Cefpodoxime use while Breastfeeding

Drugs containing Cefpodoxime: Vantin

Cefpodoxime Levels and Effects while Breastfeeding

Summary of Use during Lactation

Limited information indicates that cefpodoxime produces low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefpodoxime is acceptable to use during breastfeeding.

Drug Levels

Maternal Levels. According to the manufacturer, levels of cefpodoxime in the milk of 3 nursing mothers were 0%, 2% and 6% of concomitant maternal serum levels at 4 hours following a 200 mg oral dose of cefpodoxime proxetil. At 6 hours after the dose, levels were 0%, 9% and 16% of concomitant maternal serum levels. No study details or measured milk levels were provided. After a 200 mg oral dose, the average peak serum level is 2.3 mg/L. Using this serum level and the maximum reported milk to plasma ratio of 0.16 above, a fully breastfed infant would receive a maximum daily dose of about 0.055 mg/kg daily after a maternal dose of 200 mg, compared to the recommend treatment dosage of 10 mg/kg daily for infants of 2 months or older.

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

Hyperprolactinemia and bilateral galactorrhea occurred in a nonpregnant, 40-year-old woman taking cefpodoxime 200 mg twice daily for 2 days. Seven days after stopping the drug, galactorrhea ceased and the serum prolactin dropped markedly into the normal range. One month later it had dropped further. Because no other cause could be found, the authors determined that the galactorrhea and hyperprolactinemia were probably caused by cefpodoxime.[1]

The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs to Consider

Ceftibuten

References

1. Khurana V, Gambhir IS. Cefpodoxime-induced hyperprolactinemic galactorrhea. Ann Intern Med. 2010;152:136. Letter. PMID: 20083845

Cefpodoxime Identification

Substance Name

Cefpodoxime

CAS Registry Number

82619-04-3

Drug Class

Administrative Information

LactMed Record Number

52

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-09-07

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.

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