Last update: Feb. 19, 2017
Minimal risk for breastfeeding and infant.
A high protein-binding capacity may explain its low excretion into breastmilk observed after oral administration.
Low levels that would reach the infant’s gut through breastmilk would barely be absorbed due to the alkaline environment that hinders the absorption.
Because it is topically used on creams or vaginal ovules, it would have a low or nil absorption in mother’s plasma (Ene 1984, AEMPS 2015), hence, the amount excreted in milk is expected to be even lower than that following a systemic administration.
It would be wise to avoid applying creams, gels and other topical products containing paraffin (mineral oil) on the nipple so that the infant could not ingest it (Noti 2003, Concin 2008).
American Academy of Pediatrics: medication usually compatible with breastfeeding.
We do not have alternatives for Ketoconazole since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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