Can you take acitretin while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
A maternal acitretin dose of 0.65 mg/kg daily produced low levels in milk in one woman. Because there is no published experience with the safe use of acitretin during breastfeeding, current expert opinion recommends avoiding acitretin during breastfeeding. Various topical agents that are less likely to be absorbed by the mother may be preferred during breastfeeding, especially while nursing a newborn or preterm infant. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.
Quoted from Acitretin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised May 15, 2026.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of acitretin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much acitretin gets into breastmilk
Maternal Levels. A woman who was 8 months postpartum discontinued breastfeeding and began acitretin 40 mg (0.65 mg/kg) once daily by mouth after breakfast. Milk was collected before starting the drug and then twice daily for 9 days. Acitretin and its 13-cis-metabolite were detected in milk 12 hours after the first dose and levels gradually increased over 4 to 5 days to steady-state levels between 30 and 40 mcg/L that did not fluctuate markedly during the day. Acitretin was the main component found in milk 10 to 12 hours after a dose while the metabolite was the primary component in milk 22 to 24 hours after the previous dose. Assuming an average milk level of 35 mcg/L, an exclusively breastfed infant would receive an estimated 0.8% of the maternal weight-adjusted dosage as acitretin and its metabolite.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information was not found as of the revision date.
Effects on milk supply
A review of adverse reaction reports on retinoids causing a breast reaction submitted to a French pharmacovigilance center found 8 cases of gynecomastia associated with acitretin use.
Frequently asked questions
Can you take acitretin while breastfeeding?
A maternal acitretin dose of 0.65 mg/kg daily produced low levels in milk in one woman. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of acitretin while breastfeeding?
LactMed lists Adalimumab, Certolizumab Pegol, Etanercept, Infliximab, Phototherapy, Tretinoin as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does acitretin pass into breastmilk?
LactMed's measured drug levels for acitretin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking acitretin?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on acitretin
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.