Is Praziquantel safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Praziquantel. 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
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Five women were given a single oral dose of praziquantel of about 50 mg/kg. The average peak milk level of 440 mcg/L usually occurred 2 hours after the dose, although the peak occurred 6 hours after the dose in 1 individual. By 24 hours after the dose, the drug was undetectable ( 4 mcg/L) in 4 women and near the lower limit of detection (6 mcg/L) in the other. The authors calculated that the average amount excreted into milk in 24 hours was 27 mcg (range 6.8 to 75 mcg) which corresponded to 0.0087% of the total (not weight-adjusted) dosage.[ 4 ] The same paper reported another 5 women given three 20 mg/kg oral doses at 4-hour intervals. With this regimen, peaks were observed 4 and 10 hours after the first dose. A meal near the second dose probably delayed its absorption. The peaks were 250 and 460 mcg/L, respectively. The authors calculated that the average amount excreted into milk in 24 hours was 25.6 mcg (range 4.6 to 49 mcg) which corresponded to 0.0007% of the total (not weight-adjusted) dosage.[ 4 ] Fifteen women in the Philippines who were 5 to 7 months postpartum and infected with Schistosoma japonicum were given praziquantel 30 mg/kg twice at an interval of 3 hours. The average milk praziquantel level was 0.185 mg/L. Praziquantel elimination from milk had a half-life averaging 1.9 hours and paralleled plasma elimination. By 24 hours after the dose, the milk level was estimated to be 4 mcg/L. Using the average milk level, the authors estimated that a fully breasted infant would receive about 0.028 mg/kg daily, which would be about 0.05% of the maternal weight-adjusted dosage.[ 5 ] Infant Levels. Relevant published information was not found as of the revision date.
“No published information” means the studies do not exist yet — not that Praziquantel is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
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.