Can you take capecitabine 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.
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence. some have suggested a period of 24 hours before resuming nursing, although the manufacturer recommends an abstinence period of 2 weeks. Capecitabine is metabolized to fluorouracil. Limited information indicates that a maternal continuous intravenous fluorouracil infusion at a dose of 200 mg/square meter daily produces undetectable levels in milk. If capecitabine use is undertaken, monitoring of the infant's complete blood count and differential is advisable. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.
Quoted from Capecitabine — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised August 16, 2021.
How much capecitabine gets into breastmilk
Capecitabine is a prodrug that is metabolized to fluorouracil.
Maternal Levels. A mother who was 9 months postpartum was diagnosed with rectal cancer and began treatment with pelvic radiotherapy and a continuous intravenous infusion of fluorouracil 200 mg/square meter daily. Her plasma fluorouracil concentration was constant at about 110 micromoles/L (14.3 mg/L) from weeks 2 to 5 of therapy. She discontinued nursing her infant and pumped her breasts twice daily and collected 36 breastmilk samples before, during and for 10 days following fluorouracil therapy (exact times not specified). Fluorouracil was undetectable (<0.5 micromole/L [<65 mcg/L]) in all of the milk samples.
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 capecitabine while breastfeeding?
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. 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 capecitabine pass into breastmilk?
LactMed's measured drug levels for capecitabine are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking capecitabine?
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 capecitabine
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.