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Safety of Commonly Used Drugs in Nursing Mothers
by Philip O. Anderson, Pharm.D., FASHP

Updated March 2010

Although many medications are safe to use while breastfeeding, most drugs will get into your milk to some degree and may even affect your milk supply. To be safe, check with your child's doctor before taking any kind of medication, even over-the-counter drugs.

The information in our chart was compiled by Philip Anderson, a pharmacist and the editor of LactMed, the U.S. National Library of Medicine's drugs and lactation database. If you have more questions about how a drug you're taking might affect your breast milk or your baby, check the LactMed database online or call the nearest teratogen information service.

Safe in Usual Doses. Although the potential for rare allergic or idiosyncratic reactions should be kept in mind, usual doses pose little risk for the breastfed infant.
Name of Drug Brand Name Use
Acetaminophen
Tylenol
Analgesic
Acyclovir and Valacyclovir
Zovirax, Valtrex
Antiviral for herpes infections
Antacids
Maalox, Mylanta
Used to treat upset stomachs
Bupivacaine
Marcaine
Local anesthetic
Caffeine
Coffee, soft drinks
A stimulant
Cephalosporins
Keflex, Ceclor, Ceftin, Omnicef, Suprax
Antibiotics for lung, ear, skin, urinary tract, throat and bone infections
Clotrimazole
Lotrimin, Mycelex
Used to treat yeast and fungal infections
Contraceptives, Progestin-Only
Micronor, Norplant, Depo-Provera
Used for birth control
Corticosteroids
Prednisone
Used to treat inflammation of joints and other conditions
Decongestant Nasal Sprays
Afrin
Used to treat stuffy noses
Digoxin
Lanoxin
Used to treat heart problems
Erythromycin
E-Mycin, Erythrocin
Used for skin and respiratory infections
Fexofenadine
Allegra
Antihistamine for allergies and hay fever
Fluconazole
Diflucan
Used to treat yeast infections
Heparin & LMW Heparins

Keep blood from clotting
Ibuprofen
Advil, Motrin
Used for pain relief
Inhalers, bronchodilators, and corticosteroids
Albuterol, Vanceril
Used for asthma
Laxatives, bulk-forming and stool softening
Metamucil, Colace
Used to treat constipation
Lidocaine
Xylocaine
A local anesthetic
Loratadine
Claritin
Antihistamine for allergies and hay fever
Low molecular weight heparins (enoxaparin, dalteparin, tinzaparin)
Lovenox, Fragmin, Innohep
Anticoagulants
Magnesium Sulfate


Used to treat preeclampsia and eclampsia
Methyldopa
Aldomet
Used to treat high blood pressure
Methylergonovine (short courses)
Methergine
Used to prevent or control bleeding after childbirth
Metoprolol
Lopressor
A beta-blocker used to treat high blood pressure
Miconazole
Monistat 3
Used to treat yeast infections
Nifedipine
Adalat, Procardia
Used for high blood pressure and Raynaud's syndrome of the nipple
Penicillins
Amoxicillin
Used to treat bacterial infections
Propranolol
Inderal
A beta blocker used to treat heart problems, and high blood pressure
Theophylline
Theo-Dur
Used to treat asthma and bronchitis
Thyroid Replacement
Synthroid
Used to treat thyroid problems
Tretinoin
Retin A
Cream used for acne
Vaccines (except smallpox and yellow fever)


Vancomycin
Vancocin
Antibiotic
Verapamil
Calan, Isoptin, Verelan
Used for high blood pressure
Warfarin Coumadin
Used to treat or prevent blood clots


Probably Safe in Usual Doses. Little is known about the effects of these drugs on a breastfeeding infant, but if there is an effect, it will probably be mild. In rare cases, a child might have an allergic reaction.
Name of Drug Brand Name Use
ACE Inhibitors Enalapril (Vasotec), Benazepril (Lotensin)
Used to treat high blood pressure
Anticholinergic Agents *
Pro-Banthine
Used to treat intestinal and gall bladder spasms; may reduce milk supply
Anticonvulsants
Depakote, Dilantin, Tegretol (avoid ethosuximide, phenobarbital, and primidone)
Used for seizures and mood disorders
Antihistamines *
Benadryl, Chlor-Trimeton
Used to treat hay fever and allergies. May reduce milk supply and cause infant drowsiness or fussiness
Antituberculars (Isoniazid)
INH
Used to treat tuberculosis
Azathioprine
Imuran
Used to suppress the immune system following organ transplants
Barbiturates (except phenobarbital)
Fiorinal, Fioricet
For sedation and tension headaches
Bupropion
Wellbutrin
For depression
Clindamycin
Cleocin
Used to treat abdominal and vaginal infections
Decongestants, Oral *
Sudafed, Entex PSE
Used to treat congestion associated with colds or allergies; often reduces milk supply
Ergonovine *
(short courses)

Used to treat uterine bleeding. May reduce milk supply.
Fluconazole
Diflucan
Antifungal
Gadolinium
Magnevist, Omniscan
Contrast agent for MRI studies
Haloperidol
Haldol
Used to treat psychosis
Histamine H2 Blockers
Cimetidine (Tagamet), ranitidine (Zantac), nizatadine (Axid), and famotidine (Pepcid - preferred)
Used to treat stomach problems
Hydrochlorothiazide (low doses)
HydroDiuril
Diuretic for high blood pressure
Labetalol
Normodyne, Trandate
Used for high blood pressure; caution in preterm infants
Lorazepam
Ativan
Used to treat anxiety
Methimazole
Tapazole
Used for hyperthyroidism; less than 20 mg/day is probably safe
Metoclopramide
Reglan
Used for gastrointestinal problems and to increase milk supply
Midazolam

Sedative used in anesthesia
Naproxen
Naprosyn, Anaprox, Aleve
Used for pain relief; okay if baby is at least 1 month old
Oxazepam
Serax
Used to treat anxiety
Paroxetine
Paxil
Used to treat depression
Phenothiazines
Compazine (anti-nausea), Stelazine, Thorazine (anti-psychotic)

Propofol
Diprivan
Sedative used in anesthesia
Propylthiouracil (PTU)

Used to treat hyperthyroidism
Quinidine

Used to treat heartbeat irregularities
Quinolone antibacterials
Cipro and Levaquin; Noroxin is preferred
Treatment of urinary tract infections
Salicylates (occasional use)
Aspirin
Used for pain relief
Sertraline
Zoloft
Used to treat depression
Spironolactone
Aldactone, Aldactazide
Used to treat high blood pressure
Sumatriptan
Imitrex
Used to treat migraines
Tetracyclines (less than 14 days)
tetracycline, doxycycline
Used to treat acne and urinary tract infections
Trazodone

Used for depression and sleep
Tricyclic Antidepressants (avoid doxepin)
Elavil, Tofranil, Pamelor
Used to treat depression; nortriptyline preferred
Verapamil Calan, Isoptin, Verelan
Used for high blood pressure


Potentially Hazardous. You should avoid or use these drugs with caution, particularly while breastfeeding a newborn or premature infant.
Name of Drug Brand Name Use
Acebutolol
Sectral
A beta blocker used to treat high blood pressure and abnormal heart rhythms.
Atenolol
Tenormin
A beta blocker used to treat high blood pressure and abnormal heart rhythms.
Antihistamine/Decongestant Combinations *
Contac, Dimetapp
Used to treat colds and allergies; may reduce milk supply
Benzodiazepines (lorazepam, oxazepam preferred)
long-acting Librium, Valium, Dalmane
Used to treat anxiety and for sleep (lorazepam, oxazepam preferred)
Chlorthalidone *

Diuretic used to treat high blood pressure; may reduce milk supply
Citalopram
Celexa
Antidepressant; can cause infant drowsiness
Clonidine *
Catapres
Used to treat high blood pressure, may reduce milk supply
Contraceptives, Estrogen-Containing *
Ortho-Novum, Lo-Ovral, Loestrin
Used for birth control; may reduce milk supply
Doxepin
Sinequan
Used to treat depression
Ergotamine
Cafergot
Used to treat migraines
Ethosuximide
Zarontin
Used to treat epilepsy
Fluorescein (IV)

Used to diagnose retinal problems
Fluoxetine
Prozac
Used to treat depression
Iodinated Contrast Media (withhold breastfeeding temporarily)

Used to examine kidneys; withhold breastfeeding temporarily
Lamotrigine
Lamictal
Used for seizures and mood disorders
Lithium (monitor infant serum levels)

Used to treat bipolar disease
Metronidazole
Flagyl
An antibiotic used to treat some intestinal and genital infections
Nadolol
Corgard
A beta blocker used to treat high blood pressure and heart problems
Narcotics, especially meperidine in addicts, or with high doses in neonates
Tylenol #3, Vicodin
Used for pain (one tablet every six hours maximum; watch for drowsiness). Limit to 4 days after milk comes in.
Nefazodone
Serzone
Used for depression
Nicotine*

Smoking can decrease milk supply and toxins in smoke reach the infant
Nitrofurantoin
Macrobid
Used to treat urinary tract infections (safe after the baby is one month old
Phenobarbital (anticonvulsant doses)

Sedative and anticonvulsant
Piroxicam
Feldene
Used to treat arthritis and pain
Primidone
Mysoline
Used to treat seizures
Reserpine

Used to treat hypertension
Sotalol
Betapace
Used to treat heart problems
Thiazide diuretics, long-acting or high doses*
Enduron, Lozol, Renese
edema; high dose may decrease milk supply
Venlafaxine Effexor
Used to treat depression

Contraindicated. You shouldn't use any of these drugs while breastfeeding. If you must take them for health reasons, you should stop breastfeeding - either temporarily or permanently - depending on how long you need to take them. To keep your milk supply up you can "pump and dump" - that is, use a breast pump and discard what you collect until you're ready to breastfeed again.
Name of Drug Brand Name Use
Amantadine *
Symmetrel
Used to treat the flu or Parkinson's disease; may reduce milk supply
Amiodarone
Cordarone
Used to treat heart problems
Antilipemics (excluding resins)
(Lescol, Lipitor, Lopid, Mevacor, Pravacor, Zocor
Used to lower the level of cholesterol in the blood
Antineoplastic Agents

Used to treat cancer
Aspirin (large doses)

Analgesic
Chloramphenicol

Used to treat serious infections
Clozapine
Clozaril
Used to treat schizophrenia
Cocaine


Dipyrone (dipirona in Mexican drugs)

Used for pain and inflammation
Gold Salts
Myochrysine
Used to treat arthritis
Iodide products
Betadine, potassium iodide
Used for douching or as an expectorant
Iodine, Radioactive
Used to diagnose and treat hyperthyroidism
Lipid-lowering drugs
Lescol, Lipitor, Lopid, Mevacor, Pravacor, Zocor
Used to lower the level of fats in the blood
Metamizol (same as dipyrone)

Analgesic/anti-inflammatory. Banned in U.S. but available in Mexico
Salicylates (large doses)
Aspirin
Used to treat arthritis

* Drug may also inhibit lactation.

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