Doxorubicin use while Breastfeeding
Drugs containing Doxorubicin: Adriamycin, Adriamycin PFS, Adriamycin RDF
Doxorubicin Levels and Effects while Breastfeeding
Summary of Use during Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially anthracyclines such as doxorubicin. It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence; however, the high levels and persistence of doxorubicinol in milk make defining an appropriate abstinence interval difficult.
Maternal Levels. Doxorubicin, doxorubicinol and two other metabolites were detected in milk after administration of 70 mg/sq m (90 mg) of doxorubicin intravenously. Peak milk levels of 128 mcg/L of doxorubicin and 111 mcg/L of its active metabolite doxorubicinol occurred 24 hours after the dose. Both drugs were detectable in milk for at least 72 hours after the dose. Other metabolites were also detected in milk at lower levels. Using these data, the breastfed infant in this case would have received an estimated 2% of maternal weight-adjusted dosage if he had been allowed to nurse throughout the 72 hours after the dose.
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.
Effects on Lactation and Breastmilk
A study of adolescent males who had received chemotherapy for childhood malignancies found that having received doxorubicin was associated with elevated serum prolactin concentrations.
1. Pistilli B, Bellettini G, Giovannetti E et al. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013;39:207-11. PMID: 23199900
2. Egan PC, Costanza M, Dodion P et al. Secretion of doxorubicin (DOX) and cisplatin (DDP) into human milk. Proc ASCO. 1984;3:21. Abstract.
3. Egan PC, Costanza ME, Dodion P et al. Doxorubicin and cisplatin excretion into human milk. Cancer Treat Rep. 1985;69:1387-9. PMID: 4075315
4. Siimes MA, Ropponen P, Aalberg V et al. Prolactinemia in adolescent males surviving malignancies in childhood: impaired dating activity. J Adolesc Health. 1993;14:543-7. PMID: 8312290
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