Is Fluconazole Safe in Breastfeeding

Question

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

Fluconazole lactation summary

DrLact safety Score for Fluconazole is 1 out of 8 which is considered Safe as per our analyses.
A safety Score of 1 indicates that usage of Fluconazole is mostly safe during lactation for breastfed baby.
Our study of different scientific research also indicates that Fluconazole does not cause any serious side effects in breastfeeding mothers.
Most of scientific studies and research papers declaring usage of Fluconazole safe in breastfeeding are based on normal dosage and may not hold true for higher dosage.
Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Fluconazole usage in lactation

Excreted into breast milk in much lesser amount than that used for the treatment of Candida infection in the infant. Problems have not appeared in breastfed infants from treated mothers. Widely used for the treatment of breast pain due or allegedly due to Candida infection. In those cases of breast candidiasis where topical treatment fails, oral Fluconazole may be used at a dose of 200 mg for the first day to be followed by 100 mg daily for two weeks. The American Academy of Pediatrics rates it compatible with breastfeeding.

Answer by DrLact: About Fluconazole usage in lactation

Fluconazole is acceptable in nursing mothers because amounts excreted into breastmilk are less than the neonatal fluconazole dosage.[1] Although no adequate clinical studies on fluconazole in mastitis have been published, a survey of members of the Academy of Breastfeeding Medicine found that fluconazole is often prescribed for nursing mothers to treat breast candidiasis, especially with recurrent or persistent infections.[2] Treatment of the mother and infant simultaneously with fluconazole is often used when other treatments fail.[2][3][4][5] The most common maternal dosage regimen is 400 mg once, followed by 200 mg daily for at least 2 weeks or until pain is resolved,[6][7] although a study in Australia used a dose of 150 mg every other day until breast pain resolved.[8] The dosage of fluconazole in breastmilk with these maternal dosages is not sufficient to treat oral thrush in the infant.

Fluconazole Side Effects in Breastfeeding

In a study of fluconazole for treatment of lactation-associated thrush of the breasts, mothers took an average of 7.3 capsules (range 1 to 29 capsules) of 150 mg every other day until pain resolved. Seven of the 96 women reported side effects possibly caused by fluconazole in their breastfed infants. These included flushed cheeks, gastrointestinal upset, and runny or mucous stools.[8]