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

Miconazole

July 2, 2015 (Very Low Risk)

Excretion into breast milk is highly unlikely due to an almost nil systemic absorption through the skin, vaginal mucosa and even the intestine, with non-significant plasma levels (< 1 mcg/ mL) observed.

In case of use on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed.

Do not apply creams, gels and other products that would contain paraffin (mineral oil) to avoid absorption by the infant since it is a hydrocarbon-derived substance.

Miconazole has not been found to be more effective than pure lanolin for treatment of sore or cracked nipples.

List of Essential Medicines by WHO 2002: compatible with breastfeeding.

Alternatives

We do not have alternatives for Miconazole 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.

Synonyms

  • R-18134

Writings

  • μικοναζόλη (Greek)
  • ميكونازول (Arabic)
  • Миконазол (Cyrillic)
  • 咪康唑 (Chinese)
  • ミコナゾール (Japanese)

References

  1. Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: a randomized controlled trial. Breastfeed Med. 2012Abstract
  2. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  3. 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)
  4. Andersson M, Helldén A. [Treatment of nipple candidiasis in breast feeding mothers]. Lakartidningen. 2010Abstract
  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. 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
  7. Eichenfield LF, Bogen ML. Absorption and efficacy of miconazole nitrate 0.25% ointment in infants with diaper dermatitis. J Drugs Dermatol. 2007Abstract
  8. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006Abstract
  9. Cardot JM, Chaumont C, Dubray C, Costantini D, Aiache JM. Comparison of the pharmacokinetics of miconazole after administration via a bioadhesive slow release tablet and an oral gel to healthy male and female subjects. Br J Clin Pharmacol. 2004Abstract
  10. de Vries TW, Wewerinke ME, de Langen JJ. [Near asphyxiation of a neonate due to miconazole oral gel]. Ned Tijdschr Geneeskd. 2004Abstract
  11. 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
  12. Stevens RE, Konsil J, Verrill SS, Roy P, Desai PB, Upmalis DH, Cone FL. Bioavailability study of a 1200 mg miconazole nitrate vaginal ovule in healthy female adults. J Clin Pharmacol. 2002Abstract
  13. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  14. 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
  15. Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001Abstract
  16. Timonen H. Shorter treatment for vaginal candidosis: comparison between single-dose oral fluconazole and three-day treatment with local miconazole. Mycoses. 1992Abstract
  17. 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
  18. Daneshmend TK. Systemic absorption of miconazole from the vagina. J Antimicrob Chemother. 1986Abstract