Can you take cefuroxime 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.
Limited information indicates that cefuroxime produces low levels in milk that are not expected to cause severe adverse effects in breastfed infants. Cefuroxime does not appear to alter the flora of breastmilk when used alone, but it can alter the infant’s fecal flora.[1] Occasionally, diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefuroxime is acceptable in nursing mothers.
Quoted from Cefuroxime — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised November 15, 2023.
How much cefuroxime gets into breastmilk
Maternal Levels. A single intravenous dose of 750 mg of cefuroxime was given to 5 women. The average peak cefuroxime level in milk was 0.37 mg/L 3 hours after the dose. Individual peak levels of 0.33 to 0.5 mg/L occurred 2 to 4 hours after the dose.[2]
A single intramuscular injection of 750 mg of cefuroxime was given to 8 women with endometritis. Milk cefuroxime levels increased from 0.34 mg/L at 30 minutes after the injection to 1.45 mg/L at 8 hours after the injection.[3]
After cefuroxime 750 mg three times daily intramuscularly, peak milk levels averaging 1.2 mg/L occurred 6 hours after the dose. Cefuroxime was detectable at a concentration of 0.36 mg/L 30 minutes after the dose, and by 8 hours the milk level had decreased to 1.06 mg/L.[4]
One mother received cefuroxime axetil 500 mg orally three times daily for acute mastitis of the left breast following incision and drainage of the lesion. Milk samples were taken from each breast 30 minutes after the dose on day 1 of therapy. The concentration of cefuroxime in the unaffected breast was 90 mcg/L and the concentration in the breast treated for mastitis was 590 mcg/L. On day 2 of therapy, milk samples from the right and left breast were taken 90 minutes after the dose were 57 and 59 mcg/L, respectively. On day 3, milk samples obtained 90 minutes after the dose contained 27 mcg/L in the unaffected breast and 1.07 mg/L in the affected breast.[5]
Two women were who had been receiving intravenous cefuroxime 750 mg 3 times daily for 2 days following cesarean section donated milk samples 1 hours after the dose. Milk concentrations were 0.34 and 0.39 mg/L.[6]
Two women who had just stopped breastfeeding each took a single 500 mg dose or oral cefuroxime axetil. Ten milk samples collected over 24 hours found peak milk concentrations of 618.9 and 685.3 mcg/L at 4 hours after the dose. At 24 hours after the dose, the milk concentration were 28.6 and 26.4 mcg/L.[7]
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A prospective, controlled study asked mothers who called an information service about adverse reactions experience by their breastfed infants. Mothers were taking either cephalexin or cefuroxime. No statistical difference was found in the rate of adverse reactions in the 2 groups, with 1 case of diarrhea in each. This amounted to 2.6% of the cefuroxime-exposed infants.[8]
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take cefuroxime while breastfeeding?
Limited information indicates that cefuroxime produces low levels in milk that are not expected to cause severe adverse effects in breastfed infants. 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 cefuroxime pass into breastmilk?
LactMed's measured drug levels for cefuroxime are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking cefuroxime?
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 cefuroxime
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.