Is Moxifloxacin Safe in Breastfeeding

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

It is a Fluoroquinolone-type antibiotic which is similar to Ciprofloxacin on both characteristics and indications. At latest update, relevant published data on excretion into breast milk were not found. Until more data on this medication is available, safer alternative drugs are preferred, especially in such critical age periods. Should a Fluoroquinolone-type antibiotic be necessary, Norfloxacin, Ofloxacin or Ciprofloxacin are preferred since they achieve the lowest levels in the plasma. When topically applied, as with eye drops, the small dose used and limited absorption to the plasma, which is common for most ophthalmic preparations, it is excreted in a non-significant amount into breast milk. In addition, quinolone-type medications have been used in neonates and infants without overt side effects (joint, bone or teeth impairment). It is excreted in tiny amounts into breast milk. Absorption through the child’s gut may be interfered by the calcium contained in the milk. Because of one case of pseudomembranous colitis that has been described possibly related to mother ingestion of Ciporfloxacine in a premature infant previously affected of NEC, a close follow-up looking for diarrhea is warranted. Be aware of the risk for false negative results of bacterial cultures in the infant, when the mother is taking antibiotics.

No information is available on the use of moxifloxacin during breastfeeding. 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] but insufficient data exist to prove or disprove this assertion. Use of moxifloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). However, it is preferable to use an alternate drug for which safety information is available. Maternal use of an eye drop that contains moxifloxacin 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.