimited data indicate that the levels of glyburide in milk are negligible.
- GlycopyrrolateNo information is available on the use of glycopyrrolate during breastfeeding.
- GuaifenesinNeither the excretion of guaifenesin in milk nor its effect on breastfed infants have been studied.
- GuanabenzBecause no information is available on the use of guanabenz during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- Guanfacine
- GuselkumabNo information is available on the clinical use of guselkumab during breastfeeding.
H
- HalobetasolHalobetasol has not been studied during breastfeeding.
- HalofantrineHalofantrine is no longer available in the US.
- HaloperidolLimited information indicates that maternal doses of haloperidol up to 10 mg daily produce low levels in milk and usually do not affect the breastfed infant.
- HalothaneHalothane is no longer available in the United States.
- HeparinAlthough heparin itself has not been studied, low molecular weight heparins (e.g., dalteparin, enoxaparin) are not excreted into breastmilk in clinically relevant amounts.
- Hydralazine
- HydrochlorothiazideHydrochlorothiazide doses of 50 mg daily or less are acceptable during lactation.
- HydrocodoneHydrocodone is an opioid narcotic.
- HydrocortisoneHydrocortisone (cortisol) is a normal component of breastmilk, but it has not been studied in milk after exogenous administration in pharmacologic amounts.
- HydroflumethiazideNo information is available on the amount of hydroflumethiazide in breastmilk.
- HydromorphoneLimited data indicate that hydromorphone is excreted into breastmilk in small amounts, but large maternal dosages have caused neonatal central nervous system depression.
- HydroxychloroquineInfants exposed to hydroxychloroquine during breastfeeding receive only small amounts of the drug in breastmilk.
- HydroxyureaMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, although the evidence for this recommendation for hydroxyurea is very weak.
- HydroxyzineSmall occasional doses of hydroxyzine would not be expected to cause any adverse effects in breastfed infants.
I
- IbandronateIbandronate is poorly absorbed orally (average in adults 6% on an empty stomach, negligible with food), so absorption of ibandronate by a breastfed infant is unlikely.
- IbrutinibNo information is available on the clinical use of ibrutinib during breastfeeding.
- Ibuprofen
- IdarucizumabNo information is available on the clinical use of idarucizumab during breastfeeding.
- IdursulfaseNo information is available on the clinical use of idursulfase during breastfeeding.
- IloperidoneBecause no information is available on the use of iloperidone during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- ImatinibLimited information indicates that maternal doses of imatinib up to 400 mg daily produce low levels of the drug and its active metabolite in milk.
- ImigluceraseImiglucerase is a synthetic form of beta-glucocerebrosidase, which is a normal component of human milk.
- ImipramineMilk levels of imipramine and its metabolite are low and have not been detected in the serum of breastfed infants.
- IndacaterolIndacaterol is no longer marketed in the US.
- IndapamideNo information is available on the amount of indapamide in breastmilk.
- IndinavirIndinavir is no longer marketed in the US.
- IndomethacinBecause of the low levels of indomethacin in breastmilk and therapeutic administration directly to infants, it is acceptable to use in nursing mothers.
- InfliximabInfliximab is usually either not detectable in breastmilk or detectable at very low levels in milk.
- Inotuzumab OzogamicinNo information is available on the clinical use of inotuzumab ozogamicin during breastfeeding.
- Interferon Gamma-1bInterferon gamma is a normal component of human milk.
- IodineIodine is an essential trace nutrient for all infants that is a normal component of breastmilk.
- Iodixanol
- IohexolLimited information indicates that maternal doses of iohexol up to 45.3 grams (containing 21 grams of iodine) produce low levels in milk.
- Iopamidol
- Iopromide
- Iothalamate
- Ioversol
- Ioxilan
- IpratropiumAlthough no published data exist on the use of ipratropium, its use produces negligible maternal serum levels and any drug in breastmilk would not be absorbed by the infant.
- IrbesartanBecause no information is available on the use of irbesartan during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- Irinotecan
- Iron DextranLimited data indicate that trace amounts of iron dextran are excreted into breastmilk.
- Iron SucroseLimited data indicate that breastmilk iron is not increased after intravenous infusion of iron sucrose.
- IsofluraneThere is no published experience with isoflurane during breastfeeding.
- Isoniazid
- IsotretinoinNo information is available on the use of isotretinoin during breastfeeding.
- ItraconazoleNo information is available on the clinical use of itraconazole during breastfeeding.
- IvacaftorMaternal ivacaftor therapy produce low levels in milk and very low levels in the serum of breastfed infants.
- IvermectinLimited data indicate that ivermectin is poorly excreted into breastmilk after oral administration.
- IvosidenibNo information is available on the clinical use of ivosidenib during breastfeeding.
- IxekizumabLittle information is available on the clinical use of ixekizumab during breastfeeding.
K
- KanamycinIf kanamycin is required by the mother, it is not a reason to discontinue breastfeeding.
- KetamineKetamine and its active metabolite appear in milk in very low levels, and its oral bioavailability is low, indicating a low risk to breastfed infants.
- KetoconazoleBecause there is little published experience with ketoconazole or levoketoconazole during breastfeeding and its potential liver enzyme inhibition and liver toxicity, other agents are preferred.
- Ketoprofen
- KetotifenBecause absorption from the eye is limited, ketotifen would not be expected to cause any adverse effects in breastfed infants after maternal use of ketotifen eye drops.
L
- LabetalolBecause of the low levels of labetalol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in fullterm breastfed infants.
- LacosamideLimited information indicates that a maternal dose of 200 mg daily produce low levels in milk.
- LamivudineLamivudine has been well studied in HIV-positive nursing mothers and appears to be well tolerated by their breastfed infants.
- LamotrigineBreastfeeding during lamotrigine monotherapy does not appear to adversely affect infant growth or development in most infants.
- LanreotideThe excretion of lanreotide into breastmilk has not been studied.
- LansoprazoleNo information is available on the use of lansoprazole during breastfeeding.
- Laronidase
- LatanoprostNo information is available on the use of latanoprost during breastfeeding.
- Latanoprostene BunodNo information is available on the use of latanoprostene bunod during breastfeeding.
- LeflunomideNo information is available on the use of leflunomide during breastfeeding, so an alternate drug is preferred, especially while nursing a newborn or preterm infant
- LenvatinibNo information is available on the clinical use of lenvatinib during breastfeeding.
- LetrozoleA minimal amount of information on letrozole excretion into milk indicates that the amounts might be of concern.
- LevalbuterolLevalbuterol is the R-enantiomer of the beta-2 adrenergic agonist, albuterol (salbutamol).
- LevetiracetamLevels of levetiracetam in milk can be high in some women and can occasionally cause sedation and other adverse effects in their breastfed infants.
- LevobunololBased on its physicochemical properties and its ophthalmic route of administration, levobunolol appears to present a moderately low risk to the breastfed infant.
- LevocabastineLevocabastine is no longer marketed in the United States.
- LevocarnitineLevocarnitine and acetyl-l-carnitine (acetlycarnitine) are normal components of human milk that are required for fat metabolism.
- LevocetirizineLevocetirizine is the R-enantiomer of cetirizine.
- Levodopa
- LevofloxacinLevofloxacin amounts in breastmilk appear to be considerably lower than the infant dose and would not be expected to cause any serious adverse effects in breastfed infants.
- LevomilnacipranLevomilnacipran has not been studied in nursing mothers.
- LevothyroxineLevothyroxine (T4) is a normal component of human milk.
- LidocaineLidocaine concentrations in milk during continuous IV infusion, epidural administration and in high doses as a local anesthetic are low and the lidocaine is poorly absorbed by the infant.
- LinaclotideLinaclotide is minimally absorbed from the gastrointestinal tract and the drug and its active metabolite are not measurable in milk following administration of doses up to 290 mcg daily.
- LinagliptinNo information is available on the clinical use of linagliptin during breastfeeding.
- LindaneTopical application of lindane can increase lindane milk levels for at least several days.
- LinezolidLinezolid is excreted into breastmilk in concentrations likely to be effective against staphylococcal strains found in mastitis.
- LiothyronineLiothyronine (T3) is a normal component of human milk.
- LiraglutideNo information is available on the use of liraglutide during breastfeeding.
- LisinoprilBecause of the low levels of lisinopril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- LithiumLithium excretion into breastmilk and concentrations in infant serum are highly variable.
- LixisenatideNo information is available on the clinical use of lixisenatide during breastfeeding.
- LofexidineNo data are available in nursing mothers on the excretion into milk or safety of lofexidine in nursing mothers.
- LomefloxacinLomefloxacin is no longer available on the US market.
- LomitapideNo published information exists with the use of lomitapide during breastfeeding.
- LoperamideThe amount of loperamide that enters milk from a prodrug of loperamide is minimal.
- LoratadineBecause of its lack of sedation and low milk levels, maternal use of loratadine would not be expected to cause any adverse effects in breastfed infants.
- LorazepamLorazepam has low levels in breastmilk, a short half-life relative to many other benzodiazepines, and is safely administered directly to infants.
- LorlatinibNo information is available on the clinical use of lorlatinib during breastfeeding.
- LosartanBecause no information is available on the use of losartan during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- LovastatinNo relevant published information exists on the use of lovastatin during breastfeeding.
- LoxapineBecause no information is available on the use of loxapine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- LubiprostoneNo information is available on the use of lubiprostone during breastfeeding.
- LuliconazoleTopical luliconazole has not been studied during breastfeeding.
- LurasidoneLurasidone is more than 99% bound to plasma proteins, so it is unlikely that the drug would be excreted into milk in sufficient amounts to affect a breastfed infant.
- Lutetium Lu 177 DotatateLutetium Lu 177 dotatate is a radiolabeled somatostatin analog indicated for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors.
M
- MalathionMalathion appears to be poorly absorbed after topical application, so it is not likely to reach the breastmilk in large amounts.
- MaprotilineBecause there is little published experience with maprotiline during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- MaravirocMinimal information is available on the use of maraviroc during breastfeeding.
- MebendazoleMebendazole is poorly excreted into breastmilk and poorly absorbed orally.
- MeclizineOccasional doses of meclizine are probably acceptable during breastfeeding.
- MeclofenamateBecause no information is available on the use of meclofenamate during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- Medroxyprogesterone Acetate
- MefloquineVery small amounts of mefloquine are excreted in breastmilk; the amount of drug is not sufficient to harm the infant nor is the quantity sufficient to protect the child from malaria.
- MelatoninMelatonin has no specific use during breastfeeding, and no data exist on the safety of maternal use of melatonin during breastfeeding.
- MeloxicamBecause no information is available on the use of meloxicam during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- MepenzolateNo information is available on the use of mepenzolate during breastfeeding.
- MeperidineIntravenous meperidine during labor can interfere with nursing and maternal use of meperidine during breastfeeding can sedate the infants.
- MepivacaineNo information is available on the use of mepivacaine during breastfeeding.
- MepolizumabNo information is available on the clinical use of mepolizumab during breastfeeding.
- Meprobamate
- Mercaptopurine
- Meropenem
- MesalamineMesalamine is poorly excreted into breastmilk.
- MesoridazineMesoridazine is no longer marketed in the United States.
- MetaproterenolMetaproterenol (orciprenaline) is no longer marketed in the US.
- MetforminData from well-conducted studies indicate that metformin levels in milk are low and infants would receive less than 0.5% of their mother's weight-adjusted dosage.
- MethadoneMaternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression.
- MethamphetamineBecause there is no published experience with methamphetamine as a therapeutic agent during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- MethazolamideNo information is available on the use of methazolamide during breastfeeding.
- Methenamine HippurateMethenamine passes into milk in small quantities and appears safe to use, even while nursing a newborn.
- MethicillinAmounts of methicillin ingested by the infant in breastmilk are small and would not be expected to cause any adverse effects.
- MethimazoleMaternal methimazole therapy does not affect thyroid function or intellectual development in breastfed infants with doses up to 20 mg daily.
- MethohexitalAmounts of methohexital in milk are very small.
- MethotrexateMaternal doses of methotrexate up to 92 mg (1.12 mg/kg) produce low levels in milk.
- MethoxsalenNo information is available on the use of methoxsalen during breastfeeding.
- Methscopolamine BromideNo information is available on the use of methscopolamine bromide during breastfeeding.
- MethyclothiazideNo information is available on the amount of methyclothiazide in breastmilk.
- MethyldopaBecause of the low levels of methyldopa in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- MethylergonovineLimited information indicates that maternal doses of methylergonovine up to 0.75 mg daily produce low levels in milk.
- MethylphenidateIn dosages prescribed for medical indications, limited evidence indicates that methylphenidate levels in milk are very low and not detectable in infant serum.
- MethylprednisoloneAmounts of methylprednisolone in breastmilk are very low and no adverse reactions in breastfed infants have been reported, even with intravenous doses of 1 gram.
- MetipranololBased on its physicochemical properties and its ophthalmic route of administration, metipranolol eye drops would not be expected to cause any adverse effects in breastfed infants.
- MetoclopramideMetoclopramide is excreted in variable amounts in breastmilk.
- MetolazoneNo information is available on the amount of metolazone in breastmilk.
- MetoprololBecause of the low levels of metoprolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- Metronidazole
- MetyraponeEvidence from two patients indicate that amounts of metyrapone and its active metabolite in breastmilk are very small and unlikely to adversely affect a breastfed infant.
- MexiletineMaternal doses of mexiletine up to 600 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants.
- Miconazole
- MidazolamThe small amounts of midazolam excreted into breastmilk would not be expected to cause adverse effects in most breastfed infants.
- MidostaurinNo information is available on the clinical use of midostaurin during breastfeeding.
- Mifepristone
- MiglitolLimited data indicate that miglitol is poorly excreted into breastmilk.
- MilnacipranAmounts of milnacipran in breastmilk are low and would not be expected to cause any adverse effects in breastfed infants.
- MinocyclineMany reviews state that tetracyclines are contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines.
- MinoxidilBecause of the minimal amount of information on this potent agent, use oral minoxidil with caution, particularly when therapy involves a large maternal dosage or breastfeeding a newborn.
- MipomersenMipomersen marketing has been discontinued in the United States.
- Mirtazapine
- MitoxantroneMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.
- ModafinilLittle information is available on the excretion of modafinil into breastmilk.
- MoexiprilBecause no information is available on the use of moexipril during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- MolindoneBecause there is no published experience with molindone during breastfeeding, other antipsychotic agents are preferred.
- MontelukastVery low levels of montelukast appear in breastmilk.
- MorphineEpidural morphine given to mothers for postcesarean section analgesia results in trivial amounts of morphine in their colostrum and milk.
- MoxifloxacinNo information is available on the use of moxifloxacin during breastfeeding.
- MupirocinBecause less than 1% is absorbed after topical application, mupirocin is considered a low risk to the nursing infant.
- MycophenolateInformation from 3 patients on the excretion of mycophenolate into milk is inconsistent.
N
- NabumetoneBecause no information is available on the use of nabumetone during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- NafcillinAlthough no information is available on the use of nafcillin during breastfeeding, penicillins are generally not expected to cause adverse effects in breastfed infants.
- NaftifineTopical naftifine has not been studied during breastfeeding.
- NalbuphineNalbuphine is excreted into breastmilk in amounts much smaller than the dose given to infants for analgesia.
- Nalidixic Acid
- NaloxoneNaloxone is excreted into milk in very small amounts and is not detectable in the plasma of breastfed infants because of its very poor oral bioavailability.
- NaltrexoneLimited data indicate that naltrexone is minimally excreted into breastmilk.
- NaproxenLimited information indicates that levels of naproxen in breastmilk are low and adverse effects in breastfed infants are apparently uncommon.
- NaratriptanThere is minimal published experience with naratriptan during breastfeeding.
- NatalizumabMeasurable, but low, amounts of natalizumab are excreted into breastmilk in some women.
- NateglinideNo information is available on the use of nateglinide during breastfeeding.
- NebivololBecause no information is available on the use of nebivolol during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- NecitumumabNo information is available on the clinical use of necitumumab during breastfeeding.
- NedocromilNedocromil is no longer marketed in the United States.
- Nefazodone
- NelfinavirNelfinavir levels in milk are low and the drug is usually not detectable in the serum of breastfed infants.
- NeomycinAlthough no information exists on the excretion of neomycin into milk, other aminoglycoside antibiotics are poorly excreted into breastmilk.
- NepafenacNo information is available on the clinical use of nepafenac during breastfeeding.
- NevirapineNevirapine has been well studied in nursing mothers and is well tolerated by their breastfed infants.
- NicardipineBecause of the low levels of nicardipine in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- NicotineSmoking tobacco reduces milk yield and often results in early cessation of breastfeeding.
- Nifedipine
- NifurtimoxLimited information indicates that maternal doses of nifurtimox up to 15 mg/kg daily produce do not cause any adverse serious effects in breastfed infants.
- NilotinibAlthough the amount of nilotinib in milk appears to be small and one breastfed infant apparently experienced no adverse effects during maternal use of nilotinib, no long-term data are available.
- NimodipineBased on limited data, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- Nitazoxanide
- Nitrofurantoin
- NitroglycerinTopical use of nitroglycerin for anal fissures by nursing mothers appears to have no adverse effects on their breastfed infants.
- NitroprussideBreastmilk levels of nitroprusside sodium have not been measured after exogenous administration.
- Nitrous OxideBecause the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.
- Nivolumab
- NizatidineBecause of the low levels of nizatidine in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- Nonoxynol-9Nonoxynol-9 is a relatively nontoxic nonionic surfactant and only trivial amounts of the drug have been found in the milk of animals after vaginal administration.
- NorepinephrineNo information is available on the use of norepinephrine during breastfeeding.
- NorethindroneThis record contains information specific to oral norethindrone used alone for contraception.
- NorfloxacinNo information is available on the clinical use of norfloxacin during breastfeeding; however, amounts in breastmilk appear to be low.
- Nortriptyline
- Nystatin
O
- ObiltoxaximabNo information is available on the clinical use of obiltoxaximab during breastfeeding.
- OcrelizumabAmounts of ocrelizumab in milk are low and undetectable in the serum of breastfed infants.
- OctreotideThe excretion of octreotide into breastmilk has not been studied.
- OfloxacinOfloxacin appears in breastmilk in low levels.
- OlanzapineMaternal doses of olanzapine up to 20 mg daily produce low levels in milk and undetectable levels in the serum of breastfed infants.
- OlaparibNo information is available on the clinical use of olaparib during breastfeeding.
- OlaratumabOlaratumab is no longer marketed in the United States.
- OlodaterolAlthough no published data exist on the use of olodaterol during lactation, data from the related drug, terbutaline, indicate that very little is expected to be excreted into breastmilk.
- OlsalazineLimited data indicate that olsalazine is poorly excreted into breastmilk.
- OmadacyclineNo information is available on the use of omadacycline during breastfeeding.
- OmalizumabPreliminary evidence indicates that the amount of omalizumab in milk is very low.
- OmeprazoleLimited information indicates that maternal omeprazole doses of 20 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants.
- OndansetronOndansetron is frequently used for nausea during and after cesarean section, usually in doses of 4 to 8 mg intravenously.
- OrlistatOrlistat is poorly absorbed orally, but a small amount has been detected in the milk of one woman.
- OseltamivirLimited data indicate that oseltamivir and its active metabolite are poorly excreted into breastmilk.
- OsimertinibNo information is available on the clinical use of osimertinib during breastfeeding.
- OxacillinLimited information indicates that oxacillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- OxaprozinBecause there is no published experience with oxaprozin during breastfeeding, other agents are preferred, especially while nursing a newborn or preterm infant.
- OxazepamOxazepam has low levels in breastmilk, a short half-life relative to many other benzodiazepines, and is administration directly to infants.
- OxcarbazepineOxcarbazepine levels in breastmilk are low and it is not expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.
- OxiconazoleTopical oxiconazole has not been studied during breastfeeding.
- OxycodoneMaternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression.
- Oxymetazoline
- OxymorphoneNo data are available on the use of oxymorphone during breastfeeding.
- OxytetracyclineA number of reviews have stated that tetracyclines are contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines.
- OxytocinOxytocin is an essential lactation hormone released during breastfeeding that causes milk ejection and appears to have calming effect on the mother.
P
- PalbociclibNo information is available on the clinical use of palbociclib during breastfeeding.
- Paliperidone
- PalivizumabNo information is available on the clinical use of palivizumab during breastfeeding.
- PancuroniumNo information is available on the use of pancuronium during breastfeeding.
- PanitumumabNo information is available on the clinical use of panitumumab during breastfeeding.
- PantoprazoleMaternal pantoprazole doses of 40 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants.
- ParomomycinNo information is available on the clinical use of paromomycin during breastfeeding.
- ParoxetineBecause of the low levels of paroxetine in breastmilk, amounts ingested by the infant are small and paroxetine has not been detected in the serum of most infants tested.
- PasireotideThe excretion of pasireotide into breastmilk has not been studied.
- Pegademase BovineNo information is available on the clinical use of pegademase bovine during breastfeeding.
- PeginesatidePeginesatide is no longer marketed in the US.
- PegvisomantLimited data indicate that pegvisomant is poorly excreted into breastmilk.
- PembrolizumabNo information is available on the clinical use of pembrolizumab during breastfeeding.
- PemetrexedMost sources consider breastfeeding to be contraindicated during maternal high-dose antineoplastic drug therapy.
- PemirolastPemirolast is no longer marketed in the United States.
- PenbutololPenbutolol is not marketed in the United States.
- Penciclovir
- PenicillamineLimited information indicates that penicillamine is not detectable in breastmilk and no adverse effects have been reported among breastfed infants whose mothers were taking the drug.
- Penicillin GLimited information indicates that penicillin G produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- Penicillin VLimited information indicates that penicillin V produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- PentazocineNo information is available on the use of pentazocine during breastfeeding.
- PentoxifyllineLimited data indicate that pentoxifylline is poorly excreted into breastmilk.
- PerampanelA minimal amount of information indicates that perampanel milk levels are quite low.
- PerflutrenNo information is available on the clinical use of perflutren during breastfeeding.
- Permethrin
- PerphenazineLimited information indicates that maternal doses of perphenazine up to 24 mg daily produce low levels in milk.
- PhenelzineBecause of the lack of data on use during breastfeeding, other antidepressants are preferred during breastfeeding.
- PhenobarbitalInter- and intrapatient variability in excretion of phenobarbital into breastmilk is extensive.
- PhenprocoumonPhenprocoumon is not approved by the U.S.
- PhenylephrineThe oral bioavailability of phenylephrine is negligible, so the drug is unlikely to reach the infant.
- Phenytoin
- PimecrolimusTopical pimecrolimus has not been studied during breastfeeding; however, it is used topically in children as young as 3 months of age.
- PindololRecommendation for Use During Lactation: Limited information indicates that maternal pindolol produces low levels in milk.
- PioglitazoneNo information is available on the clinical use of pioglitazone during breastfeeding.
- PiperacillinLimited information indicates that piperacillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants.
- PirbuterolPirbuterol is no longer marketed in the US.
- Piroxicam
- PitavastatinNo published information exists on the use of pitavastatin during breastfeeding.
- PlazomicinPlazomicin is an aminoglycoside antibiotic similar to gentamicin and amikacin.
- PlecanatidePlecanatide is not absorbed from the gastrointestinal tract and the drug and its active metabolite are not measurable in milk following administration of recommended doses to nursing mothers.
- PolythiazideNo information is available on the amount of polythiazide in breastmilk.
- PonatinibNo information is available on the clinical use of ponatinib during breastfeeding.
- Povidone-Iodine
- PramipexoleNo information is available on the use of pramipexole during breastfeeding, but it suppresses serum prolactin and may interfere with breastfeeding.
- PrasugrelNo published information is available on the use of prasugrel during breastfeeding.
- PravastatinLevels of pravastatin in milk are low, but no relevant published information exists with its use during breastfeeding.
- PraziquantelBecause of the minute levels of praziquantel in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- PrazosinBecause little is available on the use of prazosin during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- PrednicarbateTopical prednicarbate has not been studied during breastfeeding.
- PrednisoloneAmounts of prednisolone in breastmilk are very low.
- PrednisoneAmounts of prednisone in breastmilk are very low.
- PregabalinLimited data indicate that amounts of pregabalin in breastmilk are low and one infant breastfed for 3 months with no discernable adverse effects.
- PrilocaineNo information is available on the use of prilocaine during breastfeeding.
- PrimidoneAmple evidence exists that primidone taken during nursing can affect the breastfed infant.
- Probenecid
- ProcainamideMaternal doses of procainamide 2 grams daily produced low levels of the drug and its active metabolite in the milk of one mother.
- ProcaineThe term "Novocaine" (an old procaine brand name) is often equated to local anesthetic.
- Prochlorperazine
- Progesterone
- Promethazine
- PropafenoneLimited information indicates that maternal doses of propafenone up to 900 mg daily produce low levels in milk.
- PropanthelineNo information is available on the use of propantheline during breastfeeding.
- PropofolAmounts of propofol in milk are very small and are not expected to be absorbed by the infant.
- PropoxypheneMaternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression.
- PropranololBecause of the low levels of propranolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- Propylthiouracil
- PrucaloprideNo published experience exists with prucalopride during breastfeeding.
- PseudoephedrineAlthough the small amounts of pseudoephedrine in breastmilk are unlikely to harm the nursing infant, it may cause irritability occasionally.
- PsylliumFew data are available on psyllium use during breastfeeding.
- PyridostigmineBecause of the low levels of pyridostigmine in breastmilk, amounts ingested by the infant are small and infant serum levels are very low.
- PyrimethamineNo adverse reactions in breastfed infants have been reported during maternal pyrimethamine use.
Q
- QuazepamNo information is available on the long-term use of quazepam during breastfeeding.
- QuetiapineMaternal quetiapine doses of up to 400 mg daily produce doses in milk that are less than 1% of the maternal weight-adjusted dosage.
- QuinaprilBecause of the low levels of quinapril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- Quinidine
- QuinineBecause of the low levels of quinine in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
R
- RabeprazoleBecause no information is available on the use of rabeprazole during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- Raltegravir
- RamelteonData from one patient indicates that ramelteon and its principle active metabolite have low levels in milk.
- RamiprilBecause no information is available on the use of ramipril during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- RanibizumabMilk levels of ranibizumab are very low after intravitreal injection in nursing mothers.
- RanitidineAlthough interpatient variability exists, the dose of ranitidine in breastmilk is less than the dose used in newborn infants.
- RasagilineNo clinical use of rasagiline during breastfeeding has been reported.
- RasburicaseNo information is available on the clinical use of rasburicase during breastfeeding.
- RegadenosonNo information is available on the use of regadenoson during breastfeeding.
- RemifentanilBecause the half-life of remifentanil is extremely short, it is unlikely to cause any adverse effects in the breastfed newborn if it is given to the mother for labor analgesia or a surgical procedure.
- RepaglinideNo information is available on the use of repaglinide during breastfeeding.
- Reserpine
- ReslizumabNo information is available on the clinical use of reslizumab during breastfeeding.
- ResveratrolResveratrol (3,4',5-trans-trihydroxystilbene) is an antioxidant found in numerous plant species and in red wine.
- RevefenacinNo information is available on the use of revefenacin during breastfeeding.
- RibavirinRibavirin has not been studied in nursing mothers being treated for hepatitis C infection.
- RibociclibNo information is available on the clinical use of ribociclib during breastfeeding.
- RifabutinThe amount of rifabutin in milk is insufficient to treat tuberculosis in the breastfed infant.
- RifampinLimited information indicates that there are low levels of rifampin in breastmilk that would not be expected to cause any adverse effects in breastfed infants.
- RifamycinRifamycin is negligibly absorbed orally and used only for gastrointestinal infections.
- RifapentineThe amount of rifapentine and its metabolite in milk is insufficient to treat tuberculosis in the breastfed infant.
- RifaximinRifaximin is poorly absorbed orally and used only for gastrointestinal infections.
- RilpivirineLimited information indicates that maternal rilpivirine doses of 25 mg daily produce low levels in milk and infant serum.
- Riluzole
- RisperidoneLimited information indicates that maternal risperidone doses of up to 6 mg daily produce low levels in milk.
- RitonavirRitonavir is excreted into milk in measurable concentrations and low levels can be found in the blood of some breastfed infants.
- RituximabRituximab is a genetically engineered chimeric murine/human monoclonal antibody that targets CD20, a B-cell-specific surface antigen.
- Rivaroxaban
- RocuroniumLimited information on the use of rocuronium during breastfeeding indicates that no adverse infant effects occur.
- RopiniroleNo information is available on the use of ropinirole during breastfeeding, but it suppresses serum prolactin and may interfere with breastfeeding.
- RopivacaineRopivacaine passes into milk poorly and is not orally absorbed by breastfed infants.
- RosiglitazoneNo information is available on the clinical use of rosiglitazone during breastfeeding.
- RosuvastatinLevels of rosuvastatin in milk are low, and one case of an older infant breastfed during maternal rosuvastatin therapy found no adverse effects.
- RotigotineNo information is available on the use of rotigotine during breastfeeding, but it suppresses serum prolactin and may interfere with breastfeeding.
- RuxolitinibNo information is available on the clinical use of ruxolitinib during breastfeeding.
S
- Salmeterol
- SaquinavirSaquinavir is no longer marketed in the United States.
- SarecyclineNo information is available on the use of sarecycline during breastfeeding.
- SarilumabBecause sarilumab is a large protein molecule with a molecular weight of about 150,000 Da, the amount in milk is likely to be very low.
- SaxagliptinNo information is available on the clinical use of saxagliptin during breastfeeding.
- ScopolamineNo information is available on the use of scopolamine during breastfeeding.
- Secnidazole
- SecobarbitalBecause there is little published experience with secobarbital during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- SecukinumabNo information is available on the clinical use of secukinumab during breastfeeding.
- SelegilineA minimal amount of clinical use of selegiline during breastfeeding has been reported.
- SelinexorNo information is available on the use of selinexor during breastfeeding.
- SemaglutideSemaglutide was not detectable in the milk of mothers taking the drug subcutaneously.
- Sertraline
- SevelamerBecause sevelamer is not orally absorbed, sevelamer does not reach the breastmilk or adversely affect the breastfed infant after maternal administration.
- SevofluraneThere is little published experience with sevoflurane during breastfeeding.
- SibutramineSibutramine is no longer marketed in the United States.
- SildenafilLimited data indicate that sildenafil and its active metabolite in breastmilk are poorly excreted into breastmilk.
- SiltuximabNo information is available on the clinical use of siltuximab during breastfeeding.
- SimvastatinNo relevant published information exists on the use of simvastatin during breastfeeding.
- SincalideSincalide is a synthetic octapeptide analogue of cholecystokinin.
- SiponimodAlthough siponimod is 99.9% bound to plasma proteins and unlikely to reach the breastmilk in large amounts, it has a slow clearance and long half-life and is potentially toxic to the breastfed infant.
- SirolimusBecause almost no information is available on the use of oral sirolimus during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- SitagliptinNo information is available on the clinical use of sitagliptin during breastfeeding.
- Sodium Ferric Gluconate ComplexNo information is available on the use of sodium ferric gluconate complex during breastfeeding.
- Sodium Polystyrene SulfonateBecause sodium polystyrene sulfonate is not orally absorbed, it is unlikely to reach the breastmilk or adversely affect the breastfed infant after maternal administration.
- Sodium Zirconium CyclosilicateBecause sodium zirconium cyclosilicate is not orally absorbed it is unlikely to reach the breastmilk or adversely affect the breastfed infant.
- Sofosbuvir
- Solifenacin
- SolriamfetolNo information is available on the clinical use of solriamfetol during breastfeeding.
- Somatropin
- SotalolBecause of its extensive excretion into breastmilk and its renal excretion, other beta-adrenergic blocking drugs are preferred to sotalol, especially while nursing a newborn or preterm infant.
- SparfloxacinNo information is available on the use of sparfloxacin during breastfeeding.
- SpironolactoneLimited data indicate that spironolactone is poorly excreted into breastmilk.
- SpirulinaSpirulina (Aphanizomenon sp., Spirulina sp., and others) is a fresh-water blue-green alga that contains various nutrients such as protein, B vitamins, vitamin E, chlorophyll, beta-carotene, and iron.
- StavudineStavudine is not a recommended agent during breastfeeding.
- SucralfateNo data are available on sucralfate use during breastfeeding; however, it is virtually unabsorbed orally.
- Sufentanil
- SugammadexNegligible amounts of sugammadex are excreted into breastmilk after usual doses.
- SulconazoleTopical sulconazole has not been studied during breastfeeding.
- SulfamethoxazoleWith healthy, fullterm infants it appears acceptable to use sulfamethoxazole during breastfeeding after the newborn period.
- SulfasalazineSulfasalazine and its active metabolite mesalamine are poorly excreted into breastmilk.
- SulfurSulfur 5% to 10% in a petrolatum base is safe for topical use in children, including infants under 2 months of age.
- Sulindac
- SumatriptanBecause of the low levels of sumatriptan in breastmilk, amounts ingested by the infant are small.
T
- TacrolimusThe amounts of systemically administered tacrolimus are low in breastmilk and do not adversely affect the breastfed infant.
- TafenoquineNo information is available on the use of tafenoquine during breastfeeding.
- TafluprostNo information is available on the use of tafluprost during breastfeeding.
- TalazoparibNo information is available on the clinical use of talazoparib during breastfeeding.
- TamoxifenTamoxifen and its active metabolites are detectable in milk and accumulate in milk over time.
- TapentadolMaternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression.
- TazaroteneTopical tazarotene has not been studied during breastfeeding.
- TedizolidNo information is available on the use of tedizolid during breastfeeding.
- TelaprevirTelaprevir is no longer marketed in the United States and has not been studied in nursing mothers.
- TelavancinNo information is available on the use of telavancin during breastfeeding.
- TelbivudineTelbivudine has been discontinued from the US market.
- TelmisartanNo information is available on the use of telmisartan during breastfeeding and the manufacturer advises avoidance of breastfeeding during telmisartan therapy.
- Temazepam
- TemsirolimusTemsirolimus is a prodrug of sirolimus.
- Tenofovir Disoproxil FumarateTenofovir is available in the U.S. in two forms, tenofovir disoproxil fumarate and tenofovir alafenamide.
- TerazosinBecause no information is available on the use of terazosin during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- Terbinafine
- TerbutalineMaternal use of oral or inhaled terbutaline is unlikely to affect a breastfed infant.
- Teriflunomide
- TestosteroneLimited data indicate that a low-dose (100 mg) subcutaneous testosterone pellet given to a nursing mother appears not to increase milk testosterone levels markedly.
- TetracyclineA number of reviews have stated that tetracycline is contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines.
- TheophyllineExpert opinion considers use of theophylline to be acceptable during breastfeeding.
- Thiethylperazine
- ThioridazineBecause there is no published experience with thioridazine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- ThiothixeneBecause there is no published experience with thiothixene during breastfeeding, other antipsychotic agents are preferred.
- Tiagabine
- TigecyclineTigecycline is a tetracycline antibiotic.
- Timolol
- TinidazoleAmounts of tinidazole in milk are less than doses given to infants.
- TinzaparinTinzaparin is no longer available in the US.
- TiotropiumAlthough no published data exist on the use of tiotropium, its use produces negligible maternal serum levels and any drug in breastmilk would not be absorbed by the infant.
- TipranavirNo published information is available on the use of tipranavir during breastfeeding.
- TobramycinTobramycin is poorly excreted into breastmilk.
- TofacitinibData from 3 mothers indicate that the amount in milk is low, and no adverse effects were seen in infants who were exclusively breastfed during maternal tofacitinib use.
- TolazamideTolazamide is no longer marketed in the United Staes.
- TolbutamideTolbutamide is no longer marketed in the United States.
- TolmetinBecause of the low levels of tolmetin in breastmilk and its short half-life, it is unlikely to adversely affect the breastfed infant.
- TolterodineNo information is available on the use of tolterodine during breastfeeding.
- TopiramateMaternal doses of topiramate up to 200 mg daily produce low levels in infant serum.
- TopotecanMost sources consider breastfeeding to be contraindicated during maternal high-dose antineoplastic drug therapy.
- Torsemide
- TramadolThe excretion of tramadol into milk is low and even lower amounts of the active metabolite, O-desmethyltramadol, are excreted.
- TrandolaprilBecause no information is available on the use of trandolapril during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- Tranexamic AcidAmounts of tranexamic acid in breastmilk appear to be low.
- TrastuzumabTrastuzumab milk concentrations were collected in one mother.
- TravoprostNo information is available on the use of travoprost during breastfeeding.
- Trazodone
- TreprostinilThe amount of treprostinil in milk appears to be low and it is not well absorbed orally.
- TretinoinTretinoin has not been studied during breastfeeding.
- TriamtereneBecause there is no published experience with triamterene during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- TriazolamBecause little information is available on the use of triazolam during breastfeeding, an alternate hypnotic may be preferred, especially while nursing a newborn or preterm infant.
- TrichlormethiazideNo information is available on the amount of trichlormethiazide in breastmilk.
- TriclabendazoleNo information is available on the use of triclabendazole during breastfeeding.
- TrientineLimited information indicates that trientine is not detectable in breastmilk, and no adverse effects have been reported among breastfed infants whose mothers were taking the drug.
- TrifluoperazineLimited information indicates that maternal doses of trifluoperazine up to 10 mg daily do not affect the breastfed infant.
- TrihexyphenidylLimited information indicates that maternal doses of trihexyphenidyl up to 4 mg daily together with haloperidol or risperidone did not produce any adverse effects in breastfed infants.
- TrimethobenzamideBecause no information is available on the continuous use of trimethobenzamide during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- TrimethoprimBecause of the low levels of trimethoprim in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
- TrimipramineBecause there is no published experience with trimipramine during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
- TripelennamineTripelennamine is no longer marketed in the United States.
- TriprolidineSmall, occasional doses of triprolidine would not be expected to cause any adverse effects in breastfed infants.
- TropicamideNo information is available on the use of tropicamide during breastfeeding.
- TrovafloxacinNo information is available on the clinical use of trovafloxacin during breastfeeding; however, amounts in breastmilk appear to be low.
U
- UlipristalUlipristal is a selective progesterone receptor modulator used in a single dose as an emergency postcoital contraceptive.
- UmeclidiniumAlthough no published data exist on the use of umeclidinium during breastfeeding, it produces low systemic maternal serum levels and any drug in breastmilk would not be absorbed by the infant.
- UrsodiolUrsodiol (ursodeoxycholic acid) is naturally present in human milk.
- UstekinumabUstekinumab is usually either not detectable in breastmilk or detectable at very low levels in breastmilk.
V
- ValacyclovirThe dosage of acyclovir in milk after valacyclovir is less than 1% of a typical infant dosage and would not be expected to cause any adverse effects in breastfed infants.
- ValganciclovirValganciclovir is rapidly converted to ganciclovir.
- Valproic AcidValproic acid levels in breastmilk are low and infant serum levels range from undetectable to low.
- ValsartanMilk levels after the lowest dose of the combination of valsartan and sacubitril (Entresto) are very low.
- Vancomycin
- VareniclineVarenicline is a partial nicotine agonist used orally to assist smoking cessation and by nasal spray for dry eyes.
- VasopressinNo information is available on the clinical use of vasopressin (arginine vasopressin) during breastfeeding.
- VedolizumabMaternal vedolizumab injections produce low levels in breastmilk and do not appear to adversely affect the nursing infant.
- Velaglucerase AlfaNo information is available on the clinical use of velaglucerase during breastfeeding.
- Venlafaxine
- VerapamilLimited information indicates that maternal doses of verapamil up to 360 mg daily produce low levels in milk.
- VigabatrinLimited information indicates that maternal doses of vigabatrin up to 2000 mg daily produce low levels in milk.
- VilazodoneBecause there is no published experience with vilazodone during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
- VinblastineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- VincristineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- VinorelbineMost sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.
- VismodegibNo information is available on the clinical use of vismodegib during breastfeeding.
- Vitamin AVitamin A (retinol) and provitamin A carotenoids are normal components of human milk.
- VortioxetineAmounts of vortioxetine in milk appear to be low.
W
Z
- ZafirlukastNo published information is available on the use of zafirlukast during breastfeeding; however, manufacturer's data indicate that the dose in milk is low.
- ZaleplonLittle information is available on the use of zaleplon during breastfeeding.
- ZanamivirNo information is available on the use of zanamivir during breastfeeding.
- ZidovudineZidovudine has been well studied during breastfeeding.
- ZileutonNo published information is available on the use of zileuton during breastfeeding; however, manufacturer's data indicate that the dose in milk is low.
- ZiprasidoneBecause there is little published experience with ziprasidone during breastfeeding, other antipsychotic agents may be preferred, especially while nursing a newborn or preterm infant.
- ZolmitriptanPreliminary evidence indicates that zolmitriptan levels in breastmilk are low.
- Zolpidem
- ZonisamideLimited information indicates that maternal doses of zonisamide up to 400 mg daily produce high levels in milk and infant serum.
Frequently asked questions
Where do these answers come from?
From LactMed, the Drugs and Lactation Database maintained by the US National Library of Medicine — the reference clinicians consult for this question. We quote each record rather than rewriting it, and link back to the original. LactMed revises records individually; each page shows that record's own revision date.
Why does a drug I take have no page here?
Because LactMed has no record for it. We publish a page only where the national library has written one — filling the gap with our own reasoning is exactly the wrong move on this question.
Is this medical advice?
No. LactMed itself states that the information is not a substitute for professional judgement and that you should consult your healthcare provider about your particular situation. These pages show you what the evidence base says so that conversation starts better informed.
What makes these pages different from a general 'safe medications while breastfeeding' list?
Those lists give one word per drug. LactMed gives measured drug levels in milk, what has actually been observed in breastfed infants, effects on milk supply, and — on most records — the specific drugs it would consider instead. All of that is on the page for each drug, with every alternate linked to its own record.
Some records do not resolve to a one-line answer — that is LactMed’s position on a genuinely unsettled question, not an omission on our part. LactMed states that its information is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation.