Last update: May 8, 2015

Terbinafine

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Pharmacokinetics data (low oral bioavailability, high volume of distribution and high protein-binding capacity) explains the scanty excretion into breast milk observed in nursing mothers who received this medication.

In addition, a poor oral absorption would make even more difficult any pass of this drug through ingested milk to the infant's blood, except in newborns or premature who would show a higher intestinal absorption.

Avoid using in prematures who are under treatment with caffeine or theophylline because terbinafine alters its metabolic degradation and increases plasma concentration.

Since topical absorption is less than 1%, a significant excretion into breast milk after application on skin is not expected.

Do not use on the breast to prevent ingestion by the infant, otherwise apply after a meal and wipe it out thoroughly with water before next feeding.

It is recommended to avoid using on the nipple creams, gels and other products intended for use on skin that may contain paraffin (mineral oil) in order to keep from absorption the infant.

Alternatives

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.

Tradenames

Main tradenames from several countries containing Terbinafine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 %
Molecular weight 291 daltons
Protein Binding 99 %
VD 28 l/Kg
Tmax 2 hours
T1/2 27 - 31 hours
M/P ratio 7 -
Theoretical Dose 0,55 mg/Kg/d
Relative Dose 3,8 - 6,6 %

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. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008 Abstract
  3. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006 Abstract
  4. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  5. Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001 Abstract
  6. Schatz F, Haberl H. Analytical methods for the determination of terbinafine and its metabolites in human plasma, milk and urine. Arzneimittelforschung. 1989 Abstract

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