Can you take procainamide 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.
Maternal doses of procainamide 2 grams daily produced low levels of the drug and its active metabolite in the milk of one mother. Although it would not be expected to cause adverse effects in older breastfed infants, the relative lack of data concerning breastfeeding during maternal procainamide therapy would argue for careful monitoring if this drug is used while breastfeeding a neonate possibly Measurement of infant serum levels could help to rule out toxicity if there is a concern.
Quoted from Procainamide — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised July 15, 2024.
How much procainamide gets into breastmilk
Maternal Levels. One mother was taking a dose of 500 mg 4 times daily (dosage form not stated, but probably immediate-release). Milk procainamide and N-acetyl procainamide (NAPA) levels were measured on one of the first postpartum days. Procainamide levels averaged 5.4 mg/L (range 2.6 to 10.2 mg/L), and NAPA averaged 3.5 mg/L (range 3.1 to 5 mg/L). Because the mother's serum levels were consistently below the therapeutic range, usual milk levels would probably be higher than reported here. There was no clear correlation between time after the dose and milk levels. Based on data in this case, the average expected dose of procainamide plus NAPA that an infant would receive in breastmilk is less than 5% and the maximum would be less than 7% of the mother's weight-adjusted dosage.
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 procainamide while breastfeeding?
Maternal doses of procainamide 2 grams daily produced low levels of the drug and its active metabolite in the milk of one mother. 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 procainamide pass into breastmilk?
LactMed's measured drug levels for procainamide are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking procainamide?
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 procainamide
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.