Question

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

Primaquine lactation summary

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

Avoid its use on patients suffering of G-6-P dehydrogenasa deficiency. Whenever possible, do not give it to mothers of premature infants or younger than 1 month, as well. Not commercially available in Spain

Answer by DrLact: About Primaquine usage in lactation

Primaquine is poorly excreted into breastmilk of nursing mothers and undetectable in the serum of their breastfed infants. Breastfed infants beyond the neonatal period have shown no evidence of hemolysis. Neonates and infants with glucose-6-phosphate dehydrogenase (G6PD) deficiency have not been studied, however, G6PD-deficient infants over 28 days of age appear to have a low risk of hemolysis from exposure in breastmilk.[1] If primaquine is required, testing the mother and infant for G6PD deficiency is advisable before the drug is given to a nursing mother. United Kingdom malaria treatment guidelines recommend that primaquine be avoided in nursing mothers with malaria and that weekly chloroquine 500 mg be given until breastfeeding is completed.[2] However, these guidelines were developed before information on the excretion of primaquine into breastmilk and safety in breastfed infants was published. More recent information indicates that all mothers nursing infant over 28 days of age could safely receive primaquine.[1] The Centers for Disease Control and Prevention guidelines state that primaquine may be used in breastfeeding mothers and infants with normal G6PD levels.[3] Because the small amounts of primaquine transferred in breast milk are insufficient to provide adequate protection or treatment of malaria, infants who require chemoprophylaxis or therapy must receive the recommended dosages of primaquine.

Primaquine Side Effects in Breastfeeding

Twenty-one mothers with vivax malaria were give a dosage of primaquine 0.5 mg/kg daily for 14 days while breastfeeding their infants who were at least 28 days old. No alterations in hematocrit, Heinz body counts, serum bilirubin, oxygen saturation, or methemoglobinemia were seen in any of the infants.[4]

Alternate Drugs

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Atovaquone(Low Risk)
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Cefaclor(Safe)
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Nevirapine(Low Risk)
Levofloxacin(Low Risk)
Linezolid(Low Risk)
Erythromycin(Low Risk)
Nelfinavir(Unsafe)
Kanamycin(Safe)
Clindamycin(Low Risk)
Naftifine(Safe)
Cefprozil(Safe)
Aztreonam(Safe)
Capreomycin(Low Risk)
Dapsone(Low Risk)
Acyclovir(Safe)
Cefoxitin(Safe)
Indinavir(Unsafe)
Rifaximin(Safe)
Gatifloxacin(Low Risk)
Ertapenem(Safe)
Cefotetan(Safe)
Enoxacin(Low Risk)
Zidovudine(Low Risk)
Ofloxacin(Safe)
Doxycycline(Low Risk)
Quinine(Safe)
Valganciclovir(Low Risk)
Amantadine(Low Risk)
Tenofovir(Safe)
Amikacin(Safe)
Neomycin(Safe)
Cefixime(Safe)
Demeclocycline(Low Risk)
Nafcillin(Safe)
Ganciclovir(Low Risk)
Cefepime(Safe)
Efavirenz(Unsafe)
Econazole(Safe)
Moxifloxacin(Low Risk)
Primaquine(Low Risk)
Didanosine(Unsafe)
Lindane(Unsafe)
Malathion(Low Risk)
Cefdinir(Safe)
Saquinavir(Unsafe)
Methicillin(Low Risk)
Cefazolin(Safe)
Meropenem(Safe)
Quinine(Safe)
Primaquine(Low Risk)
Atovaquone(Low Risk)
Atovaquone(Low Risk)
Quinine(Safe)
Primaquine(Low Risk)
Pyrantel(Safe)
Lindane(Unsafe)
Malathion(Low Risk)
Quinine(Safe)
Primaquine(Low Risk)
Atovaquone(Low Risk)
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.