Misoprostol use while Breastfeeding
Drugs containing Misoprostol: Arthrotec, Cytotec
Misoprostol Levels and Effects while Breastfeeding
Summary of Use during Lactation
Mispoprostol is a prostaglandin E1 analogue. Prostaglandin E1 and other prostaglandins appear normally in colostrum and milk.[1] Because of the low levels of misoprostol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.
Drug Levels
Maternal Levels. Twenty women received misoprostol 600 mcg orally during the first 4 days postpartum and collected a total of 24 colostrum samples at various times during the first 5 hours after the dose. The average misoprostol concentration was highest in milk 1 hour after the dose at 20.9 ng/L. Average concentrations fell to 17.8 ng/L at 2 hours after the dose, 9.4 ng/L at 3 hours, 2.8 ng/L at 4 hours and <1 ng/L at 5 hours after the dose. These colostrum levels result in an average infant dose of 7 picograms/kg or 0.07% of the weight-adjusted maternal dosage.[2]
Ten women who averaged 3.9 days postpartum received a single oral dose of misoprostol 200 mcg. Milk samples were obtained from one breast from 0.5 to 5 hours after the dose. The mean and median peak milk levels were 7.6 and 3.6 ng/L, respectively, at 1.1 hours after the dose. In 2 women, the peak milk level occurred 2 hours after the dose. By 5 hours, the median milk level was 0.2 ng/L. The half-life in milk averaged 1.1 hours.[3]
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
(Oxytocic) Ergonovine, Methylergonovine, (Ulcers) Famotidine, Ranitidine, Omeprazole, Pantoprazole
References
1. Shimizu T, Yamashiro Y, Yabuta K. Prostaglandin E1, E2, and F2 alpha in human milk and plasma. Biol Neonate. 1992;61:222-5. PMID: 1610950
2. Abdel-Aleem H, Villar J, Gulmezoglu AM et al. The pharmacokinetics of the prostaglandin E1 analogue misoprostol in plasma and colostrum after postpartum oral administration. Eur J Obstet Gynecol Reprod Biol. 2003;108:25-8. PMID: 12694965
3. Vogel D, Burkhardt T, Rentsch K et al. Misoprostol versus methylergometrine: pharmacokinetics in human milk. Am J Obstet Gynecol. 2004;191:2168-73. PMID: 15592308
Misoprostol Identification
Substance Name
CAS Registry Number
59122-46-2
Drug Class
- Abortifacient Agents, Nonsteroidal
- Anti-Ulcer Agents
- Prostaglandins
- Oxytocics
Administrative Information
LactMed Record Number
554
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
2010-12-07
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.
See Also...
- Misoprostol use during Pregnancy
- Misoprostol 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.
