Pantoprazole use while Breastfeeding
Drugs containing Pantoprazole: Protonix, Protonix IV
Medically reviewed by Drugs.com. Last updated on Mar 5, 2019.
Pantoprazole Levels and Effects while Breastfeeding
Summary of Use during Lactation
Maternal pantoprazole doses of 40 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants.
Maternal Levels. A mother who was 10 months postpartum and partially nursing her infant was given a single 40 mg dose of oral pantoprazole. Pantoprazole was detectable in milk only 2 and 4 hours after the dose with milk levels of 36 mcg/L and 24 mcg/L, respectively, at those times. It was not detectable (<10 mcg/L) in milk at 6, 8 and 24 hours after the dose. The authors estimated that a fully breastfed infant would receive 0.14% of the maternal weight-adjusted dosage.
Twelve lactating women were given oral pantoprazole 40 mg daily for one week. Maternal blood and breastmilk samples were obtained 7 times over the 12 hours following the dose on both days. The mean pantoprazole concentration in breastmilk was 62 mcg/L on day 1 and 153 mcg/L on day 7. Overall, 21 of 97 breastmilk samples contained detectable (>30 mcg/L) pantoprazole. On day 1, 21% of milk samples contained measurable pantoprazole and on day 7, 22% contained measurable pantoprazole. Further description of the time course was not contained in the abstract.
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 retrospective claims database study in the United States found that users of proton pump inhibitors had an increased risk of gynecomastia.
Alternate Drugs to Consider
1. Plante L, Ferron GM, Unruh M et al. Excretion of pantoprazole in human breast. J Reprod Med. 2004;49:825-7. PMID: 15568407
2. Bor S, Karacaoglu S, Ergun P et al. The levels of pantoprazole in human breast milk and plasma: Two compartment model. Neurogastroenterol Motil. 2017;29:79-80. Abstract. DOI: doi:10.1111/nmo.13180
3. He B, Carleton B, Etminan M. Risk of gynecomastia with users of proton pump inhibitors. Pharmacotherapy. 2019;39:614-8. PMID: 30865318
CAS Registry Number
Proton Pump Inhibitors
LactMed Record Number
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