Is Thioguanine Safe in Breastfeeding

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

Indicated for treatment of leukemia.

Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, although antimetabolites such as thioguanine appear to pose the least risk to breastfed infants.[1] Thioguanine levels in milk are reportedly low. Thioguanine nucleosides are active intracellular metabolites of azathioprine and have been measured in breastmilk and in infant serum following maternal use of azathioprine as an immunosuppressant. Although amounts in milk were low in breastmilk and mostly undetectable in infant serum, relatively low dosages of azathioprine were used. After high-dose chemotherapy, it might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence. Although no data are available to determine an appropriate period to withhold breastfeeding, the drug's terminal half-life suggests that withholding breastfeeding for 4 days may be sufficient. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[2]

Thioguanine is an active metabolite of azathioprine. Numerous infants breastfed during maternal azathioprine in dosages up to 250 mg daily have been reported with no adverse effects noted. See Azathioprine record for details.