Metronidazole (Dermal and Vaginal use)
Metronidazole is used topically in the treatment of acne (Kong 2013) and vaginitis.
Metronidazole, taken orally, is excreted in small amounts in breast milk (Zhang 1997, Passmore 1988, Heisterberg 1983, Erickson 1981, Gray 1961) and does not cause problems in infants (Passmore 1988, Gray 1961).
The low content of topical preparations (<1% metronidazole) and its poor absorption through skin or vaginal mucosa makes it unlikely that it reaches in a significant amount to breast milk.
Compared with oral administration, the plasma levels reached are 1% through the skin and 2% vaginally (AEMPS 2018, Sanofi 2018, FDA 2005, AEMPS 2001) being even more compatible with breastfeeding than systemic administration (Rowe 2013, Kong 2013).
See below the information of this related product:
- Metronidazole (Very Low Risk)
We do not have alternatives for Metronidazole (Dermal and Vaginal use) since it is relatively safe.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
- Metronidazole Ovules
- Metronidazole Vaginal Gel
Drug trade names
- AEMPS-Meda. Metronidazol vaginal. Ficha técnica. 2018 Full text (in our servers)
- Sanofi. Metronidazole (cream). Drug Summary. 2018 Full text (in our servers)
- Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013Abstract
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
- FDA-Teva. Metronidazole (Vaginal). Drug Summary. 2005 Full text (in our servers)
- AEMPS-Galderma. Metronidazol Gel. Ficha técnica. 2001 Full text (in our servers)
- Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997Abstract
- Passmore CM, McElnay JC, Rainey EA, D'Arcy PF. Metronidazole excretion in human milk and its effect on the suckling neonate. Br J Clin Pharmacol. 1988Abstract Full text (link to original source) Full text (in our servers)
- Heisterberg L, Branebjerg PE. Blood and milk concentrations of metronidazole in mothers and infants. J Perinat Med. 1983Abstract
- Erickson SH, Oppenheim GL, Smith GH. Metronidazole in breast milk. Obstet Gynecol. 1981Abstract
- GRAY MS, KANE PO, SQUIRES S. Further observations on metronidazole (Flagyl). Br J Vener Dis. 1961Abstract Full text (link to original source) Full text (in our servers)