Is Daptomycin safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Daptomycin. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A mother nursing (extent not stated) a 5-month-old infant received intravenous daptomycin 500 mg and ertapenem 1 gram once daily for 28 days to treat a pelvic infection. No adverse events were noted in the infant during the treatment or follow-up examination.[ 1 ] A woman nursing a newborn was given daptomycin 500 mg intravenously once daily for 14 days. No adverse effects were noted in the infant during therapy and for 7 days after the end of therapy.[ 2 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A nursing mother received intravenous daptomycin 500 mg (6.7 mg/kg) and ertapenem 1 gram once daily for 28 days to treat a pelvic infection. On day 27 of therapy, expressed breastmilk was collected over six 4-hour intervals. Daptomycin milk concentrations were highest in the second sample with a concentration of 44.7 mcg/L. The fifth sample, ending at 20 hours after the dose, contained 29.2 mcg/L of daptomycin and the final sample had no detectable drug ( 25 mcg/L).[ 1 ] Using the average maximum milk level, the infant would receive a weight-adjusted dosage of 0.1% of the maternal dosage. A woman nursing a newborn was given daptomycin 500 mg (7.4 mg/kg) intravenously once daily for 14 days for a soft tissue infection. Hindmilk samples were taken during the last 4 days of therapy and for 2 days after the last dose. Trough daptomycin levels taken during therapy averaged 208 mcg/L. Levels of about 270 mcg/L were found at 6 and 12 hours after one of the doses. The highest concentration in milk was at 78 h after the eleventh dose, with a concentration of 329 mcg/L. After the last dose, milk levels dropped from 330 mcg/L to 121 mcg/L over a period of 42 hours. Using the median milk level, the infant would receive a dose of 36.5 mcg/kg daily or a weight-adjusted dosage of 0.5% of the maternal dosage.[ 2 , 3 ] 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.