Question

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

Zidovudine lactation summary

Zidovudine usage has low risk in breastfeeding
  • DrLact safety Score for Zidovudine is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Zidovudine may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Zidovudine may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Zidovudine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Zidovudine We suggest monitoring 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 Zidovudine usage in lactation

Anti-HIV drug. It is used to decrease the risk of vertical transmission in newborns. Mothers must be adviced that transmission of HIV infection through breastfeeding has been documented.

Answer by DrLact: About Zidovudine usage in lactation

In the United States and other developed countries, HIV-infected mothers should generally not breastfeed their infants. Zidovudine has been well studied during breastfeeding. 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] Breastfed infants whose mothers receive a highly active antiretroviral (HAART) regimen containing zidovudine have higher rates of neutropenia during the first month and severe anemia during the first 6 months of life.

Zidovudine Side Effects in Breastfeeding

A study assigned pregnant women to zidovudine alone or highly-active antiretroviral therapy (HAART: zidovudine, lamivudine and nevirapine) to prevent maternal-to-child transmission of HIV infection. After delivery, All infants received one month of zidovudine prophylaxis; some infants were breastfed and others were formula fed. A higher percentage of infants in the HAART-exposed group had neutropenia than those in the unexposed group at 1 month of age (15.9 and 3.7%, respectively). Hematologic toxicity was transient and asymptomatic. From 2 to 6 months postpartum, no differences in hematologic toxicity were seen between breastfed and formula-fed infants. No statistical difference in hepatic toxicity was seen between the breastfed and formula-fed infants.[12] A study compared the rates of severe anemia in 3 groups of infants who received postpartum prophylaxis with zidovudine for prevention of maternal-to-child transmission of HIV infection. Through 6 months of age, breastfed infants whose mothers received HAART had a higher rate of severe anemia (7.4%) than breastfed infants whose mothers received only zidovudine (5.3%). Formula-fed infants had the lowest rate of severe anemia (2.5%). The anemia generally responded well to iron and multivitamin supplementation, and discontinuation of zidovudine.[13]

Alternate Drugs

Didanosine(Unsafe)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Saquinavir(Unsafe)
Nelfinavir(Unsafe)
Indinavir(Unsafe)
Ritonavir(Unsafe)
Efavirenz(Unsafe)
Tenofovir(Safe)
Aztreonam(Safe)
Cefprozil(Safe)
Didanosine(Unsafe)
Malathion(Low Risk)
Naftifine(Safe)
Rifaximin(Safe)
Ofloxacin(Safe)
Cefoxitin(Safe)
Gatifloxacin(Low Risk)
Cefotetan(Safe)
Abacavir(Safe)
Enoxacin(Low Risk)
Zidovudine(Low Risk)
Neomycin(Safe)
Nevirapine(Low Risk)
Doxycycline(Low Risk)
Valganciclovir(Low Risk)
Amikacin(Safe)
Nafcillin(Safe)
Moxifloxacin(Low Risk)
Primaquine(Low Risk)
Lindane(Unsafe)
Cefixime(Safe)
Saquinavir(Unsafe)
Demeclocycline(Low Risk)
Ganciclovir(Low Risk)
Atovaquone(Low Risk)
Cefepime(Safe)
Methicillin(Low Risk)
Nelfinavir(Unsafe)
Linezolid(Low Risk)
Indinavir(Unsafe)
Famciclovir(Low Risk)
Meropenem(Safe)
Cefdinir(Safe)
Econazole(Safe)
Erythromycin(Low Risk)
Cefazolin(Safe)
Clindamycin(Low Risk)
Ritonavir(Unsafe)
Lomefloxacin(Low Risk)
Dapsone(Low Risk)
Cefaclor(Safe)
Efavirenz(Unsafe)
Tenofovir(Safe)
Levofloxacin(Low Risk)
Capreomycin(Low Risk)
Kanamycin(Safe)
Ertapenem(Safe)
Acyclovir(Safe)
Amantadine(Low Risk)
Quinine(Safe)
Zidovudine(Low Risk)
Abacavir(Safe)
Nevirapine(Low Risk)
Saquinavir(Unsafe)
Nelfinavir(Unsafe)
Indinavir(Unsafe)
Ritonavir(Unsafe)
Efavirenz(Unsafe)
Tenofovir(Safe)
Didanosine(Unsafe)
Ledipasvir(Low Risk)
Zidovudine(Low Risk)
Ombitasvir(Low Risk)
Abacavir(Safe)
Nevirapine(Low Risk)
Daclatasvir(Low Risk)
Valganciclovir(Low Risk)
Dasabuvir(Low Risk)
Saquinavir(Unsafe)
Ganciclovir(Low Risk)
Nelfinavir(Unsafe)
Indinavir(Unsafe)
Famciclovir(Low Risk)
Ribavirin(Low Risk)
Zanamivir(Safe)
Ritonavir(Unsafe)
Efavirenz(Unsafe)
Tenofovir(Safe)
Velpatasvir(Low Risk)
Simeprevir(Low Risk)
Acyclovir(Safe)
Amantadine(Low Risk)
Sofosbuvir(Low Risk)
Didanosine(Unsafe)
Nevirapine(Low Risk)
Efavirenz(Unsafe)
Tenofovir(Safe)
Didanosine(Unsafe)
Zidovudine(Low Risk)
Abacavir(Safe)
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.