Last update: May 11, 2019
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.
Fluoroquinolone antibacterial with actions and uses similar to those of ciprofloxacin.
Oral administration once a day.
Since the last update we have not found any published data on its excretion in breast milk.
Their pharmacokinetic data do not allow to predict well their excretion in breast milk, because their large volume of distribution and pKa acid would hinder it, while low plasma protein binding and long half-life would facilitate it.
Structurally similar Quinolone-related medication has been used in neonates and infants without known side effects (Newby 2017, Dutta 2006, Belet 2004, Drossou 2004, Chin 2001, van den Oever 1998, Gürpinar 1997). There are excreted tiny amounts into breast milk and absorption through the child’s gut may be interfered by calcium in the milk (Fleiss 1992, Neuvonen 1991).
Until there is more published data on this drug in relation to breastfeeding, safer known alternatives with a safer pharmacokinetic profile for breastfeeding may be preferable, especially in the neonatal period and in case of prematurity.
Should it be prescribed to a nursing mother Norfloxacine, Ofloxacine and Ciprofloxacine are to be chosen since they have shown a lowest excretion into the milk (Butler 2014).
The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account,
Unreasonably prolonged or repetitive use of antibiotics is harmful to health.
Due to the publication of reports of serious or potentially serious side effects in patients treated with fluoroquinolones, several health authorities propose restricting their indiscriminate outpatient use and reserving them for certain serious diseases (EMA 2018, FDA 2016, Arbex 2010).
The small dose and poor plasma uptake of most topical ophthalmologic preparations make it very unlikely that significant amounts will pass into breast milk, so ophthalmic use would be compatible with breastfeeding.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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