Clofazimine use while Breastfeeding

Drugs containing Clofazimine: Lamprene

Clofazimine Levels and Effects while Breastfeeding

Summary of Use during Lactation

Limited information indicates that clofazimine appears in milk in relatively large amounts. Milk can be colored pink by the drug and breastfed infant's skin can be discolored the typical red color that is common in persons taking the drug. No serious or permanent toxicity has been reported in breastfed infants; however, an alternate drug might be considered.

Drug Levels

Clofazimine is excreted into milk, reportedly coloring it bright pink to red.[1][2]

Maternal Levels. Eight women with leprosy who had been breastfeeding for 4 months or less had been receiving clofazimine either 50 mg daily (n = 5), 100 mg every other day (n = 2) or 100 mg daily (n = 1) for an average of 5 months. Milk levels collected 4 to 6 hours after the dose averaged 1.33 mg/L (range 0.8 to 1.7 mg/L). Infants received an average of 0.199 mg/kg daily (range 0.17 to 0.26 mg/kg daily) which averaged 22.1% (range 13.5 to 30%) of the maternal weight-adjusted dosage.[3]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Probable cases of skin discoloration in breastfed infants whose mothers were taking clofazimine have been reported. In one infant, red skin color was reported.[1] In another (exact maternal dosage not stated, but in the range of 100 to 300 mg daily), the infant's skin color was reported as ruddy and slightly hypermelanotic; this infant's skin color returned to normal 5 months after the end of maternal therapy.[4]

Clofazimine was used as part of a six-drug regimen to treat a pregnant woman with multidrug-resistant tuberculosis during the first trimester of pregnancy and postpartum. The infant was breastfed (extent and duration not stated). At age 1.8 years, the child had failure to thrive, possibly due to tuberculosis contracted after birth, but was otherwise developing normally. The child also had bronze coloration of the skin color which faded over time.[5]

Possible Effects on Lactation

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Dapsone

References

1. Waters MFR. G 30 320 or B 663--Lampren (Geigy). A working party held at the Royal Garden Hotel London, September 1968. Lepr Rev. 1969;40 (1):21-47. PMID: 4888382

2. Freerksen E, Seydel JK. Critical comments on the treatment of leprosy and other mycobacterial infections with clofazimine. Arzneimittelforschung. 1992;42:1243-5. PMID: 1472145

3. Venkatesan K, Mathur A, Girdhar A et al. Excretion of clofazimine in human milk in leprosy patients. Lepr Rev. 1997;68:242-6. PMID: 9364825

4. Browne SG, Hogerzeil LM. "B 663" in the treatment of leprosy: preliminary report of a pilot trial. Lepr Rev. 1962;33:6-10. PMID: 13873759

5. Drobac PC, del Castillo H, Sweetland A et al. Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis. 2005;40:1689-92. PMID: 15889370

Clofazimine Identification

Substance Name

Clofazimine

CAS Registry Number

2030-63-9

Drug Class

  • Leprostatic Agents

Administrative Information

LactMed Record Number

430

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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