Last update Dec. 2, 2022



Safe substance and/or breastfeeding is the best option.

Antifungal used topically in cutaneous candidiasis and mucosal surfaces (oropharyngeal, esophageal and vaginal) and orally or intravenously in candidiasis, coccidioidomycosis and systemic cryptococcosis. Active against dermatophytes.

It is excreted in breast milk in a moderate amount (DR 18%) but much less than would be needed to treat candidiasis in an infant or premature newborn (Kaplan 2015, Force 1995, Schilling 1993). No serious problems have been observed in infants of mothers taking it. (Moorhead 2011, Bodley 1997)

It has been widely used to treat breast pain due to or allegedly due (without evidence) to candida infection (Hanna 2011, Moorhead 2011, Carmichael 2002 Chetwynd 2002, Brent 2001, Hoover 1999, Bodley 1997); deep breast pain may also be due to auric staphylococcus infection. (Betzold 2012)

In breast candidiasis, if topical treatments fail, oral Fluconazole can be used at doses of 200 mg on the first day and 100 mg daily for two to four weeks. (Hanna 2011)

Its use is authorized in newborns and infants.

Expert authors consider safe the use of this medication during breastfeeding (Hale, Kaplan 2015, Briggs 2015, Schaefer 2015, Butler 2014, Amir 2011, Chen 2010).

List of essential medicines WHO: compatible with breastfeeding (WHO 2002).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).


We do not have alternatives for Fluconazole since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Fluconazole in other languages or writings:


Main tradenames from several countries containing Fluconazole in its composition:


Variable Value Unit
Oral Bioavail. 90 %
Molecular weight 306 daltons
Protein Binding 11 - 15 %
VD 0.7 - 0.8 l/Kg
pKa 12.71 -
Tmax 1 - 2 hours
30 - 40 hours
M/P ratio 0.5 - 0.9 -
Theoretical Dose 0.4 - 0. 6 mg/Kg/d
Relative Dose 12 - 18 %
Ped.Relat.Dose 7 - 10 %


  1. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  2. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  3. Kaplan YC, Koren G, Ito S, Bozzo P. Fluconazole use during breastfeeding. Can Fam Physician. 2015 Oct;61(10):875-6. Abstract
  4. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  5. Betzold CM. Results of microbial testing exploring the etiology of deep breast pain during lactation: a systematic review and meta-analysis of nonrandomized trials. J Midwifery Womens Health. 2012 Jul-Aug;57(4):353-64. Abstract
  6. Hanna L, Cruz SA. Candida mastitis: a case report. Perm J. 2011 Abstract Full text (link to original source) Full text (in our servers)
  7. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  8. Moorhead AM, Amir LH, O'Brien PW, Wong S. A prospective study of fluconazole treatment for breast and nipple thrush. Breastfeed Rev. 2011 Abstract
  9. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  10. Chetwynd EM, Ives TJ, Payne PM, Edens-Bartholomew N. Fluconazole for postpartum candidal mastitis and infant thrush. J Hum Lact. 2002 May;18(2):168-71. Abstract
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  12. Carmichael AR, Dixon JM. Is lactation mastitis and shooting breast pain experienced by women during lactation caused by Candida albicans? Breast. 2002 Abstract
  13. Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001 Abstract
  14. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  15. Hoover K. Breast pain during lactation that resolved with fluconazole: two case studies. J Hum Lact. 1999 Abstract
  16. Bodley V, Powers D. Long-term treatment of a breastfeeding mother with fluconazole-resolved nipple pain caused by yeast: a case study. J Hum Lact. 1997 Abstract
  17. Debruyne D. Clinical pharmacokinetics of fluconazole in superficial and systemic mycoses. Clin Pharmacokinet. 1997 Abstract
  18. Force RW. Fluconazole concentrations in breast milk. Pediatr Infect Dis J. 1995 Abstract

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