Is Clotrimazole compatible with breastfeeding? Do we have alternatives for Clotrimazole?

Clotrimazole

March 22, 2018 (Very Low Risk)

Excretion into breast milk is very unlikely since absorption through skin, vaginal mucosa, and, even intestinal mucosa into plasma is very poor with non-significant plasma levels or below the detection threshold (<10 ng/mL). In addition, because of a high plasma protein binding capacity, excretion into breast milk seems to be less likely.

It is used frequently for treatment of Candida infection, either in skin or mouth mucosa, even in newborn and premature infants without observed side-effects.

In case of use on the nipple, do it after feeding the baby and cleanse thoroughly the surface before the next one.

Do not use creams, gels and other locally applied products that contain paraffin (mineral oil) to prevent absorption by the infant.

Alternatives

We do not have alternatives for Clotrimazole since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Κλοτριμαζόλη (Greek)
  • كلوتريمازول (Arabic)
  • Клотримазол (Cyrillic)
  • 克霉唑 (Chinese)
  • クロトリマゾール (Japanese)
  • C22 H17 ClN2 (Molecular formula)
  • 1-(α-2-Chlorotrityl)imidazole (Chemical name)
  • A01AB18; D01AC01; G01AF02 (ATC Code/s)

References

  1. MSyC-AgEspMed. Clotrimazol. Ficha técnica. 2014 Full text (in our servers)
  2. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  3. New Zealand Data Sheet. Clotrimazole. Data Sheet. 2013 Full text (in our servers)
  4. Andersson M, Helldén A. Behandling av bröstvårtesvamp ­hos ammande kvinnor. \ [Treatment of nipple candidiasis in breast feeding mothers]. Lakartidningen. 2010Abstract Full text (link to original source) Full text (in our servers)
  5. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010Abstract Full text (link to original source) Full text (in our servers)
  6. Hoeger PH, Stark S, Jost G. Efficacy and safety of two different antifungal pastes in infants with diaper dermatitis: a randomized, controlled study. J Eur Acad Dermatol Venereol. 2010Abstract
  7. Andersson M, Helldén A. [Treatment of nipple candidiasis in breast feeding mothers]. Lakartidningen. 2010Abstract
  8. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008Abstract
  9. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003Abstract
  10. Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001Abstract
  11. Dhondt F, Ninane J, De Beule K, Dhondt A, Cauwenbergh G. Oral candidosis: treatment with absorbable and non-absorbable antifungal agents in children. Mycoses. 1992Abstract
  12. Johnstone HA, Marcinak JF. Candidiasis in the breastfeeding mother and infant. J Obstet Gynecol Neonatal Nurs. 1990Abstract
  13. Lücker PW, Beubler E, Kukovetz WR, Ritter W. Retention time and concentration in human skin of bifonazole and clotrimazole. Dermatologica. 1984Abstract
  14. Sitka U, Weingärtner L. [Clotrimazol in the treatment of candida infections in premature and newborn children (author's transl)]. Med Klin. 1976Abstract
  15. Cohen M, Harkness RA, Renz M, Farquhar JW. Trials of the use of clotrimazole in the treatment of oral candidiasis in newborn babies. Postgrad Med J. 1974Abstract