Can you take isotretinoin 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.
No information is available on the use of isotretinoin during breastfeeding. Various topical agents that are less likely to be absorbed by the mother may be preferred during breastfeeding, especially while nursing a newborn or preterm infant.
Quoted from Isotretinoin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised October 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of isotretinoin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much isotretinoin gets into breastmilk
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information was not found as of the revision date.
Effects on milk supply
A woman who had weaned her infant 18 months previously developed a nipple discharge from her right breast after 5.5 months of therapy with isotretinoin. Microbiological, hormonal (including prolactin), radiologic, and physical examinations were otherwise normal. One month after discontinuing isotretinoin, the discharge ceased. After isotretinoin was reinstituted at the same dose, the discharge reappeared within 10 days. The galactorrhea was probably caused by isotretinoin.
A review of adverse reaction reports on retinoids causing a breast reaction submitted to a French pharmacovigilance center found 22 cases of gynecomastia was associated with isotretinoin use. Fourteen of the cases were gynecomastia, 6 were galactorrhea and 2 were of both gynecomastia and galactorrhea. Gynecomastia and/or galactorrhea was unilateral for almost half of the reported retinoid cases. The median time of onset was 90 days (IQR 39 to 347 days). The outcome was known for 27 of 31 patients and a total recovery after withdrawal of retinoid was observed for 63% of them.
Frequently asked questions
Can you take isotretinoin while breastfeeding?
No information is available on the use of isotretinoin during breastfeeding. 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 isotretinoin while breastfeeding?
LactMed lists 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 isotretinoin pass into breastmilk?
LactMed's measured drug levels for isotretinoin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking isotretinoin?
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 isotretinoin
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.