Last update Sept. 5, 2022

Doxycycline

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Indicated in the treatment of infections caused by Mycoplasma pneumoniae, Chlamydia, Rickettsia and spirochetes. Oral administration once a day.

It is excreted into breast milk in quantities that would be clinically significant (Matsuda 1984, Lutziger 1969, Morganti 1968), however, theoretically, intestinal absorption by infant's gut is hampered because of formation of chelating products by union with the milk's calcium. (Chin 2001)

There are no studies that have evaluated dental staining in infants exposed to doxycycline through breastfeeding. (Wormser 2019)

Tetracycline is at lesser amount excreted into breast milk and at higher proportion bound to calcium, hence, it is fewer absorbed than Doxycycline. (Hale, Saito 2018, Chin 2001)

Long-term treatments are not recommended (over 3-4 weeks) since it may cause damage of the growth cartilage, teeth discoloration and imbalance of intestinal flora.

Several medical societies, experts and expert consensus, consider the use of this medication safe or probably safe during breastfeeding, especially if its use does not exceed 3-4 weeks. (Hale, Peyriere 2018, Briggs 2015, Rowe 2013, Chen 2010, Mitrano 2009, Nahum 2006, Mahadevan 2006, WHO 2002, Chin 2001)

Although rare, the possibility of transient gastroenteritis due to alteration of the intestinal flora in infants whose mothers take antibiotics should be taken into account. (Briggs 2015, Ito 1993)

Alternatives

  • Azithromycin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Erythromycin (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Tetracycline ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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.

Other names

Doxycycline is also known as


Doxycycline in other languages or writings:

Tradenames

Main tradenames from several countries containing Doxycycline in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 90 - 100 %
Molecular weight 462 daltons
Protein Binding 90 %
VD 0.75 l/Kg
Tmax 2 - 3 hours
18 - 22 hours
M/P ratio 0.3 - 0.4 -
Theoretical Dose 0.12 - 0.29 mg/Kg/d
Relative Dose 7.2 - 17.4 %
Ped.Relat.Dose 6 - 14.5 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  2. Wormser GP, Wormser RP, Strle F, Myers R, Cunha BA. How safe is doxycycline for young children or for pregnant or breastfeeding women? Diagn Microbiol Infect Dis. 2019 Mar;93(3):238-242. Abstract
  3. Peyriere H, Makinson A, Marchandin H, Reynes J. Doxycycline in the management of sexually transmitted infections. J Antimicrob Chemother. 2018 Mar 1;73(3):553-563. Abstract Full text (link to original source)
  4. Saito M, Gilder ME, McGready R, Nosten F. Antimalarial drugs for treating and preventing malaria in pregnant and lactating women. Expert Opin Drug Saf. 2018 Nov;17(11):1129-1144. Abstract Full text (link to original source) Full text (in our servers)
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  7. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  8. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009 Sep;29(9):1103-9. Abstract
  9. 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)
  10. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006 Abstract
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  12. 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
  13. 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
  14. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  15. Lutziger H. [Concentration determinations and clinical effectiveness of doxycycline (Vibramycin) in the uterus, adnexa and maternal milk]. Ther Umsch. 1969 Abstract
  16. Morganti G, Ceccarelli G, Ciaffi G. [Comparative concentrations of a tetracycline antibiotic in serum and maternal milk]. Antibiotica. 1968 Abstract

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