Table 6.

Maternal Medication Usually Compatible With Breastfeeding*

DrugReported Sign or Symptom in Infant or Effect on LactationReference No.
AcetaminophenNone142–144
AcetazolamideNone145
Acitretin146
Acyclovir None147, 148
Alcohol (ethanol)With large amounts, drowsiness, diaphoresis, deep sleep, weakness, decrease in linear growth, abnormal weight gain; maternal ingestion of 1 g/kg daily decreases milk ejection reflex4, 149–152
Allopurinol153
AmoxicillinNone154
Antimony155
AtropineNone156
Azapropazone (apazone)157
AztreonamNone158
B1(thiamin)None159
B6(pyridoxine)None160–162
B12 None163
BaclofenNone164
BarbiturateSee Table 5
BendroflumethiazideSuppresses lactation165
Bishydroxycoumarin (dicumarol)None166
BromideRash, weakness, absence of cry with maternal intake of 5.4 g/d167
ButorphanolNone168
CaffeineIrritability, poor sleeping pattern, excreted slowly; no effect with moderate intake of caffeinated beverages (2–3 cups per day)169–174
CaptoprilNone175
CarbamazepineNone176, 177
CarbetocinNone178
CarbimazoleGoiter83, 179, 180
CascaraNone181
CefadroxilNone154
CefazolinNone182
CefotaximeNone183
CefoxitinNone183
Cefprozil184
CeftazidimeNone185
CeftriaxoneNone186
Chloral hydrateSleepiness187
ChloroformNone188
ChloroquineNone189–191
ChlorothiazideNone192, 193
ChlorthalidoneExcreted slowly194
Cimetidine None195, 196
CiprofloxacinNone197, 198
CisaprideNone199
CisplatinNot found in milk 30
ClindamycinNone200
ClogestoneNone201
CodeineNone144, 156, 202
Colchicine203–205
Contraceptive pill with estrogen/progesteroneRare breast enlargement; decrease in milk production and protein content (not confirmed in several studies)206–213
CycloserineNone214
D (vitamin)None; follow up infant's serum calcium level if mother receives pharmacologic doses215–217
DanthronIncreased bowel activity218
DapsoneNone; sulfonamide detected in infant's urine191, 219
Dexbrompheniramine maleate withd-isoephedrineCrying, poor sleeping patterns, irritability220
DiatrizoateNone221
DigoxinNone222, 223
DiltiazemNone224
DipyroneNone225
DisopyramideNone226, 227
DomperidoneNone228
Dyphylline None229
Enalapril230
Erythromycin None231
EstradiolWithdrawal, vaginal bleeding232
EthambutolNone214
Ethanol (cf. alcohol)
DrugReported Sign or Symptom in Infant or Effect on LactationReference No.
EthosuximideNone, drug appears in infant serum176, 233
Fentanyl234
FexofenadineNone235
Flecainide236, 237
FleroxacinOne 400-mg dose given to nursing mothers; infants not given breast milk for 48 h238
FluconazoleNone239
Flufenamic acidNone240
Fluorescein241
Folic acidNone242
Gadopentetic (Gadolinium)None243
GentamicinNone244
Gold saltsNone245–249
HalothaneNone250
HydralazineNone251
Hydrochlorothiazide192, 193
Hydroxychloroquine None252, 253
IbuprofenNone254, 255
IndomethacinSeizure (1 case)256–258
IodidesMay affect thyroid activity; see iodine259
IodineGoiter259
Iodine (povidone-iodine, eg, in a vaginal douche)Elevated iodine levels in breast milk, odor of iodine on infant's skin259
IohexolNone 97
Iopanoic acidNone260
IsoniazidNone; acetyl (hepatotoxic) metabolite secreted but no hepatotoxicity reported in infants214, 261
Interferon-α262
IvermectinNone263, 264
K1 (vitamin)None265, 266
KanamycinNone214
KetoconazoleNone267
Ketorolac268
LabetalolNone269, 270
Levonorgestrel271–274
LevothyroxineNone275
LidocaineNone276
Loperamide277
LoratadineNone278
Magnesium sulfateNone279
MedroxyprogesteroneNone201, 280
Mefenamic acidNone281
MeperidineNone61, 282
MethadoneNone283–287
Methimazole (active metabolite of carbimazole)None288, 289
MethohexitalNone 61
MethyldopaNone290
MethyprylonDrowsiness291
Metoprolol None120
MetrizamideNone292
MetrizoateNone 97
MexiletineNone293, 294
MinoxidilNone295
MorphineNone; infant may have measurable blood concentration282, 296–298
MoxalactamNone299
Nadolol None300
Nalidixic acidHemolysis in infant with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency301
Naproxen302
NefopamNone303
Nifedipine304
NitrofurantoinHemolysis in infant with G-6-PD deficiency305
NorethynodrelNone306
NorsteroidsNone307
NoscapineNone308
OfloxacinNone198
OxprenololNone309, 310
PhenylbutazoneNone311
PhenytoinMethemoglobinemia (1 case)138, 176, 312
PiroxicamNone313
PrednisoloneNone314, 315
PrednisoneNone316
DrugReported Sign or Symptom in Infant or Effect on LactationReference No.
ProcainamideNone317
ProgesteroneNone318
PropoxypheneNone319
PropranololNone320–322
PropylthiouracilNone323
Pseudoephedrine None324
PyridostigmineNone325
PyrimethamineNone326
QuinidineNone191, 327
QuinineNone296
RiboflavinNone159
RifampinNone214
Scopolamine156
SecobarbitalNone328
SennaNone329
Sotalol237, 330
SpironolactoneNone331
StreptomycinNone214
SulbactamNone332
SulfapyridineCaution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk333, 334
SulfisoxazoleCaution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk335
SumatriptanNone336
SuprofenNone337
TerbutalineNone338
TerfenadineNone235
TetracyclineNone; negligible absorption by infant339, 340
TheophyllineIrritability169, 341
ThiopentalNone139, 342
ThiouracilNone mentioned; drug not used in United States343
TicarcillinNone344
TimololNone310
TolbutamidePossible jaundice345
TolmetinNone346
Trimethoprim/sulfamethoxazoleNone347, 348
TriprolidineNone324
Valproic acidNone176, 349, 350
VerapamilNone351
WarfarinNone352
ZolpidemNone353
  • * Drugs listed have been reported in the literature as having the effects listed or no effect. The word “none” means that no observable change was seen in the nursing infant while the mother was ingesting the compound. Dashes indicate no mention of clinical effect on the infant. It is emphasized that many of the literature citations concern single case reports or small series of infants.

  • Drug is concentrated in human milk.