Is Fluconazole safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Fluconazole. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
In a study of fluconazole for treatment of lactation-associated thrush of the breasts, mothers took an average of 7.3 capsules (range 1 to 29 capsules) of 150 mg every other day until pain resolved. Seven of the 96 women reported side effects possibly caused by fluconazole in their breastfed infants. These included flushed cheeks, gastrointestinal upset, and runny or mucous stools.[ 8 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A woman taking fluconazole 200 mg orally once daily for 18 days had a peak milk level of 4.1 mg/L 2 hours after the dose on day 20 postpartum. The half-life of elimination from breastmilk was 26.9 hours.[ 9 ] A 12-week postpartum woman was given a single oral dose of fluconazole 150 mg. The highest milk levels were 2.9 and 2.7 mg/L at 2 and 5 hours after the dose. Milk fluconazole levels were 1.8 and 1 mg/L at 24 and 48 hours after the dose, respectively. The half-life in milk was about 30 hours.[ 10 ] Using peak milk level data from these two patients, an exclusively breastfed infant whose mother was taking 200 mg daily of fluconazole would receive a maximum of about 0.6 mg/kg daily, which is 60% of the recommended neonatal ( 2 weeks) dosage and 20% of the dosage used in older infants for oral thrush. 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.