Nifurtimox use while Breastfeeding

Nifurtimox Levels and Effects while Breastfeeding

Summary of Use during Lactation

Limited information indicates that maternal doses of nifurtimox up to 15 mg/kg daily produce do not cause any adverse serious effects in breastfed infants. Breastmilk levels have not been measured, but a computer simulation found that the dose that an exclusively breastfed infant would receive through breastmilk would be much less than the dose given to treat Chagas disease in newborn infants. Other authors consider that breastfeeding is not contraindicated during the use of nifurtimox.[1][2]

Drug Levels

Maternal Levels. A computer simulation using pharmacokinetic data from adults and assuming milk-plasma ratios of 1 to 6 resulted in an estimated maximum infant dose of less than 10% of the maternal weight-adjusted dosage.[3]

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

Effects in Breastfed Infants

A cohort of 33 infants who were breastfed (extent not stated) by hospitalized mothers taking nifurtimox was followed in the Democratic Republic of the Congo. Thirty mothers took a full course of 30 doses of oral nifurtimox 15 mg/kg daily and all received 14 doses of intravenous eflornithine 400 mg/kg daily for 7 days for human African trypanosomiasis. (sleeping sickness). Nursing mothers also took a median of 4 other concomitant medications. No serious adverse events were reported in any of the breastfed infants.[4]

Possible Effects on Lactation

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

References

1. Sankale M, Brun A. Les medicaments des parasitoses tropicales au cours de la grossesse et de l'allaitement. (2 parts). Concours Medl. 1991;14:2335-9; 2248-51.

2. Barennes H, Choonara I. Breast feeding and drug therapy in neglected diseases. Arch Dis Child. 2010;95:222-3. PMID: 20308339

3. Garcia-Bournissen F, Altcheh J, Panchaud A, Ito S. Is use of nifurtimox for the treatment of Chagas disease compatible with breastfeeding? A population pharmacokinetics analysis. Arch Dis Child. 2010;95:224-8. PMID: 19948512

4. Schmid C, Kuemmerle A, Blum J et al. In-hospital safety in field conditions of nifurtimox eflornithine combination therapy (NECT) for T. b. gambiense sleeping sickness. PLoS Negl Trop Dis. 2012;6:e1920. PMID: 23209861

Nifurtimox Identification

Substance Name

Nifurtimox

CAS Registry Number

23256-30-6

Drug Class

  • Antiprotozoal Agents
  • Nitrofurans
  • Trypanocidal Agents

Administrative Information

LactMed Record Number

799

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

Last Revision Date

2013-09-07

Disclaimer

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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.

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