Can you take miconazole 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.
Because miconazole has poor absorption from the skin and vagina and has poor oral bioavailability, it is unlikely to adversely affect the breastfed infant, including after topical application to the nipples. However, miconazole ointment appears to have no advantage over lanolin for treating sore nipples during breastfeeding and a survey of members of the Academy of Breastfeeding Medicine found topical miconazole is rarely prescribed to nursing mothers to treat thrush. Any excess cream or ointment should be removed from the nipples before nursing. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.
Quoted from Miconazole — 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 miconazole. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much miconazole 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
In a randomized, double-bind trial, lanolin was compared to an all-purpose nipple ointment containing mupirocin 1%, betamethasone 0.05%, and miconazole 2% for painful nipples while nursing in the first 2 weeks postpartum. The two treatments were equally effective in reducing nipple pain, nipple healing time, breastfeeding duration, breastfeeding exclusivity rate, mastitis and nipple symptoms, side effects or maternal satisfaction with treatment.
Frequently asked questions
Can you take miconazole while breastfeeding?
What the NIH's Drugs and Lactation Database says about Miconazole 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 miconazole while breastfeeding?
LactMed lists Clotrimazole, Fluconazole, Nystatin 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 miconazole pass into breastmilk?
LactMed's measured drug levels for miconazole are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking miconazole?
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 miconazole
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.