Is Itraconazole Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Itraconazole? Is Itraconazole safe for nursing mother and child? Does Itraconazole extracts into breast milk? Does Itraconazole has any long term or short term side effects on infants? Can Itraconazole influence milk supply or can Itraconazole decrease milk supply in lactating mothers?

Pharmacokinetic data (moderately high molecular weight and high protein binding capacity) explain its nil or negligible amount observed in breast milk (McNamara, 2004), such that a breastfed infant would receive a maximum of 35 micrograms per day of Itraconazole, amount which is a hundred times lower than the pediatric dose of 5 mg / kg / day currently recommended (Janssen Cazzaniga 2014 and 1996) Both, low oral bioavailability and alkaline pH hinder its absorption from ingested milk. It is used to treat fungal infections in children, including premature babies, with a good tolerance. Itraconazole significantly increases plasma concentrations of Domperidone, which must be taken into account in case of simultaneous administration of both drugs.

No information is available on the clinical use of itraconazole during breastfeeding. However, limited data indicate that maternal itraconazole produces levels in milk that are less than the 5 mg/kg daily doses that have been recommended to treat infants. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.