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

Furazolidone

August 16, 2018 (Low Risk)

It is a derivative of nitrofuran with antiprotozoal and antibacterial activity.
Indicated in giardiasis and cholera. In the rest gastroenteritis is not usually indicated any antibiotic treatment. It is also used in the treatment of peptic ulcer by Helicobacter pylori.
Oral administration 4 times a day for 2 to 5 days or a maximum of 7 to 10 days in the infestation by Giardia lamblia.

At the date of last update, we did not find published data on its excretion in breast milk.

Few pharmacokinetic data of this drug in humans are known.
There is controversy about its oral bioavailability. Although it is believed that it exerts its effect locally in the intestine without being absorbed (Kumar 1995, Valadez 1989), there are authors who publish a 65% absorption (Calafatti 2001 -> White 1989).

Side effects are rare and mild, usually nausea / vomiting (Altamirano 1989). Although its properties as an inhibitor of mono-amino-oxidase (MAOI) are known, no adverse neurological reactions due to the isolated use of this drug have been published (Karamanakos 2008, Bettinger 1968).

Authorized use in infants from the month of life (Induquímica 2018, RxList 2004, Drugs.com 1995).

Do not use if there is a history of glucose-6-phosphate dehydrogenase deficiency to avoid risk of hemolysis (Induquímica 2018, RxList 2004, Drugs.com 1995).

Some authors discourage its use during lactation (Mahadevan 2006). Other authors and the manufacturer only advise against it in mothers of infants younger than one month (Induquímica 2018, Drugs.com 1995).

A mother told us in 2018 that after taking 4 doses of 100 mg of furazolidone along with famotidine, in 24 hours she noticed more drowsiness than usual in her 13-week-old lactating daughter, returning to normal within 48 hours of stopping the medication.

Alternatives

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.

Synonyms

  • Nifurazolidone

Writings

  • Φουραζολιδόνη (Greek)
  • فورازوليدون (Arabic)
  • Фуразолидон (Cyrillic)
  • 呋喃唑酮 (Chinese)
  • フラゾリドン (Japanese)
  • C8 H7 N3 O5 (Molecular formula)
  • 3-(5-Nitrofurfurylideneamino)-2-oxazolidone (Chemical name)
  • G01AX06 (ATC Code/s)

References

  1. Induquímica. Furazolidona. Acceso online en 2018 Full text (in our servers)
  2. Karamanakos PN. Furazolidone and serotonin syndrome: is there any association? Clinics (Sao Paulo). 2008Abstract
  3. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  4. RxList. Furazolidone (Furoxone). Drug Summary. 2004 Full text (in our servers)
  5. Calafatti SA, Ortiz RA, Deguer M, Martinez M, Pedrazzoli J Jr. Effect of acid secretion blockade by omeprazole on the relative bioavailability of orally administered furazolidone in healthy volunteers. Br J Clin Pharmacol. 2001Abstract
  6. Drugs.com Furazolidone. 1995 Full text (in our servers)
  7. Kumar AS, Legori M, Sathy N, Mathew R. Furazolidone in typhoid fever--correlation of clinical efficacy with serum bactericidal activity. Indian Pediatr. 1995Abstract
  8. Valadez-Salazar A, Guiscafre-Gallardo H, Sanchez-Garcia S, Muñoz O. Detection of furazolidone in human biological fluids by high performance liquid chromatography. J Antimicrob Chemother. 1989Abstract
  9. White AH. Absorption, distribution, metabolism, and excretion of furazolidone. A review of the literature. Scand J Gastroenterol Suppl. 1989Abstract
  10. Altamirano A, Bondani A. Adverse reactions to furazolidone and other drugs. A comparative review. Scand J Gastroenterol Suppl. 1989Abstract
  11. Pettinger WA, Soyangco FG, Oates JA. Inhibition of monoamine oxidase in man by furazolidone. Clin Pharmacol Ther. 1968Abstract