Can you take sofosbuvir 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 typical doses of sofosbuvir 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. If sofosbuvir alone or in combination with ledipasvir (Harvoni), velpatasvir (Epclusa) or velpatasvir, and voxilaprevir (Vosevi), it is not a reason to discontinue breastfeeding.
Hepatitis C is not transmitted through breastmilk, and breastmilk has been shown to inactivate hepatitis C virus (HCV). However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C.
Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.
Quoted from Sofosbuvir — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised July 15, 2026.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of sofosbuvir. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Interferon Alfa
- Interferon Alfacon-1
- Peginterferon Alfa
How much sofosbuvir gets into breastmilk
Maternal Levels. Four mothers with hepatitis C infections began taking sofosbuvir 400 mg in combination with velpatasvir 100 mg orally once daily shortly after delivery. Paired samples of maternal serum and breastmilk were collected within the first 24 hours after commencing the drug regimen and at up to 6 days after initiation. Samples were collected from 1 to 25.6 hours after a dose. Sofosbuvir and its inactive metabolite, were quantifiable (1 mcg/L or greater) in 9 breastmilk samples. The median sofosbuvir milk concentration was 11.1 mcg/L (range 1.3 to 60.1 mcg/L) with a median infant daily dosage of 1.7 mcg/kg and a relative infant dose of 0.014%. The median GS-331007 milk concentration was 5.4 mcg/L (range 1.8 to 15 mcg/L) with a median infant daily dosage of 0.8 mcg/kg and a relative infant dose of 0.014%. Because of the random collection and the reporting method, the true values may vary somewhat from these numbers.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
An infant was breastfed (extent not stated) for 3 weeks postpartum by a mother who took sofosbuvir 400 mg plus ledipasvir 90 mg daily for 12 weeks beginning at 31 weeks of gestation for her chronic hepatitis C infection. The infant was followed for 1 year and found to have normal growth and development.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take sofosbuvir while breastfeeding?
What the NIH's Drugs and Lactation Database says about Sofosbuvir 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 sofosbuvir while breastfeeding?
LactMed lists Interferon Alfa, Interferon Alfacon-1, Peginterferon Alfa 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 sofosbuvir pass into breastmilk?
LactMed's measured drug levels for sofosbuvir are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking sofosbuvir?
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 sofosbuvir
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.