Can you take rabeprazole 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 no information is available on the use of rabeprazole during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Quoted from Rabeprazole — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised June 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of rabeprazole. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much rabeprazole 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
A retrospective claims database study in the United States found that users of proton pump inhibitors had an increased risk of gynecomastia.
The Spanish pharmacovigilance system found one case of a 90-year-old man who developed gynecomastia associated with rabeprazole reported during the time period of 1982 to 2006. The reaction occurred after 32 days of therapy and resolved after discontinuation of the drug.
A review article reported that a search of database from the European Pharmacovigilance Centre found 11 cases of gynecomastia, 3 cases of galactorrhea, 2 cases of breast pain and 1 case of breast enlargement associated with rabeprazole. A search of the WHO global pharmacovigilance database found 38 cases of gynecomastia, 29 cases of galactorrhea, 28 cases of breast pain and 5 cases of breast enlargement associated with rabeprazole.
A woman was prescribed metronidazole 400 mg three times a day, and a combination product containing rabeprazole 20 mg and domperidone 30 mg daily for diarrhea and dyspepsia. After 3 days of treatment, she developed bilateral galactorrhea. The combination of rabeprazole and domperidone was thought to be the cause.
A 27-year-old woman with gastroesophageal reflux disease was prescribed rabeprazole 20 mg once daily. After 10 days of treatment, she complained of sudden-onset bilateral galactorrhea. A bilateral breast ultrasound demonstrated dilated retroareolar ducts containing anechoic fluid. Her serum prolactin level was 245 ng/mL (normal range 4.79 to 23.3 ng/mL). Ten days after discontinuing rabeprazole, her serum prolactin had returned to a normal value of 15.0 ng/mL and her symptoms resolved.
Frequently asked questions
Can you take rabeprazole while breastfeeding?
What the NIH's Drugs and Lactation Database says about Rabeprazole 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 rabeprazole while breastfeeding?
LactMed lists Antacids, Cimetidine, Famotidine, Omeprazole, Pantoprazole, Sucralfate 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 rabeprazole pass into breastmilk?
LactMed's measured drug levels for rabeprazole are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking rabeprazole?
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 rabeprazole
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.