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

Sulfamethoxazole

December 23, 2015 (Very Low Risk)

Excreted in non-significant levels into breast milk. No adverse effects have been shown in breastfed infants.

Caution with those neonates suffering of hyperbilirrubinemia or G-6-P-D deficiency is required. Avoid use in affected patients Check-up for infant jaundice.

Be aware of false negative results of bacterial cultures when the mother is on antibiotics.

American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding.
Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

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

  • SMX
  • SMZ

Writings

  • σουλφαμεθοξαζόλη (Greek)
  • سولفاميثوكسازول (Arabic)
  • Сульфаметоксазол (Cyrillic)
  • 磺胺甲噁唑 (Chinese)
  • スルファメトキサゾール (Japanese)
  • C10H11N3O3S (Molecular formula)

Drug trade names

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  2. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009Abstract
  3. Kaiser J, McPherson V, Kaufman L, Huber T. Clinical inquiries. Which UTI therapies are safe and effective during breastfeeding? J Fam Pract. 2007Abstract
  4. Forna F, McConnell M, Kitabire FN, Homsy J, Brooks JT, Mermin J, Weidle PJ. Systematic review of the safety of trimethoprim-sulfamethoxazole for prophylaxis in HIV-infected pregnant women: implications for resource-limited settings. AIDS Rev. 2006Abstract
  5. 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)
  6. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001Abstract
  7. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  8. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993Abstract
  9. Miller RD, Salter AJ.\ The passage of trimethoprim/sulpha-methoxazole into breast milk and its significance. \ Proceedings of the 8th International Congress of Chemotherapy, Athens. Hellenic Soc Chemother. 1974;1:687. 1974
  10. Rasmussen F.\ Mammary excretion of sulphonamides. Acta Pharmacol Toxicol 1958; 15: 139-48. 1958