Is Nalidixic Acid Safe in Breastfeeding

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

Hemolysis in an infant with glucose-6-phophate dehydrogenasa deficiency has been described. Avoid its use in patients suffering this disorder. Cases of drug-induced intracraneal hypertension have been reported when given to the infant. Norfloxacin would be a better option because of its lower secretion into breast milk on those cases when the use of fluorquinolones would be necessary.

Limited information indicates that maternal doses of nalidixic acid up to 2 grams daily produce low levels in milk and would usually not be expected to cause any adverse effects in breastfed infants with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Nalidixic acid should be avoided while breastfeeding a glucose-6-phosphate dehydrogenase (G6PD) deficient infant. Other agents are preferred, especially while nursing a newborn or preterm infant.

Decreased weight gain, pallor, jaundice occurred in a 16-day-old infant probably caused by hemolytic anemia induced by maternal use of nalidixic acid orally 1 gram four times daily and amobarbital 65 mg orally three times daily. The infant developed jaundice, hyperbilirubinemia, reticulocytosis, eosinophilia, Heinz bodies and other signs of hemolysis 7 days after its mother was started on nalidixic acid. No G-6-PD deficiency or hemoglobin Zurich could be demonstrated.[1]