Is Terbinafine Safe in Breastfeeding

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

Pharmacokinetics data (low oral bioavailability, high volume of distribution and high protein-binding capacity) explains the scanty excretion into breast milk observed in nursing mothers who received this medication. In addition, a poor oral absorption would make even more difficult any pass of this drug through ingested milk to the infant's blood, except in newborns or premature who would show a higher intestinal absorption. Avoid using in prematures who are under treatment with caffeine or theophylline because terbinafine alters its metabolic degradation and increases plasma concentration. Since topical absorption is less than 1%, a significant excretion into breast milk after application on skin is not expected. Do not use on the breast to prevent ingestion by the infant, otherwise apply after a meal and wipe it out thoroughly with water before next feeding. It is recommended to avoid using on the nipple creams, gels and other products intended for use on skin that may contain paraffin (mineral oil) in order to keep from absorption the infant.

Limited information indicates that oral maternal doses of 500 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Monitor the infant for jaundice or other signs of liver toxicity, especially in younger, exclusively breastfed infants. Some sources recommend avoiding oral terbinafine during nursing.[1] Topical terbinafine has not been studied during breastfeeding. Because only about 1% is absorbed after topical application, it is considered a low risk to the nursing infant.[1][2] Avoid application to the nipple area and ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only water-miscible cream, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]