Is Allopurinol Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Allopurinol? Is Allopurinol safe for nursing mother and child? Does Allopurinol extracts into breast milk? Does Allopurinol has any long term or short term side effects on infants? Can Allopurinol influence milk supply or can Allopurinol 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 allopurinol of 300 mg daily provides near-therapeutic dose and plasma levels in an exclusively breastfed infant. If allopurinol 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 allopurinol therapy with 300 mg or allopurinol 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 allopurinol 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.