Last update Jan. 23, 2022

Phenoxymethylpenicillin

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Penicillin. Beta-lactam antibiotic, with bactericidal action. Oral administration every 6 hours. 

Penicillins are excreted in breast milk in clinically insignificant amounts.  (vanWattum 2018, Matheson 1988, Matsuda 1984, Borderon 1975, Knowles 1973, Rozansky 1949, Greene 1946)

No problems have been observed in infants of mothers treated with penicillin, except for occasional transient gastroenteritis due to altered intestinal flora. (Matheson 1988)

When measured, plasma levels in these infants were undetectable or very low. (Matheson 1988)

Penicillin is a broad spectrum antibiotic that is commonly used in Pediatrics and Neonatology with very good tolerance even in premature newborns. 

Expert authors consider the use of the use of penicillin and its derivatives to be safe during breastfeeding. (Hale, LactMed, Briggs 2015, Butler 2014, Rowe 2013, ASGE 2012, Amir 2011, Nahum 2006, Bar-Oz 2003, Niebyl 2003, Fulton 1992, Léophonte 1988)

Eleventh WHO's Model List of Essential Drugs 2002: benzathine benzylpenicillin, benzylpenicillin, phenoxymethylpenicillin and procaine benzylpenicillin are compatible with breastfeeding. (OMS / UNICEF 2002)

Alternatives

We do not have alternatives for Phenoxymethylpenicillin 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

Phenoxymethylpenicillin is also known as Penicillin V. Here it is a list of alternative known names::


Phenoxymethylpenicillin in other languages or writings:

Group

Phenoxymethylpenicillin belongs to this group or family:

Tradenames

Main tradenames from several countries containing Phenoxymethylpenicillin in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 25 - 60 %
Molecular weight 350 daltons
Protein Binding 50 - 80 %
VD 0.5 l/Kg
pKa 3.39 -
Tmax 0.5 - 1 hours
0.5 - 1 hours
M/P ratio 0.1 -
Theoretical Dose 0.05 (0.02 - 0.09) mg/Kg/d
Relative Dose 0.05 - 0.2 %
Ped.Relat.Dose 0.04 - 0.2 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  2. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on March 15, 2022 Full text (link to original source)
  3. van Wattum JJ, Leferink TM, Wilffert B, Ter Horst PGJ. Antibiotics and lactation: An overview of relative infant doses and a systematic assessment of clinical studies. Basic Clin Pharmacol Toxicol. 2019 Jan;124(1):5-17. Abstract
  4. 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
  5. 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
  6. ASGE Standard of Practice Committee., Shergill AK, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Evans JA, Early DS, Fanelli RD, Fisher DA, Foley KQ, Fukami N, Hwang JH, Jain R, Jue TL, Khan KM, Lightdale J, Pasha SF, Sharaf RN, Dominitz JA, Cash BD. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. 2012 Jul;76(1):18-24. 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. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006 Abstract
  9. Niebyl JR. Antibiotics and other anti-infective agents in pregnancy and lactation. Am J Perinatol. 2003 Abstract
  10. Bar-Oz B, Bulkowstein M, Benyamini L, Greenberg R, Soriano I, Zimmerman D, Bortnik O, Berkovitch M. Use of antibiotic and analgesic drugs during lactation. Drug Saf. 2003 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 Full text (link to original source) Full text (in our servers)
  12. Fulton B, Moore LL. Antiinfectives in breastmilk. Part I: Penicillins and cephalosporins. J Hum Lact. 1992 Abstract
  13. Léophonte P. [Antibiotics during pregnancy and breast feeding: consequences for the treatment of respiratory infections]. Rev Mal Respir. 1988;5(3):293-8. Review. French. Abstract
  14. Matheson I, Samseth M, Løberg R, Faegri A, Prentice A. Milk transfer of phenoxymethylpenicillin during puerperal mastitis. Br J Clin Pharmacol. 1988 Jan;25(1):33-40. Abstract
  15. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  16. Borderon E, Soutoul JH, Borderon JC. Excrétion des antibiotiques dans le lait humain. [Excretion of antibiotics in human milk]. Med Mal Infect. 1975;5:373-6.
  17. Knowles JA. Effects on the infant of drug therapy in nursing mothers. Drug Ther (NY). 1973 Abstract
  18. ROZANSKY R, BREZINSKY A. The excretion of penicillin in human milk. J Lab Clin Med. 1949 Abstract
  19. GREENE HJ, BURKHART B, HOBBY GL. Excretion of penicillin in human milk following parturition. Am J Obstet Gynecol. 1946 Abstract

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