Is Amikacin safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Amikacin. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Amikacin is poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of other aminoglycosides, but serum levels with typical three times daily dosages are far below those attained when treating newborn infections and systemic effects of amikacin are unlikely. Older infants would be expected to absorb even less amikacin. Because there is little variability in the milk amikacin levels during multiple daily dose regimens, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Data are not available with single daily dose regimens. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Two women were given a single dose of 100 mg amikacin intramuscularly, and milk levels were measured at 2 and 6 hours after the dose. Only trace levels were detected. In one woman on amikacin therapy, the peak amikacin milk level was 1.5 mg/L 2.5 hours after a 100 mg dose by injection.[1]
Two women were given a single 200 mg dose of amikacin intramuscularly and milk levels were measured hourly for 6 hours. They had only trace levels in milk 6 hours after the dose.[2]
A woman given a single dose of amikacin 100 mg intramuscularly had undetectable milk amikacin levels 1 and 2 hours after the dose and only trace amounts in milk at 4 and 6 hours after the dose.[3]
Infant Levels. Relevant published information was not found as of the revision date.
“No published information” means the studies do not exist yet — not that Amikacin is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Amikacin” (LM8). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.