Can you take mifepristone 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 information indicates that breastfeeding need not be interrupted after a single dose of mifepristone as in a medical abortion, but a dose of 200 mg might be preferable to a 600 mg dose in nursing mothers. Breastfeeding should be avoided during long-term therapy as a cortisol receptor blocker for controlling hyperglycemia. Because of its long half-life, the manufacturer recommends pumping and discarding milk during long-term therapy and for 18 to 21 days after the last dose.
Quoted from Mifepristone — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised July 18, 2022.
How much mifepristone gets into breastmilk
Maternal Levels. Twelve women (most 6 to 12 months postpartum) who had undergone a medical abortion using mifepristone and misoprostol provided milk samples for up to 5 days after the procedure for measurement of mifepristone. In the 2 women who received a single dose of 200 mg orally, mifepristone was undetectable (<5.6 mcg/L) in breastmilk at all times. Among the 10 women who received a single oral dose of 600 mg, average mifepristone breastmilk levels were 172 mcg/L on day 1 (n = 9) ; 66 mcg/L on day 2 (n = 9); 31 mcg/L on day 3 (n = 10); 24 mcg/L on day 4 (n = 4); and 25 mcg/L on day 5 (n = 3). Breastmilk levels of mifepristone were highest in the samples collected between 6 and 9 hours after drug administration. Samples collected between 9 and 15 hours after the dose had much lower mifepristone levels. The authors estimated that a fully breastfed infant would receive a weight-adjusted dosage of 0.5% of the maternal dosage. They suggested that breastfeeding need not be interrupted after a single dose of mifepristone and that a dose of 200 mg might be preferable to a 600 mg dose in nursing mothers.
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
Based on animal data, some authors suggest that mifepristone used at term might shorten the onset of lactation, increase milk flow and increase the initial growth rate of breastfed infants. However, no human data are available.
Frequently asked questions
Can you take mifepristone while breastfeeding?
What the NIH's Drugs and Lactation Database says about Mifepristone 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.
Does mifepristone pass into breastmilk?
LactMed's measured drug levels for mifepristone are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking mifepristone?
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 mifepristone
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.