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Prescribing in Breastfeeding

All medicines transfer into breast milk.
 
The benefits of breastfeeding outweigh the risk of exposure to most medicines via breast milk.

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General Advice

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General Advice

 Medicines considered "safe" when breastfeeding full-term healthy babies

The following is a guide only and the list is not exhaustive.

Class

Examples of Individual Medicines

Analgesics

opioid analgesics* (short courses < 2 days): morphine, oxycodone, codeine, paracetamol, diclofenac, ibuprofen

Anticoagulants

enoxaparin, heparin, warfarin

Antiepileptic drugs*

carbamazepine, phenytoin, valproate sodium

Antidepressants*

SSRIs: citalopram, escitalopram, paroxetine, sertraline

SNRIs: venlafaxine

tricyclics: amitriptyline, nortriptyline

Antidiabetic

insulin, metformin

Antihistamines

cetirizine, loratadine

Antihypertensives

ACE inhibitors: enalapril, perindopril

beta blockers: labetalol, metoprolol, propanolol

calcium channel blockers: diltiazem, nifedipine

methyldopa

Antimicrobials

betalactams: amoxicillin, flucloxacillin

cephalosporins: cefalexin, ceftriaxone, cefazolin, cefuroxime, cefotaxime, cefepime, ceftazidime

macrolides: azithromycin, clarithromycin, erythromycin, roxithromycin

metronidazole (shorter courses – e.g. 400 to 600 mg BD for 7 to 10 days; avoid higher doses e.g. 2000 mg)

nitrofurantoin

trimethoprim, trimethoprim/sulfamethoxazole

aciclovir, valaciclovir

Antipsychotics*

haloperidol, olanzapine, quetiapine, risperidone

Hypnotics*

short courses (< 2 days) of midazolam, temazepam, zopiclone

Cardiac glycoside

digoxin

Contraceptives

progestogen-only, combined oral contraceptives after 6 weeks post-partum

Corticosteroids (short courses)

prednisone (< 20 mg/day)

Gastrointestinal drugs

domperidone

proton pump inhibitors: omeprazole, pantoprazole

mesalazine

* For all, monitor infant for adverse effects (e.g. sedation, jitteriness, lethargy, poor feeding).

Medicines considered "unsafe" during breastfeeding

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Topic Code: 93270