Can you take rifapentine 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.
The amount of rifapentine and its metabolite in milk is insufficient to treat tuberculosis in the breastfed infant. The Centers for Disease Control and Prevention and other professional organizations state that breastfeeding should not be discouraged in women taking rifapentine. Monitor the infant for signs of liver toxicity. Breastmilk may be stained a red-orange color.
Quoted from Rifapentine — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised May 15, 2022.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of rifapentine. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much rifapentine gets into breastmilk
Rifapentine is metabolized to 25-O-desacetylrifapentine, which has about half the in vitro activity of rifapentine against M. tuberculosis. 25-O-desacetylrifapentine has a longer half-life and accumulates over time, increasing its antimycobacterial impact.
Maternal Levels. In a study of pregnant and postpartum women with latent tuberculosis infection, participants received 12 directly observed once-weekly doses of rifapentine 900 mg, isoniazid 900 mg, and pyridoxine 25 to 100 mg. In 22 women who donated milk samples, the average rifapentine milk concentrations were about 280 mcg/L at 3 hours after the first dose, 533 mcg/L at 6 hours after the second dose and 293 mcg/L at 24 hours after the last dose. The average 25-O-desacetylrifapentine milk concentrations were about 67 mcg/L at 3 hours after the first dose, 180 mcg/L at 6 hours after the second dose and 360 mcg/L at 24 hours after the last dose.
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 rifapentine while breastfeeding?
The amount of rifapentine and its metabolite in milk is insufficient to treat tuberculosis in the breastfed infant. 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 rifapentine while breastfeeding?
LactMed lists Rifampin 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 rifapentine pass into breastmilk?
LactMed's measured drug levels for rifapentine are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking rifapentine?
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 rifapentine
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.