Question

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

Ritonavir lactation summary

Ritonavir is unsafe in breastfeeding
  • DrLact safety Score for Ritonavir is 5 out of 8 which is considered Unsafe as per our analyses.
  • A safety Score of 5 indicates that usage of Ritonavir may cause serious side effects in breastfed baby.
  • Our study of different scientific research indicates that Ritonavir 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 Ritonavir .
  • It is recommended to evaluate the advantage of not breastfeeding while using Ritonavir Vs not using Ritonavir And continue breastfeeding.
  • While using Ritonavir 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.

Answer by Dr. Ru: About Ritonavir usage in lactation

Anti-HIV drug. No experience in young infants is available. Mothers must be adviced that transmission of HIV infection through breastfeeding has been documented.

Answer by DrLact: About Ritonavir usage in lactation

In the United States and other developed countries, HIV-infected mothers should generally not breastfeed their infants. Published experience with ritonavir during breastfeeding is limited. In countries in which no acceptable, feasible, sustainable and safe replacement feeding is available, World Health Organization guidelines recommend that all women with an HIV infection who are pregnant or breastfeeding should be maintained on antiretroviral therapy for at least the duration of risk for mother-to-child transmission. Mothers should exclusively breastfeed their infants for the first 6 months of life; breastfeeding with complementary feeding should continue through at least 12 months of life up to 24 months of life.[1] The first choice regimen for nursing mothers is tenofovir, efavirenz and either lamivudine or emtricitabine. If these drugs are unavailable, alternative regimens include: 1) zidovudine, lamivudine and efavirenz; 2) zidovudine, lamivudine and nevirapine; or 3) tenofovir, nevirapine and either lamivudine or emtricitabine. Exclusively breastfed infants should also receive 6 weeks of prophylaxis with nevirapine.[2][3] Hepatitis C is not transmitted through breastmilk[4][5] and breastmilk has been shown to inactivate hepatitis C virus (HCV).[6][7] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C. Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[4][5]

Ritonavir Possible Effects in Breastfeeding

Gynecomastia has been reported among men receiving highly active antiretroviral therapy. Gynecomastia is unilateral initially, but progresses to bilateral in about half of cases. No alterations in serum prolactin were noted and spontaneous resolution usually occurred within one year, even with continuation of the regimen.[13][14][15] Some case reports and in vitro studies have suggested that protease inhibitors might cause hyperprolactinemia and galactorrhea in some male patients,[16][17] although this has been disputed.[18] The relevance of these findings to nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs

Didanosine(Unsafe)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Saquinavir(Unsafe)
Nelfinavir(Unsafe)
Indinavir(Unsafe)
Efavirenz(Unsafe)
Ritonavir(Unsafe)
Tenofovir(Safe)
Ertapenem(Safe)
Aztreonam(Safe)
Cefprozil(Safe)
Didanosine(Unsafe)
Naftifine(Safe)
Ofloxacin(Safe)
Cefoxitin(Safe)
Gatifloxacin(Low Risk)
Cefotetan(Safe)
Abacavir(Safe)
Enoxacin(Low Risk)
Malathion(Low Risk)
Neomycin(Safe)
Rifaximin(Safe)
Doxycycline(Low Risk)
Zidovudine(Low Risk)
Amikacin(Safe)
Nafcillin(Safe)
Nevirapine(Low Risk)
Moxifloxacin(Low Risk)
Lindane(Unsafe)
Cefixime(Safe)
Demeclocycline(Low Risk)
Cefepime(Safe)
Saquinavir(Unsafe)
Valganciclovir(Low Risk)
Methicillin(Low Risk)
Primaquine(Low Risk)
Famciclovir(Low Risk)
Meropenem(Safe)
Atovaquone(Low Risk)
Cefdinir(Safe)
Econazole(Safe)
Ganciclovir(Low Risk)
Erythromycin(Low Risk)
Nelfinavir(Unsafe)
Linezolid(Low Risk)
Cefazolin(Safe)
Clindamycin(Low Risk)
Indinavir(Unsafe)
Lomefloxacin(Low Risk)
Cefaclor(Safe)
Levofloxacin(Low Risk)
Efavirenz(Unsafe)
Ritonavir(Unsafe)
Tenofovir(Safe)
Kanamycin(Safe)
Dapsone(Low Risk)
Acyclovir(Safe)
Capreomycin(Low Risk)
Amantadine(Low Risk)
Quinine(Safe)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Saquinavir(Unsafe)
Nelfinavir(Unsafe)
Indinavir(Unsafe)
Efavirenz(Unsafe)
Ritonavir(Unsafe)
Tenofovir(Safe)
Didanosine(Unsafe)
Simeprevir(Low Risk)
Sofosbuvir(Low Risk)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Ledipasvir(Low Risk)
Ombitasvir(Low Risk)
Saquinavir(Unsafe)
Daclatasvir(Low Risk)
Valganciclovir(Low Risk)
Dasabuvir(Low Risk)
Famciclovir(Low Risk)
Nelfinavir(Unsafe)
Ganciclovir(Low Risk)
Indinavir(Unsafe)
Ribavirin(Low Risk)
Zanamivir(Safe)
Efavirenz(Unsafe)
Ritonavir(Unsafe)
Tenofovir(Safe)
Acyclovir(Safe)
Amantadine(Low Risk)
Didanosine(Unsafe)
Velpatasvir(Low Risk)
Saquinavir(Unsafe)
Nelfinavir(Unsafe)
Indinavir(Unsafe)
Ritonavir(Unsafe)
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.