Is Pantoprazole safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Pantoprazole. 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
A retrospective claims database study in the United States found that users of proton pump inhibitors had an increased risk of gynecomastia.[ 3 ] A review article reported that a search of database from the European Pharmacovigilance Centre found 48 cases of gynecomastia, 3 cases of galactorrhea, 14 cases of breast pain and 4 cases of breast enlargement associated with pantoprazole. A search of the WHO global pharmacovigilance database found 97 cases of gynecomastia, 13 cases of galactorrhea, 35 cases of breast pain and 16 cases of breast enlargement associated with pantoprazole.[ 4 ]
Levels in milk
Maternal Levels. A mother who was 10 months postpartum and partially nursing her infant was given a single 40 mg dose of oral pantoprazole. Pantoprazole was detectable in milk only 2 and 4 hours after the dose with milk levels of 36 mcg/L and 24 mcg/L, respectively, at those times. It was not detectable ( 10 mcg/L) in milk at 6, 8 and 24 hours after the dose. The authors estimated that a fully breastfed infant would receive 0.14% of the maternal weight-adjusted dosage.[ 1 ] Sixteen lactating, but not breastfeeding, women were given oral pantoprazole 40 mg daily for one week. Breastmilk samples were obtained at baseline and 1.5, 3, 4.5, and 6 h following the dose on days 1 and 7. Of 149 breastmilk samples, only 26 had detectable ( 0.03 mg/L) pantoprazole concentrations. Peak milk concentrations typically occurred at 3 hours after the dose on day 7. Using the average peak milk concentration, the estimated worst-case infant daily dosage via milk was approximately 0.011 mg/kg. This represents a conservative estimate, as peak milk concentrations are not sustained over the full 24-hour dosing interval.[ 2 ] 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.