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TABLE 6 Maternal Medication Usually Compatible With Breastfeeding*
Drug	Reported Sign or Symptom in Infant or Effect on Lactation	Reference No.
Acetaminophen	None	142-144
Acetazolamide	None	145
Acitretin		146
Acyclovir	None	147, 148
Alcohol (ethanol)	With large amounts, drowsiness, diaphoresis, deep sleep, weakness, decrease in linear growth, abnormal weight gain; maternal ingestion of 1 g/kg daily decreases milk ejection reflex	4, 149-152
Allopurinol		153
Amoxicillin	None	154
Antimony		155
Atropine	None	156
Azapropazone (apazone)		157
Aztreonam	None	158
B1 (thiamin)	None	159
B6 (pyridoxine)	None	160-162
B12	None	163
Baclofen	None	164
Barbiturate	See Table 5
Bendroflumethiazide	Suppresses lactation	165
Bishydroxycoumarin (dicumarol)	None	166
Bromide	Rash, weakness, absence of cry with maternal intake of 5.4 g/d	167
Butorphanol	None	168
Caffeine	Irritability, poor sleeping pattern, excreted slowly; no effect with moderate intake of caffeinated beverages (2-3 cups per day)	169-174
Captopril	None	175
Carbamazepine	None	176, 177
Carbetocin	None	178
Carbimazole	Goiter	83, 179, 180
Cascara	None	181
Cefadroxil	None	154
Cefazolin	None	182
Cefotaxime	None	183
Cefoxitin	None	183
Cefprozil		184
Ceftazidime	None	185
Ceftriaxone	None	186
Chloral hydrate	Sleepiness	187
Chloroform	None	188
Chloroquine	None	189-191
Chlorothiazide	None	192, 193
Chlorthalidone	Excreted slowly	194
Cimetidine	None	195, 196
Ciprofloxacin	None	197, 198
Cisapride	None	199
Cisplatin	Not found in milk	30
Clindamycin	None	200
Clogestone	None	201
Codeine	None	144, 156, 202
Colchicine		203-205
Contraceptive pill with estrogen/progesterone	Rare breast enlargement; decrease in milk production and protein content (not confirmed in several studies)	206-213
Cycloserine	None	214
D (vitamin)	None; follow up infant's serum calcium level if mother receives pharmacologic doses	215-217
Danthron	Increased bowel activity	218
Dapsone	None; sulfonamide detected in infant's urine	191, 219
Dexbrompheniramine maleate with d-isoephedrine	Crying, poor sleeping patterns, irritability	220
Diatrizoate	None	221
Digoxin	None	222, 223
Diltiazem	None	224
Dipyrone	None	225
Disopyramide	None	226, 227
Domperidone	None	228
Dyphylline	None	229
Enalapril		230
Erythromycin	None	231
Estradiol	Withdrawal, vaginal bleeding	232
Ethambutol	None	214
Ethanol (cf. alcohol)
Drug	Reported Sign or Symptom in Infant or Effect on Lactation	Reference No.
Ethosuximide	None, drug appears in infant serum	176, 233
Fentanyl		234
Fexofenadine	None	235
Flecainide		236, 237
Fleroxacin	One 400-mg dose given to nursing mothers; infants not given breast milk for 48 h	238
Fluconazole	None	239
Flufenamic acid	None	240
Fluorescein		241
Folic acid	None	242
Gadopentetic (Gadolinium)	None	243
Gentamicin	None	244
Gold salts	None	245-249
Halothane	None	250
Hydralazine	None	251
Hydrochlorothiazide		192, 193
Hydroxychloroquine	None	252, 253
Ibuprofen	None	254, 255
Indomethacin	Seizure (1 case)	256-258
Iodides	May affect thyroid activity; see iodine	259
Iodine	Goiter	259
Iodine (povidone-iodine, eg, in a vaginal douche)	Elevated iodine levels in breast milk, odor of iodine on infant's skin	259
Iohexol	None	97
Iopanoic acid	None	260
Isoniazid	None; acetyl (hepatotoxic) metabolite secreted but no hepatotoxicity reported in infants	214, 261
Interferon-		262
Ivermectin	None	263, 264
K1 (vitamin)	None	265, 266
Kanamycin	None	214
Ketoconazole	None	267
Ketorolac		268
Labetalol	None	269, 270
Levonorgestrel		271-274
Levothyroxine	None	275
Lidocaine	None	276
Loperamide		277
Loratadine	None	278
Magnesium sulfate	None	279
Medroxyprogesterone	None	201, 280
Mefenamic acid	None	281
Meperidine	None	61, 282
Methadone	None	283-287
Methimazole (active metabolite of carbimazole)	None	288, 289
Methohexital	None	61
Methyldopa	None	290
Methyprylon	Drowsiness	291
Metoprolol	None	120
Metrizamide	None	292
Metrizoate	None	97
Mexiletine	None	293, 294
Minoxidil	None	295
Morphine	None; infant may have measurable blood concentration	282, 296-298
Moxalactam	None	299
Nadolol	None	300
Nalidixic acid	Hemolysis in infant with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency	301
Naproxen		302
Nefopam	None	303
Nifedipine		304
Nitrofurantoin	Hemolysis in infant with G-6-PD deficiency	305
Norethynodrel	None	306
Norsteroids	None	307
Noscapine	None	308
Ofloxacin	None	198
Oxprenolol	None	309, 310
Phenylbutazone	None	311
Phenytoin	Methemoglobinemia (1 case)	138, 176, 312
Piroxicam	None	313
Prednisolone	None	314, 315
Prednisone	None	316
Drug	Reported Sign or Symptom in Infant or Effect on Lactation	Reference No.
Procainamide	None	317
Progesterone	None	318
Propoxyphene	None	319
Propranolol	None	320-322
Propylthiouracil	None	323
Pseudoephedrine	None	324
Pyridostigmine	None	325
Pyrimethamine	None	326
Quinidine	None	191, 327
Quinine	None	296
Riboflavin	None	159
Rifampin	None	214
Scopolamine		156
Secobarbital	None	328
Senna	None	329
Sotalol		237, 330
Spironolactone	None	331
Streptomycin	None	214
Sulbactam	None	332
Sulfapyridine	Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk	333, 334
Sulfisoxazole	Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk	335
Sumatriptan	None	336
Suprofen	None	337
Terbutaline	None	338
Terfenadine	None	235
Tetracycline	None; negligible absorption by infant	339, 340
Theophylline	Irritability	169, 341
Thiopental	None	139, 342
Thiouracil	None mentioned; drug not used in United States	343
Ticarcillin	None	344
Timolol	None	310
Tolbutamide	Possible jaundice	345
Tolmetin	None	346
Trimethoprim/sulfamethoxazole	None	347, 348
Triprolidine	None	324
Valproic acid	None	176, 349, 350
Verapamil	None	351
Warfarin	None	352
Zolpidem	None	353
* Drugs listed have been reported in the literature as having the effects listed or no effect. The word "none" means that no observable change was seen in the nursing infant while the mother was ingesting the compound. Dashes indicate no mention of clinical effect on the infant. It is emphasized that many of the literature citations concern single case reports or small series of infants.
Drug is concentrated in human milk.