Doxorubicin use while Breastfeeding

Drugs containing Doxorubicin: Adriamycin, Adriamycin RDF, Adriamycin PFS

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.[1] 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.

Drug Levels

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.[2][3] 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.

Possible Effects on Lactation

A study of adolescent males who had received chemotherapy for childhood malignancies found that having received doxorubicin was associated with elevated serum prolactin concentrations.[4]

References

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

Doxorubicin Identification

Substance Name

Doxorubicin

CAS Registry Number

23214-92-8

Drug Class

  • Antineoplastic Agents

Administrative Information

LactMed Record Number

99

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

Last Revision Date

2014-03-06

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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