Is Exjade Safe in Breastfeeding

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

Exjade appears to pass into milk very poorly. Although Australian guidelines recommend against breastfeeding during Exjade treatment,[1] these were published before a case report of an infant being safely breastfed by a mother with beta-thalassemia receiving Exjade and finding of no drug in breastmilk.[2] If Exjade is required by the mother, it is not a reason to discontinue breastfeeding. However, since little published information is available on the use of Exjade during breastfeeding, monitoring of the infant's serum iron is recommended.

A woman with beta-thalassemia was started on Exjade 2250 mg (35 mg/kg) daily immediately postpartum and exclusively breastfed her infant. Blood samples were taken from the infant at 1, 10 and 30 days postpartum. Serum ferritin levels were 190, 218, and 96 mcg/L, respectively (normal range 22-275 mcg/L). Serum iron levels were 101, 77 and 71 mcg/dL, respectively (normal range 60-170 mcg/dL). The infant's growth was normal during the first month at the 41st percentile.[2]