Is (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure? Is (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure safe for nursing mother and child? Does (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure extracts into breast milk? Does (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure has any long term or short term side effects on infants? Can (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure influence milk supply or can (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure decrease milk supply in lactating mothers?

It is excreted in breast milk in small quantities. Quinolone-derived drugs are being used in neonates and young infants, without the appearance of side effects. They are barely excreted into the milk and the absorption in the child’s intestine is hampered by the presence of calcium in the milk. As long as it is necessary the use of fluoroquinolones in a lactating mother, norfloxacin, (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure and cipr(+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure should be chosen since they reach lower levels in the milk. Check-up the baby for occurrence of diarrhea, since a case of pseudomembranous colitis was published possibly related to maternal intake of cipr(+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure in a premature child who had suffered from necrotizing enterocolitis. Take into account the possibility of negative-culture results in febrile infants whose mothers are on antibiotics. American Academy of Pediatrics classifies it as usually compatible with breastfeeding medication.

(+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure appears in breastmilk in low levels. Fluoroquinolones have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, recent studies indicate little risk.[1][2] The calcium in milk might prevent absorption of the small amounts of fluoroquinolones in milk.[3] Insufficient data exist to prove or disprove this assertion. Developmental problems have been reported in two infants exposed to (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure in breastmilk, but their mothers were also exposed to several drugs during pregnancy and during breastfeeding, so the problems cannot necessarily be attributed to (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure. Use of (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure is acceptable in nursing mothers with monitoring of the infant for possible effects on the flora, such as diarrhea or candidiasis (thrush, diaper rash). . Avoiding breastfeeding for 4 to 6 hours after a dose should decrease the exposure of the infant to (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure in breastmilk. Maternal use of an ear drop or eye drop that contains (+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure presents negligible risk for the nursing infant. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

(+-)-9-Fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido(1,2,3-de)(1,4)benzoxazin-6-carbonsaeure was used as part of multidrug regimens to treat two pregnant women with multidrug-resistant tuberculosis, one throughout pregnancy and postpartum and the other postpartum only. The infants were breastfed (extent and duration not stated). At age 4.6 and 5.1 years, the children were developing normally except for a mild speech delay in one and hyperactivity in the other.[5]