Last update: Nov. 9, 2014

Clarithromycin

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

It is not excreted in significant amount into breast milk .

Commonly used for pediatric treatment which is very well tolerated.

Erythromycin is a macrolide that has been related to hypertrophic pyloric stenosis with early exposition. Avoiding use in the first post-partum month would be advisable yet it may occurred while breastfeeding.

Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics. Also, diarrheal disease due to imbalance of intestinal flora is possible.

Alternatives

We do not have alternatives for Clarithromycin since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Pharmacokinetics

Variable Value Unit
Bioavailability 55 %
Molecular weight 748 daltons
Protein Binding 40 - 70 %
VD 3 - 4 l/Kg
Tmax 1,7 hours
T1/2 3 - 7 hours
M/P ratio 1 -
Theoretical Dose 0,14 mg/Kg/d
Relative Dose 1,7 %
Relat.Ped.Dose 0,9 %

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  2. Goldstein LH, Berlin M, Tsur L, Bortnik O, Binyamini L, Berkovitch M. The safety of macrolides during lactation. Breastfeed Med. 2009 Abstract
  3. Maheshwai N. Are young infants treated with erythromycin at risk for developing hypertrophic pyloric stenosis? Arch Dis Child. 2007 Abstract Full text (link to original source) Full text (in our servers)
  4. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  5. Bar-Oz B, Bulkowstein M, Benyamini L, Greenberg R, Soriano I, Zimmerman D, Bortnik O, Berkovitch M. Use of antibiotic and analgesic drugs during lactation. Drug Saf. 2003 Abstract
  6. Sørensen HT, Skriver MV, Pedersen L, Larsen H, Ebbesen F, Schønheyder HC. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis. 2003 Abstract
  7. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  8. Sedlmayr T, Peters F, Raasch W, Kees F. [Clarithromycin, a new macrolide antibiotic. Effectiveness in puerperal infections and pharmacokinetics in breast milk]. Geburtshilfe Frauenheilkd. 1993 Abstract
  9. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  10. Periti P, Mazzei T, Mini E, Novelli A. Clinical pharmacokinetic properties of the macrolide antibiotics. Effects of age and various pathophysiological states (Part I). Clin Pharmacokinet. 1989 Abstract

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