Can you take ferric carboxymaltose 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.
Intravenous iron carboxymaltose increases breastmilk iron in mothers with iron deficiency anemia. Breastfed neonates of these mothers appear to have no serious adverse reactions. Ferric carboxymaltose appears to be acceptable to use in nursing mothers with no special precautions required. For additional information on iron use during breastfeeding, see the monograph on Iron Salts.
Quoted from Ferric Carboxymaltose — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised January 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of ferric carboxymaltose. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much ferric carboxymaltose gets into breastmilk
Maternal Levels. A multi-center study of postpartum mothers with iron deficiency anemia (hemoglobin 105 g/L or less) compared iron carboxymaltose to oral ferrous sulfate. Mothers were given intravenous ferric carboxymaltose in a dose of 15 mg of iron/kg body weight to a maximum dose of 1000 mg over 15 minutes on day 1, with subsequent weekly doses until each woman's total iron requirement had been given. The first dose was given within 7 days postpartum and follow-up visits were at follow-up visits after 1, 2, 4, and 12 weeks postpartum. A subset of 11 mothers had their breastmilk iron measured before and after administration of iron carboxymaltose. Baseline breastmilk iron was 0.500 mg/kg. At 24 hours after the first dose, breastmilk iron increased to 1.447 mg/kg. One week after the first dose, breastmilk iron decreased to an average of 0.513 mg/kg. After the second dose at week 1, breastmilk iron increased to 0.615 mg/kg at 1 to 3 hours after the dose. Breastmilk iron was 0.991 mg/kg before the dose on week 2.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
In a study of postpartum mothers given intravenous ferric carboxymaltose, 229 were breastfeeding their infants. Among the breastfed infants, 24 infants (10.5%) had an adverse reaction reported. The most frequent reactions included erythema, constipation, diarrhea and nasopharyngitis. The overall rate of adverse reactions was similar to the rate (12%) in the control group whose mothers received oral ferrous sulfate.
In a study of mothers with postpartum anemia, 16 women were given 1000 mg ferric carboxymaltose intravenously as a single dose, either alone (n = 8) or in combination with a red blood cell transfusion (n = 8). At the time of the iron infusion, 13 of the women were exclusively or fully breastfeeding and 2 were partially breastfed. No adverse effects in breastfed infants were reported.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take ferric carboxymaltose while breastfeeding?
Intravenous iron carboxymaltose increases breastmilk iron in mothers with iron deficiency anemia. 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 ferric carboxymaltose while breastfeeding?
LactMed lists Ferric Derisomaltose, Iron Sucrose 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 ferric carboxymaltose pass into breastmilk?
LactMed's measured drug levels for ferric carboxymaltose are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking ferric carboxymaltose?
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 ferric carboxymaltose
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.