Can you take daptomycin 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 and somewhat inconsistent information indicates that daptomycin produces very low levels in milk and it would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.
Quoted from Daptomycin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised April 19, 2021.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of daptomycin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much daptomycin gets into breastmilk
Maternal Levels. A nursing mother received intravenous daptomycin 500 mg (6.7 mg/kg) and ertapenem 1 gram once daily for 28 days to treat a pelvic infection. On day 27 of therapy, expressed breastmilk was collected over six 4-hour intervals. Daptomycin milk concentrations were highest in the second sample with a concentration of 44.7 mcg/L. The fifth sample, ending at 20 hours after the dose, contained 29.2 mcg/L of daptomycin and the final sample had no detectable drug (<25 mcg/L). Using the average maximum milk level, the infant would receive a weight-adjusted dosage of 0.1% of the maternal dosage.
A woman nursing a newborn was given daptomycin 500 mg (7.4 mg/kg) intravenously once daily for 14 days for a soft tissue infection. Hindmilk samples were taken during the last 4 days of therapy and for 2 days after the last dose. Trough daptomycin levels taken during therapy averaged 208 mcg/L. Levels of about 270 mcg/L were found at 6 and 12 hours after one of the doses. The highest concentration in milk was at 78 h after the eleventh dose, with a concentration of 329 mcg/L. After the last dose, milk levels dropped from 330 mcg/L to 121 mcg/L over a period of 42 hours. Using the median milk level, the infant would receive a dose of 36.5 mcg/kg daily or a weight-adjusted dosage of 0.5% of the maternal dosage.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A mother nursing (extent not stated) a 5-month-old infant received intravenous daptomycin 500 mg and ertapenem 1 gram once daily for 28 days to treat a pelvic infection. No adverse events were noted in the infant during the treatment or follow-up examination.
A woman nursing a newborn was given daptomycin 500 mg intravenously once daily for 14 days. No adverse effects were noted in the infant during therapy and for 7 days after the end of therapy.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take daptomycin while breastfeeding?
What the NIH's Drugs and Lactation Database says about Daptomycin 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 daptomycin while breastfeeding?
LactMed lists Vancomycin 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 daptomycin pass into breastmilk?
LactMed's measured drug levels for daptomycin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking daptomycin?
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 daptomycin
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.