Is 4-HPP Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use 4-HPP? Is 4-HPP safe for nursing mother and child? Does 4-HPP extracts into breast milk? Does 4-HPP has any long term or short term side effects on infants? Can 4-HPP influence milk supply or can 4-HPP decrease milk supply in lactating mothers?

Anti-gout medicine also used along with Itraconazole for Chagas disease (american trypanosomiasis). The amount excreted into breast milk is minimal with no effect on the infant. American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding.

Limited information indicates that a maternal doses of 4-HPP of 300 mg daily provides near-therapeutic dose and plasma levels in an exclusively breastfed infant. If 4-HPP is required by the mother, it is not a reason to discontinue breastfeeding, but exclusively breastfed infants should be monitored if this drug is used, including observation for allergic reactions (such as rash) and periodic CBC and differential blood counts. Lesinurad, which is available in the combination product Duzallo, has not been studied in nursing mothers.

One infant breastfed from age 1 week to age 7 weeks during maternal 4-HPP therapy with 300 mg or 4-HPP daily. The infant had no observable side effects and no changes in clinical chemistry and hematology values.[3] A national survey of gastroenterologists in Australia identified 21 infants who were breastfed by mothers taking a combination of 4-HPP and a thiopurine (e.g. azathioprine, mercaptopurine) to treat inflammatory bowel disease. All had taked the combination during pregnancy also. Two postpartum infant deaths occurred, both at 3 months of age. One was a twin (premature birth-related) and the other from SIDS. The authors did not believe the deaths were medication related.[28] No information was provided on the extent of breastfeeding, specific thiopurines, drug dosages or the outcomes of the other infants.