Fluconazole

Antifungal used topically in cutaneous candidiasis and mucosal surfaces (oropharyngeal, esophageal and vaginal) and orally or intravenously in candidiasis, coccidioidomycosis and systemic cryptococcosis. Active against dermatophytes.

It is excreted in breast milk in a moderate amount (DR 18%) but much less than would be needed to treat candidiasis in an infant or premature newborn ^{(Kaplan 2015, Force 1995, Schilling 1993)}. No serious problems have been observed in infants of mothers taking it. ^{(Moorhead 2011, Bodley 1997)}

It has been widely used to treat breast pain due to or allegedly due (without evidence) to candida infection ^{(Hanna 2011, Moorhead 2011, Carmichael 2002 Chetwynd 2002, Brent 2001, Hoover 1999, Bodley 1997)}; deep breast pain may also be due to auric staphylococcus infection. ^{(Betzold 2012)}

In breast candidiasis, if topical treatments fail, oral Fluconazole can be used at doses of 200 mg on the first day and 100 mg daily for two to four weeks. ^{(Hanna 2011)}

Its use is authorized in newborns and infants.

Expert authors consider safe the use of this medication during breastfeeding (Hale, Kaplan 2015, Briggs 2015, Schaefer 2015, Butler 2014, Amir 2011, Chen 2010).

List of essential medicines WHO: compatible with breastfeeding (WHO 2002).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).