Can you take amikacin 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.
Amikacin is poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of other aminoglycosides, but serum levels with typical three times daily dosages are far below those attained when treating newborn infections and systemic effects of amikacin are unlikely. Older infants would be expected to absorb even less amikacin. Because there is little variability in the milk amikacin levels during multiple daily dose regimens, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Data are not available with single daily dose regimens. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.
Quoted from Amikacin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised October 15, 2023.
How much amikacin gets into breastmilk
Maternal Levels. Two women were given a single dose of 100 mg amikacin intramuscularly, and milk levels were measured at 2 and 6 hours after the dose. Only trace levels were detected. In one woman on amikacin therapy, the peak amikacin milk level was 1.5 mg/L 2.5 hours after a 100 mg dose by injection.
Two women were given a single 200 mg dose of amikacin intramuscularly and milk levels were measured hourly for 6 hours. They had only trace levels in milk 6 hours after the dose.
A woman given a single dose of amikacin 100 mg intramuscularly had undetectable milk amikacin levels 1 and 2 hours after the dose and only trace amounts in milk at 4 and 6 hours after the dose.
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
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take amikacin while breastfeeding?
Amikacin is poorly excreted into breastmilk. 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.
Does amikacin pass into breastmilk?
LactMed's measured drug levels for amikacin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking amikacin?
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 amikacin
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.