Is Acitretin Safe in Breastfeeding

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

• DrLact safety Score for Acitretin is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Acitretin may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Acitretin may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Acitretin .
• It is recommended to evaluate the advantage of not breastfeeding while using Acitretin Vs not using Acitretin And continue breastfeeding.
• While using Acitretin Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to 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.

Synthetic retinoid derivated from vitamin A. Despite a low amount secreted through the breast milk (<2% of the equivalent maternal dose), some authorities think that product's toxicity justifies to avoid it during breastfeeding. American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding.

Limited information indicates that maternal doses of acitretin of 0.65 mg/kg daily produce low levels in milk. Because there is no published experience with acitretin during breastfeeding, opinions vary on the advisability of breastfeeding during acitretin therapy.[1][2][3] Various topical agents that are less likely to be absorbed by the mother may be preferred during breastfeeding, especially while nursing a newborn or preterm infant. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4]

A review of adverse reaction reports on retinoids causing a breast reaction submitted to a French pharmacovigilance center found 8 cases of gynecomastia was associated with acitretin use.[5]