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Pivmecilinam or Amdinofilin pivoxil (USA) is a prodrug of the beta-lactam antibiotic mecilinam (amdinofilin). Pivmecillinam is well absorbed from the gastrointestinal tract and is rapidly hydrolysed to the active drug mecillinam. It is indicated for the treatment of urinary tract infections. Oral administration 2 to 4 times daily.
Pivmecilinam(mecilinam has not been found in breast milk (Seiga 1977) or in such a trace amount that no effects on breastfed infants/newborns are anticipated. (Karo 223, AEMPS 2023, Knight 2019)
The manufacturer considers it compatible with breastfeeding. (Karo 223, AEMPS 2023, Knight 2019)
The oral bioavailability of mecilinam is very low, so it is administered in the form of pivmecilinam (which is well absorbed) and immediately converted to mecilinam by enzymatic hydrolysis (Roholt 1975). The little mecilinam that may pass into breast milk will not be absorbed by the infant.