Is Cefpodoxime safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Cefpodoxime. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Hyperprolactinemia and bilateral galactorrhea occurred in a nonpregnant, 40-year-old woman taking cefpodoxime 200 mg twice daily for 2 days. Seven days after stopping the drug, galactorrhea ceased and the serum prolactin dropped markedly into the normal range. One month later it had dropped further. Because no other cause could be found, the authors determined that the galactorrhea and hyperprolactinemia were probably caused by cefpodoxime.[ 1 ] A 22-year-old woman who had been taking slow-release venlafaxine 150 mg daily for 3 months reported bilateral breast engorgement and galactorrhea for 3 days after being prescribed cefpodoxime 200 mg twice daily for 14 days 2 weeks prior. Laboratory and head CT results were normal except for a slight elevation in alkaline phosphatase and an elevated serum prolactin level. Her galactorrhea began decreasing within 2 weeks and disappeared in 3 weeks with no change in venlafaxine dosage. Her serum prolactin level also returned to normal. The authors felt that her symptoms and hyperprolactinemia were probably caused by cefpodoxime.[ 2 ] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Levels in milk
Maternal Levels. According to the manufacturer, levels of cefpodoxime in the milk of 3 nursing mothers were 0%, 2% and 6% of concomitant maternal serum levels at 4 hours following a 200 mg oral dose of cefpodoxime proxetil. At 6 hours after the dose, levels were 0%, 9% and 16% of concomitant maternal serum levels. No study details or measured milk levels were provided. After a 200 mg oral dose, the average peak serum level is 2.3 mg/L. Using this serum level and the maximum reported milk to plasma ratio of 0.16 above, a fully breastfed infant would receive a maximum daily dose of about 0.055 mg/kg daily after a maternal dose of 200 mg, compared to the recommend treatment dosage of 10 mg/kg daily for infants of 2 months or older. Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.