Is Chloroquine safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Chloroquine. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Several authors have pointed out that malaria prophylaxis in nursing mothers with chloroquine is common in endemic areas.[ 7 9 ] As of the revision date, no reports of adverse reactions in breastfed infants have been published.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Chloroquine has a serum half-life of over a month. Some studies have sampled milk after only a few doses before steady state was reached, making interpretation of some of the data difficult. The active metabolite, desethylchloroquine, has been measured in only a few studies. Maternal Levels . Milk chloroquine levels were measured in one mother after an oral regimen of 600 mg daily of chloroquine base for 2 days, followed by 300 mg daily for 3 days. Average milk levels of 1.2 mg/L (range 0.2 to 2.8 mg/L) were detected in 17 random samples during, and 4 days following the doses. Metabolite levels averaged 0.68 mg/L (range 0.1 to 1.5 mg/L).[ 4 ] In 9 women given a total dose of 25 mg/kg of chloroquine base over 3 days (10, 10 and 5 mg/kg) for malaria treatment, up to 8 breastmilk samples were obtained over the following 28 days. Chloroquine was still detectable in milk 28 days after the last dose.[ 5 ] Three women were given a single dose of chloroquine base 600 mg orally 2 to 5 days postpartum. Milk samples were obtained periodically for about 9 days after the dose and area-under-the-curve values were calculated; milk levels were not reported. Assuming a daily intake of 1 L of milk, the authors calculated that the 3 infants would receive 0.4, 0.58 and 0.76 mg in milk over the study period. These values equate to an average of 3.1% of the maternal weight-adjusted dosage.[ 6 ] After a single 5 mg/kg intramuscular dose of chloroquine phosphate in 6 women who were 17 days postpartum, milk chloroquine levels averaged 227 mg/L (range 192 to 319 mg/L) 2 hours after the dose. No other milk levels were obtained.[ 7 ] Six women who were 2 to 2.5 months postpartum were given a single dose of 300 mg of chloroquine base orally. The peak chloroquine level in milk averaging 3.97 mg/L occurred 3 hours after the dose. The elimination half-life from milk averaged 132 hours. The authors estimated that an exclusively breastfed infant would receive 0.55% of the mother s total (nonweight-a
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.