Acitretin use while Breastfeeding
Drugs containing Acitretin: Soriatane, Soriatane CK
Acitretin Levels and Effects while Breastfeeding
Summary of Use during Lactation
Limited information indicates that maternal doses of acitretin of 0.65 mg/kg daily produce low levels in milk. Because there is no published experience with acitretin during breastfeeding, opinions vary on the advisability of breastfeeding during acitretin therapy.[1][2] Various topical agents that are less likely to be absorbed by the mother may be preferred during breastfeeding, especially while nursing a newborn or preterm infant. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]
Drug Levels
Maternal Levels. A woman who was 8 months postpartum discontinued breastfeeding and began acitretin 40 mg (0.65 mg/kg) once daily by mouth after breakfast. Milk was collected before starting the drug and then twice daily for 9 days. Acitretin and its 13-cis-metabolite were detected in milk 12 hours after the first dose and levels gradually increased over 4 to 5 days to steady-state levels between 30 and 40 mcg/L that did not fluctuate markedly during the day. Acitretin was the main component found in milk 10 to 12 hours after a dose while the metabolite was the primary component in milk 22 to 24 hours after the previous dose.[1] Assuming an average milk level of 35 mcg/L, an exclusively breastfed infant would receive an estimated 0.8% of the maternal weight-adjusted dosage as acitretin and its metabolite.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Possible Effects on Lactation
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
Depends on the severity of the psoriasis and its location on the body.
References
1. Rollman O, Pihl-Lundin I. Acitretin excretion into human breast milk. Acta Derm Venereol. 1990;70:487-90. PMID: 1981420
2. American Academy of Pediatrics Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776-89. PMID: 11533352
3. Noti A, Grob K, Biedermann M et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317-25. PMID: 14623482
Acitretin Identification
Substance Name
CAS Registry Number
55079-83-9
Drug Class
- Keratolytic Agents
- Retinoids
Administrative Information
LactMed Record Number
490
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
2011-01-31
Disclaimer
Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
See Also...
- Acitretin use during Pregnancy
- Acitretin Consumer Information
- Breastfeeding Support Group
- Safe Medications during Breastfeeding
- Medicine use while Breastfeeding
- Medicine use during Pregnancy
Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.
