Can you take dapsone 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.
Dapsone can be used during breastfeeding; however, hemolytic anemia might occur, especially in newborn infants and in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The time of greatest risk for hemolysis in fullterm newborns without G6PD deficiency might be as short as 8 days after birth. One source states that use of dapsone in the treatment of leprosy is advantageous because it kills the organisms in breastmilk. Monitor the infant for signs of hemolysis, especially in newborn or premature breastfed infants.
Topical dapsone gel used to treat acne has not been studied during breastfeeding. According to the manufacturer, topical dapsone gel results in a blood level of 1% that of a 100 mg oral dose. It is unlikely that the topical gel would affect the breastfed infant, but the manufacturer states that it should not be used during nursing. Until more data are available, an alternative topical agent might be preferred.
Quoted from Dapsone — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised September 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of dapsone. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much dapsone gets into breastmilk
Maternal Levels. In one mother who was 41 days postpartum, a random milk level of dapsone was about 1.1 mg/L with a maternal dose of 50 mg daily. Monoacetyldapsone was not detectable in milk although the maternal serum level was 744 mcg/L.
Three women who were 2 to 5 days postpartum were given a single dose of 100 mg of dapsone orally. Milk samples were obtained at various times up to about 220 hours after the dose. The authors calculated that the breastfed infants would receive an average of 9.6% (range 4.6 to 14.3%) of the maternal weight-adjusted dosage.
Infant Levels. A mother who was 41 days postpartum was taking dapsone 50 mg daily. Her breastfed infant's serum had levels of 439 mcg/L of dapsone and 204 mcg/L of monoacetyldapsone.
What has been seen in breastfed infants
A case of mild hemolytic anemia occurred in a 41-day-old breastfed infant whose mother was taking dapsone 50 mg daily. The hemolysis was probably caused by dapsone in milk.
A woman with leprosy took dapsone, clofazimine and rifampin during pregnancy and breastfeeding. Her infant developed skin discoloration attributed to clofazimine which reversed 3 months after cessation of breastfeeding.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take dapsone while breastfeeding?
What the NIH's Drugs and Lactation Database says about Dapsone while breastfeeding — quoted in full. 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 dapsone while breastfeeding?
LactMed lists Clofazimine, Adapalene, Azelaic Acid, Benzoyl Peroxide, Clindamycin, Erythromycin, 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 dapsone pass into breastmilk?
LactMed's measured drug levels for dapsone are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking dapsone?
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 dapsone
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.