Is Ketoprofen safe while breastfeeding?

Summary of use during breastfeeding

Although ketoprofen has low levels in breastmilk, one center reported that they had received reports of adverse renal and gastrointestinal side effects in breastfed infants whose mothers were taking ketoprofen. Other agents are preferred, especially while nursing a newborn or preterm infant.

Effects on the breastfed infant

All adverse reactions in breastfed infants reported in France between January 1985 and June 2011 were compiled by a French pharmacovigilance center. Of 174 reports, ketoprofen was reported to cause adverse reactions in 8 infants and to be one of the drugs most often suspected in serious adverse reactions, such as esophageal ulceration, erosive gastritis, meningeal hemorrhage, and renal insufficiency.[2]

Effects on milk supply

Relevant published information was not found as of the revision date.

Levels in milk

Maternal Levels. Eighteen women were given ketoprofen 100 mg every 12 hours (average 2.69 mg/kg daily) intravenously for 2 to 3 days postpartum. One to 4 milk samples were collected between the 3rd and 4th dose of ketoprofen. Of the 61 samples collected, ketoprofen was undetectable (<20 mcg/L) in 17 of the samples. The authors assumed a milk concentration of 20 mcg/L for undetectable samples and calculated an average milk concentration of 57 mcg/L (range 20 to 177 mcg/L). A fully breastfed infant would receive an average dosage of 8.5 mcg/kg daily or 0.31% of the maternal weight-adjusted dosage.[1]

Infant Levels. Relevant published information was not found as of the revision date.

Alternatives LactMed lists

• Acetaminophen
• Celecoxib
• Diclofenac
• Flurbiprofen
• Ibuprofen
• Indomethacin
• Naproxen
• Piroxicam