Can you take probenecid 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 maternal doses of probenecid up to 2 grams daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. In animal studies, probenecid increased the breastmilk excretion of cimetidine, possible via an interaction with an active transport mechanism in the breast. The implications of enhanced excretion of drugs given with probenecid for nursing mothers and their infants has not been studied; however, only a few drugs are known to undergo active transport into breastmilk.
Quoted from Probenecid — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised July 19, 2021.
How much probenecid gets into breastmilk
Maternal Levels. A woman was given probenecid 500 mg orally 4 times daily to enhance cephalexin serum levels. After 16 days of therapy at 4.5 weeks postpartum, 12 samples of breastmilk (6 pairs of fore- and hindmilk) were collected over a 16-hour period. The average concentration of probenecid in milk was 964 mcg/L, corresponding to an infant dosage of 145 mcg/kg daily and 0.7% of the maternal weight-adjusted dosage.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A woman with mastitis received 3 days of intravenous cephalothin, followed by 16 days of probenecid 500 mg and cephalexin 500 mg 4 times daily for 16 days. Her infant developed green liquid stools, severe diarrhea, discomfort and crying. The authors judged the effects to be probably related to the cephalothin and cephalexin in milk rather than the probenecid.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take probenecid while breastfeeding?
What the NIH's Drugs and Lactation Database says about Probenecid 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 probenecid pass into breastmilk?
LactMed's measured drug levels for probenecid are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking probenecid?
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 probenecid
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.