Can you take itraconazole 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 clinical use of itraconazole during breastfeeding. However, limited data indicate that maternal itraconazole produces levels in milk that are less than the 5 mg/kg daily doses that have been recommended to treat infants. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. If itraconazole is used during breastfeeding, monitoring of the infant’s liver enzymes should be considered, especially with long courses of therapy.
Quoted from Itraconazole — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised September 19, 2022.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of itraconazole. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much itraconazole gets into breastmilk
Maternal Levels. An unpublished study reported 2 healthy volunteers who each took 2 oral doses of itraconazole 200 mg 12 hours apart. Milk samples were obtained with a breast pump at 4, 24, and 48 hours after the second dose. The average milk concentrations of itraconazole were 70.2, 27.7, and 16.2 mcg/L, respectively. At 72 hours, the milk level was 20.1 mcg/L in one woman and not detectable (<5 mcg/L) in the other. However, steady-state was probably not attained at the time of sampling, and metabolites including the active hydroxyitraconazole were not measured.
Using data reported in the literature, including the above source, researchers estimated that fully breastfed infants between 3 and 12 months of age would receive 1.48% of the mother's weight-adjusted dosage of itraconazole and attain a plasma concentration of 0.77% of the mother's plasma concentration.
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
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take itraconazole while breastfeeding?
No information is available on the clinical use of itraconazole 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 itraconazole while breastfeeding?
LactMed lists Fluconazole 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 itraconazole pass into breastmilk?
LactMed's measured drug levels for itraconazole are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking itraconazole?
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 itraconazole
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.