Can you take rilpivirine 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 rilpivirine doses of 25 mg daily produce low levels in milk and infant serum. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Achieving and maintaining viral suppression with antiretroviral therapy decreases breastfeeding transmission risk to less than 1%, but not zero. Individuals with HIV who are on antiretroviral therapy with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision. If a viral load is not suppressed, banked pasteurized donor milk or formula is recommended. Extended postnatal prophylaxis of breastfed infants with rilpivirine should continue until breastfeeding is stopped.
Quoted from Rilpivirine — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised December 15, 2025.
How much rilpivirine gets into breastmilk
Maternal Levels. Two mothers taking rilpivirine 25 mg once daily provided milk samples at a median of 15.5 hours after a dose. The median drug concentration in milk was 123 mcg/L, which resulted in an estimated infant dosage of 20 mcg/kg daily.
In a retrospective study in a German hospital of mothers who were receiving antiretroviral prophylaxis, 3 mothers were receiving rilpivirine 25 mg once daily. Breastmilk levels obtained at unspecified times with respect to the dose at 1, 4, and 6 months postpartum were mostly <50 mcg/L in two of the patients. In the third mother, the milk level was 4300 mcg/L at 4 months after which breastfeeding was discontinued.
Infant Levels. An infant was breastfed by a mother taking rilpivirine 25 mg once daily, although the extent of breastfeeding was not sated. The infant’s serum concentrations taken 16 hours after maternal drug intake at 1 month of age was 4 mcg/L.
In a retrospective study in a German hospital of mothers who were receiving rilpivirine 25 mg once daily, three exclusively breastfed their infants. Infant serum concentrations obtained at unspecified times in two of the infants was <50 mcg/L at 1 and 4 months of age. In the third infant whose mother had high rilpivirine milk levels, the infant serum level was 660 mcg/L at 1 month and 10,450 mcg/L at 4 months of age, at which time breastfeeding was discontinued.
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 rilpivirine while breastfeeding?
Limited information indicates that maternal rilpivirine doses of 25 mg daily produce low levels in milk and infant serum. 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 rilpivirine pass into breastmilk?
LactMed's measured drug levels for rilpivirine are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking rilpivirine?
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 rilpivirine
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.