Is Cefotetan 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 Cefotetan. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Cefotetan is no longer marketed in the United States. A moderate amount of information indicates that cefotetan produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefotetan is acceptable in nursing mothers.
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. After a single 1 gram dose of cefotetan to 7 women, the drug was not detected (<0.195 mg/L) in milk in 2 women at any time up to 6 hours after the dose. In the remaining 5 women, average milk levels ranged from 0.22 to 0.34 mg/L from 1 to 6 hours after the dose. The average peak level was 0.34 mg/L 4 hours after the dose, although individual peak levels ranged from 0.25 to 0.5 mg/L at 3 to 4 hours after the dose.[1]
Five women were given 1 gram of cefotetan every 12 hours intramuscularly for 2 days. Milk cefotetan levels were undetectable 1 hour after the first dose. From 4 to 10 hours, milk levels ranged from 0.3 to 0.59 mg/L, with the peak occurring 7 hours after the dose. Ten hours after the second, third and fifth doses, milk levels ranged from 0.29 to 0.37 mg/L.[2]
After a single 1 gram dose of cefotetan in 2 women, average cefotetan concentrations of 0.1 and 0.2 mg/L occurred at 2 and 4 hours after the dose, respectively. It was undetectable at 1 and 6 hours after the dose.[3]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Cefotetan 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 “Cefotetan” (LM50). 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.