Permethrin use while Breastfeeding

Drugs containing Permethrin: Elimite, Nix, Acticin, Quellada Scabies Treatment, Lyclear, Nix Cream Rinse, Nix Complete Lice Treatment System, Quellada Head Lice Treatment, Lice Bedding Spray, RID Complete Kit, Show all 19 »RID Home Lice Control Spray for Surfaces, Complete Lice Treatment Kit, Nix Lice Control, Lice Solution, Pyrifoam Lice Breaker, Orange Medic Plus Head Lice Treatment, Quellada Head Lice Treatment for Short Hair, Ravine Anti-Lice Medicated Treatment, Orange Medic Head Lice Treatment

Permethrin Levels and Effects while Breastfeeding

Summary of Use during Lactation

Because less than 2% is absorbed after topical application, rapid metabolism to inactive metabolites and safe application directly on infants' skin, topical permethrin products are acceptable in nursing mothers.[1][2][3] This combination is recommended by the Centers for Disease Control and Prevention for the treatment of lice infestations during lactation.[3] Extensive exposure, such as from agricultural use or malaria control might have long-term health concerns because residues can be found in breastmilk.[4] Only water-miscible cream, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[5]

Drug Levels

Maternal Levels. Permethrin was found in the breastmilk of nursing mothers in 3 South African towns. Average levels in breastmilk ranged from 8.3 to 48.4 mcg/L in the 3 towns. The source was thought to be from a dusting powder widely available and used in gardening. The dosage and route of exposure (i.e., topical, inhalation, oral) could not be determined. All milk levels were below the allowable daily limit for permethrin.[6][7]

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

Effects in Breastfed Infants

In a telephone follow-up study, 5 mothers who used permethrin during breastfeeding reported no adverse reactions in their breastfed infants.[8]

Possible Effects on Lactation

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

Alternate Drugs to Consider

Pyrethrins

References

1. Porto I. Antiparasitic drugs and lactation: focus on anthelmintics, scabicides, and pediculicides. J Hum Lact. 2003;19:421-5. PMID: 14620457

2. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006;24:167-97. PMID: 16677965

3. Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines 2006. MMWR Recomm Rep. 2006;55 (RR-11):1-94. PMID: 16888612

4. Bouwman H, Kylin H. Malaria control insecticide residues in breast milk: the need to consider infant health risks. Environ Health Perspect. 2009;117:1477-80. PMID: 20019894

5. Noti A, Grob K, Biedermann M et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317-25. PMID: 14623482

6. Sereda B, Bouwman H, Kylin H. Comparing water, bovine milk, and indoor residual spraying as possible sources of DDT and pyrethroid residues in breast milk. J Toxicol Environ Health A. 2009;72:842-51. PMID: 19557612

7. Bouwman H, Sereda B, Meinhardt HM. Simultaneous presence of DDT and pyrethroid residues in human breast milk from a malaria endemic area in South Africa. Environ Pollut. 2006;144:902-17. PMID: 16564119

8. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418

Permethrin Identification

Substance Name

Permethrin

CAS Registry Number

52645-53-1

Drug Class

  • Antiinfective Agents
  • Antiparasitic Agents
  • Insecticides

Administrative Information

LactMed Record Number

505

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

Last Revision Date

2011-01-31

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...

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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