Can you take ferric derisomaltose 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 data indicate that breastmilk iron is increased 3 days after an intravenous infusion of ferric derisomaltose (formerly called iron isomaltoside), but levels remain within the normal range. By 7 days after the dose, breastmilk iron levels were similar to that of mothers taking oral iron. Ferric derisomaltose 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 Derisomaltose — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised March 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of ferric derisomaltose. 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 derisomaltose gets into breastmilk
Maternal Levels. Thirty women with postpartum anemia were given intravenous ferric derisomaltose 1200 mg in a single intravenous dose over 15 minutes. They were compared to 35 women with postpartum anemia who took 100 mg of oral iron once or twice daily. Breastmilk samples were taken before treatment, 3 (range 2 to 4) days and again at 7 (range 6 to 8) days after the intravenous iron dose. At the 3-day point, the average breastmilk iron concentration was 0.72 mg/L in the IV iron group and 0.4 mg/L in the oral iron group, which was significantly different. At the 7-day point, the average breastmilk iron concentration was 0.47 mg/L in the IV iron group and 0.44 mg/L in the oral iron group, which was not significantly different.
A study in Japan of women with postpartum hemorrhage gave ferric derisomaltose in a dose determined by a formula for iron need. The cumulative total iron dose in 1 or 2 doses was 1000 mg in 6 patients, 1500 mg in 14 patients, and 2000 mg in 1 patient. Breastmilk iron concentrations were in the normal range for the 21 women tested, with an average concentration of 0.98 mg/L on day 4 after the infusion falling to 0.66 mg/L by day 15.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
In a randomized, nonblinded study, randomly assigned to receive either a single intravenous dose of 1200 mg ferric derisomaltose (iron isomaltoside; n = 97) or oral iron 40 to 50 mg oral iron daily or 100 mg oral iron one or two times daily (n = 99). There was no significant difference between groups in the median time to lactogenesis, nor in the time of discontinuation of breastfeeding among those who weaned their infants.
A study in Japan of women with postpartum hemorrhage gave ferric derisomaltose in a dose determined by a formula for iron need. The cumulative total iron dose in 1 or 2 doses was 1000 mg in 6 patients, 1500 mg in 14 patients, and 2000 mg in 1 patient. Adverse reactions occurred in 5 of 21 breastfed neonates and included neonatal jaundice, hydrocele, anal fissure, and diaper dermatitis diaper. With the exception of neonatal jaundice, all events were mild; none were severe and none appeared to be directly related to ferric derisomaltose.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take ferric derisomaltose while breastfeeding?
What the NIH's Drugs and Lactation Database says about Ferric Derisomaltose 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 ferric derisomaltose while breastfeeding?
LactMed lists Ferric Carboxymaltose, 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 derisomaltose pass into breastmilk?
LactMed's measured drug levels for ferric derisomaltose are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking ferric derisomaltose?
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 derisomaltose
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.