Can you take ivermectin 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 ivermectin is poorly excreted into breastmilk after oral administration. Amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants over 7 days of age. No data are available on ivermectin excretion into breastmilk after topical administration, but some expert opinion considers it to be a treatment of choice for scabies during breastfeeding. Avoid application to the breast area where the infant might directly ingest the drug.
Quoted from Ivermectin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised December 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of ivermectin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Permethrin
- Pyrethrins
How much ivermectin gets into breastmilk
Maternal Levels. Four mothers who had lost their infants at term were given a single 150 mcg/kg dose of oral ivermectin. Ivermectin was detected in milk within 1 hour after the dose and for 72 hours after the dose. The average peak milk level was 15 mcg/L (range 11 to 21 mcg/L) and occurred 4 hours after the dose in 2 women, 6 hours in another and 12 hours after the dose in the fourth. The mean milk level was 9.85 mcg/L. Using the mean milk level data from this study, an exclusively breastfed infant would receive an average dose of 1.47 mcg/kg after a maternal dose of 150 mcg/kg, or 0.98% of the weight-adjusted maternal dose.
A woman was treated for Strongyloides stercoralis with a single oral dose of 200 mcg/kg of ivermectin. She collected milk samples before the dose and at 1, 3, 6, 9, 12 and 24 hours after the dose. A peak level in milk of 20.8 mcg/L occurred 6 hours after the dose. The average concentration over the 24-hour period was 9.26 mcg/L. Using the average milk level data from this study, an exclusively breastfed infant would receive an average dose of 1.39 mcg/kg after a maternal dose of 200 mcg/kg, or 0.7% of the weight-adjusted maternal dose.
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 ivermectin while breastfeeding?
Limited data indicate that ivermectin is poorly excreted into breastmilk after oral administration. 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 ivermectin while breastfeeding?
LactMed lists Permethrin, Pyrethrins 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 ivermectin pass into breastmilk?
LactMed's measured drug levels for ivermectin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking ivermectin?
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 ivermectin
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.